People's Pharmacy

People's Pharmacy

October 06, 2006|By Joe Graedon and Teresa Graedon

What can you tell me about medication used to fight alcoholism? How would I get it, and how much will it cost? I don't have much money.

The prescription medications used to treat alcoholism work best in conjunction with counseling and social support. ReVia (naltrexone) has been available for some time and takes away the pleasurable feelings associated with alcohol. Sadly, the drug is quite expensive (more than $200 for a month's supply), and there is no patient assistance from the manufacturer.

Campral (acamprosate) is relatively new and seems to affect brain chemistry by helping people avoid alcohol once they have quit. It, too, is expensive (more than $115 for a 30-day supply). Fortunately, the manufacturer (Forest Labs) does have a patient-assistance program. Your doctor will need to fill out an application for you to receive free medicine.

Recently, I experienced two rather worrisome events - total loss of vision for a minute or two and occasional double vision. My MRI and MRA were fine, but my doctor concluded that Viagra was causing these visual problems. I have taken it once or twice a week for quite some time. He told me that if I continue using it, I might have a total loss of vision. If this is the case, would Cialis or Levitra be an alternative?

The Food and Drug Administration has warned patients that a loss of vision associated with Viagra, as well as Cialis or Levitra, could be an early warning sign. Some men taking these drugs have gone blind as a result of NAION (nonarteritic anterior ischemic optic neuropathy). This condition occurs when blood can't flow easily to the optic nerve. You may want to talk to your doctor about alternative approaches to erectile dysfunction.

One possibility may be alprostadil. It can be injected or inserted into the urethra. A cream (Alprox-TD) improved erections for more than 50 percent of the men in a clinical trial. This topical form has not yet been approved by the FDA.

I have heard that people with diabetes need to be careful about fish-oil supplements. The capsules can raise blood sugar. Please tell me if this is true. My doctor doesn't know anything about it.

Norwegian scientists recently reported the results of a study of type 2 diabetics who were given high doses of fish oil (6 grams per day) (American Journal of Clinical Nutrition, September). The diabetics taking fish oil had lower insulin sensitivity and higher average blood sugar than those taking a placebo.

Even though fish oil might be beneficial for most people, these findings suggest that high doses might pose a problem for diabetics. Lower doses, such as 1 gram daily, might be fine.

Have you ever heard of using Reglan to enhance breast-milk production? Are there any side effects?

Reglan (metoclopramide) is prescribed for serious heartburn (reflux). It appears to increase breast-milk production, but this is an unofficial (off-label) use. Side effects may include drowsiness, restlessness, fatigue, insomnia and depression. Reglan gets into breast milk, and we don't know the consequences for infants.

I read your article on acne disappearing when the writer gave up bananas. I had this problem myself years ago. When I stopped eating bananas, my acne disappeared.

We don't have a clue why some people might react to bananas this way. While it might not work for others, this seems like a simple experiment to try.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or e-mail them via their Web site: PeoplesPharmacy.com.

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