Side Effects

Veteran Mount St. Mary's basketball coach Jim Phelan is expected to miss his second straight game tonight at Quinnipiac University after experiencing "a little bit of side effects" from the radiation treatment he underwent for prostate cancer. Phelan's wife, Dottie, said yesterday he has been "encouraged not to make the seven-hour drive" to the game after also skipping the Mount's 91-86 Northeast Conference loss to Central Connecticut State in New Britain, Conn., Thursday. "He finished his radiation Wednesday and did very well, but he wasn't feeling well Thursday," Mrs. Phelan said from Emmitsburg yesterday.

"One pill makes you larger, and one pill makes you small," Grace Slick of Jefferson Airplane sang in the hit tune "Go Ask Alice." "And the ones that mother gives you don't do anything at all." That 1967 recording was all about drugs. In 2004, our entire nation seems to be all about drugs, thanks to relentless commercials about them. One pill helps us stop sneezing and one pill makes us less bipolar. One pill stops erectile dysfunction and one pill ... well, it's sometimes difficult to figure out just what some of the pills actually do except make everyone using them smile.

WASHINGTON - The Federal Aviation Administration banned pilots and air traffic controllers yesterday from using a popular anti-smoking drug after a study found that it had apparently contributed to auto accidents and other mishaps that posed risks to both users and others. The drug, marketed as Chantix, has been hailed as an innovative treatment to help smokers quit. But a study by a medical safety group - also issued yesterday - linked it to a variety of unusual and serious side effects, including loss of consciousness and seizures, and prompted the FAA to act, said spokesman Les Dorr.

He's a 43-year-old man who lives outside Boston, works in investment management and has had HIV for six years. He asked that his real name not be printed. Bob is a savvy, health-conscious guy, a gay man who takes his body and his physical appearance seriously. "No one wants to age, especially gay men," he confides easily. "It's the Peter Pan syndrome - we never grow up." Besides, he says, he has to look good to be successful and "the people I work with don't know I have AIDS." But last year, the AIDS drugs he had been taking began causing lipo-atrophy - loss of fat tissue in the face that leads to sunken cheeks and a gaunt appearance.

Last Tuesday, Linda Cotton listened intently when the doctor who handed her a 10-day supply of antibiotic, Cipro, warned of possible side effects. Hours after taking her first pill, she knew exactly what he was talking about. First came splitting headaches, then nausea and a nagging irritability that hasn't yet quit. "This drug isn't easy," said Cotton, who is toughing out what she hopes will be just three more days of treatment. "But you pretty much do whatever it takes to make sure you're safe - that goes without question."

Dr. Karen E. Lasser has never prescribed Vioxx or Celebrex or any of the new arthritis drugs because, well, they're too new. The internist at Cambridge Hospital and Harvard Medical School has found that, even after the Food and Drug Administration has deemed a medication safe and effective, serious side effects crop up over time. "Basically the chance of a new drug having a serious problem is one in five," said Lasser. "In general, I really try to avoid the new drugs for this reason." Merck & Co.'s Vioxx is only the latest product to be pulled from pharmacy shelves.

New medications introduced in the past two decades have enabled seniors to live longer, healthier lives. And people older than 65, though they constitute 14 percent of the population, now take more than a third of all the prescription medications dispensed each year. But these medication advances are proving to be a double-edged sword. Because of seniors' high usage rate, greater frequency of multiple illnesses and diminished physical capacity, the elderly are at a much greater risk for disabling side effects and sometimes fatal drug reactions.

In a move that will expand dieters' access to a drug that has shown modest benefits and potentially embarrassing side effects, the U.S. Food and Drug Administration gave the OK yesterday for over-the-counter sales of orlistat, the first federally approved diet pill available without a prescription. Previously released in a stronger prescription form called Xenical, the nonprescription drug will be marketed by drugmaker GlaxoSmithKline PLC, which plans to call it Alli. Consumers hoping for a miracle weight-loss product are likely to be disappointed.

There's no such thing as a free lunch. Not even if you take alli, the latest, hottest FDA-approved diet pill. Brendon Sadowski, 24, knows this well. The 290-pound, 5-foot-10-inch Army veteran says he's "always been a big guy." So he was excited when the Food and Drug Administration approved alli for over-the-counter sale in June. He picked some up and lost 6 pounds within a week, with little change in his diet and almost no exercise. But the gastric side effects - a detailed description of which could well ruin your breakfast - eventually persuaded him to take a break from the pill.

Merck & Co. pulled its blockbuster painkiller Vioxx from the market yesterday after identifying an increased risk of heart attacks and strokes, sending its stock into a tailspin and prompting patients to begin switching to alternatives as pharmacies cleared the drug from shelves. Earlier studies had raised questions about the cardiovascular side effects associated with Vioxx, which the Food and Drug Administration approved in 1999 after concluding that tests showed it was safe and effective for treating osteoarthritis symptoms and pain.