Q. We have an exciting camping trip planned later this summer, with several days rafting on the Colorado River as well as some hiking. Can you recommend a good sunscreen with both physical and chemical agents?
My dermatologist has removed a few “precancers” from my skin called actinic keratoses, the result of a childhood spent in the sunshine. I know I need to protect my skin now, but the dermatologist has not made any specific brand recommendations. I hope you can. I really need something good and strong.
A. A sunscreen that is beginning to achieve cult-like status among some dermatologists is called Blue Lizard. It was originally developed in Australia where they take sun protection very seriously.
In addition to standard sunscreens like oxybenzone, Blue Lizard contains the physical sun blocker zinc oxide. Lifeguards used to use old-fashioned zinc oxide creams that turned their noses white.
This new formulation is so finely dispersed that it does not make skin look white, even though it blocks invisible UVA rays. Many other sunscreens don’t protect well against UVA. Blue Lizard is available from dermatologists, some drug stores, on the Web at www.bluelizard.net or (800) 877-8869.
Q. I heard that bitter orange in weight loss pills and marmalade might interfere with medicine. I take Zocor. Should I avoid eating orange marmalade? I don’t eat a whole lot but enjoy it occasionally.
A. People often ask if oranges have the same impact on medications as grapefruit. Most oranges do not interact with drugs, but the Seville orange (also called sour or bitter orange, Citrus aurantium) affects medicines almost as much as grapefruit does (Clinical Pharmacology & Therapeutics, Jan. 2001)
A tablespoon of marmalade on your muffin once in awhile is unlikely to have a big impact on the blood levels of Zocor. But we would worry if you started taking an herbal weight loss pill containing bitter orange several times a day. Such products may not have been tested to see whether they interact with drugs. If they raised blood levels, though, you might be more susceptible to serious side effects.
We are sending you our Guide to Grapefruit Interactions so that you can learn more about the medicines that might interact with bitter orange. (They are the same ones that interact with grapefruit.) Anyone who would like a copy, please send $2 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. J-91, P. O. Box 52027, Durham, NC 27717-2027.
Q. I’ve been taking Wellbutrin and Remeron for severe depression. But lately I’ve developed “paranoid” thoughts and feelings.
My psychiatrist just started me on a drug called Zyprexa. It is supposed to take away the paranoid feelings. What should I know about this medicine?
A. Antidepressants such as Wellbutrin and Remeron may occasionally bring on paranoid thoughts. Treating such a side effect with an anti-psychotic medication seems extreme. Please discuss this issue with your doctor.
Zyprexa can cause headache, weight gain, constipation, dry mouth, nausea, drowsiness, dizziness, and agitation. Diabetes may be an uncommon complication of Zyprexa.
Q. When the nurse takes blood in the doctor’s office she wipes my skin with an alcohol swab. Is that enough to kill germs?
A. No. It merely cleans the skin. To kill germs with alcohol would take much more than a casual swipe.
The People's Perspective on Medicine