Asthma Drug Warning Causes Alarm

Q. I saw a report on TV recently about the asthma drug Advair. The news wasn’t good.

I used to take Advair but am now trying free samples of Foradil from my doctor. Advair cost me almost $200 for a month’s supply.

I have a friend with asthma who’s had good results with Advair. Is he really in danger?
I’ve taken other drugs that have been pulled off the shelves, Vioxx and Bextra. Now I’m wondering about Advair. What’s going on?
A. Ever since the arthritis drugs Vioxx and Bextra were taken off the market, it seems as if the FDA has been more cautious. Several months ago an expert panel considered whether the asthma drugs Advair, Foradil and Serevent should also be withdrawn from the market. There was concern that some people taking these medications might experience hard-to-treat asthma attacks.
Although the agency decided not to ban these drugs, safety concerns remain. That’s why the FDA issued a warning recently stating that these medicines may increase the chance of severe asthma episodes that could result in death. The regulators want doctors to prescribe these drugs only if other medicines fail to control asthma symptoms.
Do not stop taking your asthma drug until you have consulted your physician, though. He or she will want to evaluate the new warning and decide whether other medications may be more appropriate.

Q. What can you suggest for chronic chapped lips? Castor oil works great, but it tastes terrible!
A. Perhaps the reason castor oil works for you is that it discourages lip licking. This habit can contribute to chronic chapped lips, especially when humidity is low.
We sometimes suggest a product containing lanolin, beeswax or coconut oil to moisturize the lips and discourage licking. Some products to consider include Burt’s Beeswax Lip Balm, Desert Essence Lip Rescue, Lip Trip or Un-petroleum Lip Balm.

Q. My husband is a walking drugstore. He suffers from depression and migraine headaches and takes Neurontin, Zoloft, Zyprexa, diazepam, Prilosec and Fiorinal.

Since he retired, his memory is getting worse and he sometimes seems almost like a zombie. I worry that his pills are hurting more than helping.
A. It’s hardly any wonder your husband feels like a zombie. Combining a sedative like diazepam (Valium) with an anti-psychotic such as Zyprexa, a barbiturate found in Fiorinal and an anti-convulsant (Neurontin) could make almost anyone forgetful and spacey. Such a combination could also increase his risk of a fall.
As people age, they become more susceptible to some drug side effects. Forgetfulness and dizziness can wreck quality of life. Please ask his doctor to review your husband’s medications.
We are sending you our Guide to Drugs and Older People. It lists medicines that may cause mental impairment, drugs that may be inappropriate for senior citizens and a drug safety check list. Anyone who would like a copy, please send $2 in check or money order with a long (no. 10) stamped, self-addressed envelope: Graedons’ The People’s Pharmacy®, No. O-85, P. O. Box 52027, Durham, NC 27717-2027.
Q. My cardiologist tells me I must take aspirin for the rest of my life to prevent a heart attack or stroke. He said to avoid ibuprofen and naproxen for pain relief. Why?
A. Pain relievers like ibuprofen and naproxen may interfere with the anti-clotting action of aspirin (New England Journal of Medicine, Dec. 1, 2005).