Q. My pharmacist said that there are effective oral medicines for the flu but they require a prescription. I didn’t manage to get a flu shot this year before they ran out. What can you tell me about flu drugs?
A. Your pharmacist was probably referring to prescription antiviral medications. Symmetrel (amantadine) was first approved to treat Parkinson’s disease in 1966. It was also found to prevent Type A influenza or speed recovery. The FDA approved it for this purpose in 1976, though relatively few doctors prescribed it.
A chemical cousin, Flumadine (rimantadine) was introduced in 1993. Like amantadine, it is effective against Type A flu when taken within 24 to 48 hours of first symptoms. Side effects such as insomnia, nausea or dizziness are less common than with amantadine.
Tamiflu is newer and works against Type B influenza as well as Type A. It too can prevent flu or speed healing if taken within 48 hours and seems well tolerated.
Q. I can’t get an answer on Premarin. I think it is HRT, but is it in the same category as estrogen/progestin?
I asked my doctor if I should stop and he said, “There have not been any negative reports on women taking Premarin after a hysterectomy.” I’ve been taking it daily for eight years and still don’t know whether I should keep on taking it. Any information you could send would be appreciated.
A. HRT stands for hormone replacement therapy. It often includes both estrogen and progestin (synthetic progesterone). Prempro, for example, contains estrogen in the form of Premarin and medroxyprogesterone. This combination increases the risk of blood clots, heart attacks, strokes, dementia and breast cancer.
Estrogen alone is still under undergoing study. It has been linked to breast cancer and blood clots. Whether it will turn out to be as problematic as combination hormone therapy remains to be established.
To help you sort out the confusion we are sending you our Guide to Estrogen: Benefits Risks and Interactions with far more detail on this issue. 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.W-49, P. O. Box 52027, Durham, NC 27717-2027.
Q. What is the law regarding purchasing prescription drugs outside the U.S.? My Parkinson’s Support Group wants to know what is permitted and what is not permitted.
A. Technically, it is illegal for any U.S. citizen to import medicine from abroad if the identical drugs exist in U.S. pharmacies. In reality, though, neither the FDA nor U.S. Customs is arresting people for purchasing pharmaceuticals in Canada or Mexico for personal use. With states like New Hampshire, Wisconsin and Illinois considering purchasing medicine from Canada, this entire issue is becoming a political and legal hot potato.
Q. I have been taking Pravachol to lower my cholesterol for a year. Yesterday for the first time my refill came with a warning to avoid grapefruit.
I have received a large box of Texas grapefruit and would like to enjoy it. How can I do that safely?
A. We are puzzled. According to the research, Pravachol is a drug that should not be affected by grapefruit. We think you could enjoy your grapefruit safely, but doublecheck with your pharmacist and physician to make sure.
The People's Perspective on Medicine