Q: I have been taking Protonix twice a day for almost 15 years. I am worried about the connection between PPIs like Protonix and dementia, but I don’t want to give up the drug. It has made such a difference in relieving my heartburn! If I start to notice memory problems, what should I do?
A: Pantoprazole (Protonix), like other proton-pump inhibitors (PPIs) such as esomeprazole (Nexium), lansoprazole (Prevacid) and omeprazole (Prilosec), eases symptoms of heartburn by dramatically reducing acid production. When these drugs were first marketed, they were perceived as very safe.
In recent years, concerns have been raised about long-term use and side effects. Reports have suggested such drugs may lead to nutrient deficiencies (vitamin B-12, calcium, iron, magnesium), osteoporosis and fractures, infections (C. diff and pneumonia), kidney disease and heart attacks. More recently, PPIs have been associated with an increased risk of dementia (JAMA Neurology, April 2016).
Never stop a PPI suddenly, as that could trigger unbearable heartburn that can last for weeks. We are sending you our Guide to Digestive Disorders with information on other strategies to ease symptoms of heartburn. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (68 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. G-3, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.
You may find that drugs like famotidine (Pepcid) and ranitidine (Zantac) will soothe your symptoms. Home remedies such as ginger, mustard, chewing gum and even baking soda also may help.
Q: I have had awesome results with T/Gel for my rosacea and blepharitis. My blepharitis was so bad that my eyelid had cracked open. After one treatment it cleared up. I was amazed that my skin also felt softer and the redness faded.
A: Blepharitis means inflammation of the eyelid. When this is caused by yeast overgrowth on the skin, dandruff shampoo often can be helpful. T/Gel discourages the yeast that is associated with seborrheic dermatitis and blepharitis as well as dandruff.
Rosacea also is an inflammatory response to yeast, bacteria or mites. Many other readers agree that washing the face with dandruff shampoo can ease redness due to rosacea.
Q: What can you tell me about gabapentin? I have just started taking it for restless legs syndrome and find it very helpful. Are there side effects I should watch for?
A: Gabapentin enacarbil (Horizant) has been approved by the Food and Drug Administration for the treatment of restless legs syndrome (RLS) and postherpetic neuralgia (the pain that can linger after a bout of shingles). The official prescribing information warns that this drug “may cause significant driving impairment.” Because it can be difficult to assess your coordination and reaction times, we would advise against driving while taking this medicine.
Other symptoms to be aware of include dizziness, sedation, fatigue, confusion (“feeling drunk”), depression, fluid retention, digestive upset, nausea, insomnia, blurred vision and headaches.
One reader wrote that gabapentin left him with brain fog, word-retrieval issues and sexual problems. Stopping suddenly caused depression, irritability, pain and sweating.
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