Q. All my life I have had a strong sex drive. Over the last few years, however, I have had some difficulty maintaining an erection.
My urologist prescribed Cialis, which works pretty well. But he scared me by saying I should see a cardiologist. I have no chest pain or other symptoms of heart disease, so why is he insisting that I have my cholesterol measured and get a stress test?
A. You do have a symptom of heart disease. Erectile dysfunction can be an early warning of coronary artery disease. A new study suggests that older men with erectile dysfunction are at double the risk of angina or a heart attack (JAMA Dec. 21, 2005).
The authors conclude that men with erectile dysfunction should have their cardiovascular risk factors evaluated. High blood pressure or cholesterol should also be treated to minimize the risk.
Q. My job was outsourced to India last year and I lost my health coverage. My wife and I dipped into savings to pay over $600 a month on our medicines. I take Lipitor for cholesterol, Norvasc, Altace and Toprol XL for high blood pressure and Actos for diabetes. My wife takes Fosamax for her bones and Aciphex for reflux.
It became essential for us to find a way to save money or we would have had to stop taking many of our essential drugs. We found that ordering our medicines from Canada saved over 40 percent. Our doctors helped out by prescribing a higher dose of some drugs so we could split pills and save even more. Other readers may want to benefit from our experience.
A. Ordering from Canada can provide significant savings. Buyers must beware, however. There are concerns that many online drugstores claiming to be Canadian are actually located elsewhere. FDA inspections reveal that many drugs ordered from such sites came from other countries. A few were counterfeits.
To distinguish legitimate Canadian pharmacies from imitators, consumers should look for the provincial pharmacy license number. We have compiled guidelines for buying medicines from genuine Canadian pharmacies in our Guide to Saving Money on Medicine. 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’ The People’s Pharmacy®, No. CA-99, P. O. Box 52027, Durham, NC 27717-2027. It may also be downloaded for $2 from www.peoplespharmacy.com.
If your doctor verifies that it is safe, pill-splitting can be an excellent way to save money. Lipitor, for example, costs the same for 30 pills whether they are 20 mg or 40 mg.
Q. I have had asthma all my life and have had very few symptom-free days. Two years ago my doctor prescribed Advair after a three-day stay in the hospital because I had quit breathing due to a severe asthma attack.
The day I started using Advair my life changed. I have been symptom free for two years. At my last office visit, my doctor (who has been my physician for nearly 25 years) commented that he had never heard my lungs that clear.
If Advair were to be pulled off the market I believe it would be a death sentence for me.
A. The FDA is not planning to take Advair off the market, but it will require a stronger warning. While it may be helpful for you, some patients experience hard-to-treat asthma episodes while taking Advair.