Q. If grapefruit increases the action of Lipitor, is it OK to drink grapefruit juice and reduce the dosage of Lipitor to save money?
A. This is an intriguing strategy. Researchers have occasionally used grapefruit to boost the power of some expensive medications. Cyclosporine (Sandimmune), used to prevent organ transplant rejection, can cost thousands of dollars a year. Although grapefruit juice may allow transplant patients to lower the dose and save money, investigators find that there is too much variability among patients and also in batches of grapefruit juice for this to be a safe practice.
The dose of Lipitor needed to lower cholesterol is less critical than that of Sandimmune. Check with your doctor before trying this approach. We know one man who breaks his Lipitor in half, takes it with grapefruit juice and gets good results on his cholesterol tests.
Q. What do you make of the cold product called Zicam? Do you have any information about the loss of smell that might result from using Zicam?
A. Zicam is a zinc nasal gel that is promoted as a homeopathic treatment for the common cold. The effectiveness of zinc against cold symptoms remains controversial. Some studies indicate benefit, while others find no advantage over placebo.
There have been reports of people losing their sense of smell following the use of zinc nasal gel (Laryngoscope, Feb. 2006). The company that makes Zicam says such reports are “completely unfounded and misleading.” Despite this reassurance, one reader of our column reported that after using Zicam she now has only 30 percent of her former senses of smell and taste.
Q. Is there anything that can increase a woman’s libido? I am interested much less often than my husband, and it is causing us trouble.
A. A few treatments have been shown to help increase women’s sexual desire (Danish Medical Bulletin, Aug., 2006). Although the FDA has not approved its use, some doctors prescribe testosterone as a patch, a gel or a tablet under the tongue. A prescription-only device, the Eros-CTD, has been shown to improve arousal.
We discuss these options and other treatments in our Guides to Female Sexuality and Treating Sexual Dysfunction. Anyone who would like copies, please send $3 in check or money order with a long (no. 10) stamped (63 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. PZ-9, P. O. Box 52027, Durham, NC 27717-2027.
Q. After being diagnosed with celiac disease, I became extremely frustrated. I knew I wasn’t getting gluten from anything I was eating, yet I had a persistent rash on my knees that would not go away.
I did some research and found that even if a brand name drug was not manufactured with wheat starch, the generic might contain it.
Now I ask the pharmacist about wheat starch in my pills and will pay extra for brand name drugs to avoid this substance that makes me sick. Sometimes my doctor has to change to another drug.
Will drug companies ever acknowledge that “inert” ingredients can still cause trouble for some people?
A. People with celiac disease cannot tolerate any gluten from wheat, barley or rye. In addition to monitoring their diets rigorously, they must also monitor their medications. Both your doctor and your pharmacist can help you avoid gluten in your medicines.
