Q: I’m 38. I have a plantar wart that turned into a mosaic wart.
This was very painful to walk on, so I went to the podiatrist. He prescribed Aldara, which only caused the warts to spread. We tried freezing and cutting the warts off, without success.
Then I started taking Tagamet (OTC) twice a day. I’ve done this for three weeks, filing the dead skin away a few times a week. As of today, the mosaic wart is almost gone! I’ve spent thousands of dollars trying to get rid of it. Who knew Tagamet would work so well?
A: Dermatologists started using cimetidine (Tagamet) for resistant warts back in the early 1990s, when Tagamet was available only by prescription. There were many skeptics. One termed this treatment “snake oil for the 21st century” (Archives of Dermatology, December 1998).
There are many case reports in the medical literature of success treating warts with cimetidine, but the few placebo-controlled trials that have been done are not encouraging (Journal of the American Academy of Dermatology, July 1999).
Presumably, cimetidine and imiquimod (Aldara) both work by stimulating the immune system to reject the wart (Indian Dermatology Online Journal, September-October 2016). People using this approach should check in with their pharmacists about potential interactions with other drugs they may be taking. Cimetidine does not combine well with certain other medicines.
Q: I have a warning for anyone taking both simvastatin (Zocor) and diltiazem (Cardizem). The very week my cardiologist started me on simvastatin, the Food and Drug Administration and Merck both came out with a warning about the interaction of these two drugs. Apparently, diltiazem raises the plasma concentration levels of simvastatin.
In my case, it must have been a huge increase. My cholesterol dropped from 231 to 143 in just three weeks. Then my doctor lowered the dose, but it was too late. I had developed multiple problems, including severe balance problems, digestive upset and a deep itchy rash on both legs and feet, as well as a wobbly walk. I am taking other medications as well, including Pradaxa, so there may be other interactions, but the rash completely disappeared after stopping the simvastatin. Unfortunately, the balance and vertigo problems remain.
A: When simvastatin (to lower cholesterol) and diltiazem (to control blood pressure) are given together, the blood level of simvastatin rises and the concentration of diltiazem decreases (Life Sciences, Dec. 3, 2004). This can lower cholesterol more rapidly, but it can result in adverse effects as well.
We also are concerned about the potential interaction of simvastatin with dabigatran (Pradaxa). This combination can cause major bleeding (CMAJ online, Nov. 21, 2016). Ask your doctor whether a different statin (not lovastatin) would work for you.
We have written about the dangers of incompatible prescriptions and the need to remain vigilant in our book “Top Screwups Doctors Make and How to Avoid Them.” It is available at www.PeoplesPharmacy.com.
Q: I would call magnesium supplements the miracle I was looking for. I had triple-bypass surgery at age 40, so I needed all the help I could get.
After 13 years, my heart is healthier because of magnesium, with no palpitations, no irregular heartbeat and great blood pressure.
A: Magnesium can be very helpful, and many of us don’t get enough in our diets. People taking medicines such as omeprazole for heartburn can easily end up with too little of this crucial mineral.
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