Q. My 28-year-old son has a receding hairline. I hate to see him look middle-aged before he is in his 30s.
Which baldness medicine works better, Rogaine or Propecia? Would they work better together than either alone? He can’t afford either drug, but I could subsidize a six-month trial.
A. A small study recently appeared in the Archives of Dermatology (Sept. 2003) comparing topical minoxidil (Rogaine) to oral finasteride (Propecia). Initially, minoxidil seemed more effective. But after two years, the two medications were “equally effective.”
Italian dermatologists report in the same journal that the combination of Propecia and Rogaine may promote more hair growth than either drug alone, though the data is anecdotal. Stopping Rogaine, however, led to rapid hair loss despite continuing Propecia treatment.
Q. My doctor told me to stop taking Prempro last spring. Within weeks of giving up hormone therapy I started experiencing hot flashes and night sweats.
I read that black cohosh is supposed to be helpful but it didn’t do a thing for me. My doctor wrote me a prescription for Paxil but warned me that there might be some side effects. A friend suggested that I try St. John’s wort instead. I am confused, frustrated and flashing. Any information you can send would be appreciated.
A. Although some herbal authorities recommend St. John’s wort for the emotional ups and downs that have traditionally been associated with menopause, there is not much data to support its use for hot flashes. A small study found this herb helpful in easing menopausal symptoms, including sexual difficulties.
A recent study (JAMA, June 4, 2003) showed that paroxetine (Paxil) helped alleviate hot flashes and night sweats. Similar antidepressants such as Prozac or Zoloft may also be helpful. Sexual side effects are not uncommon with such drugs, however.
We are sending you our Guides to Antidepressant Pros and Cons, Estrogen Benefits, Risks and Interactions and St. John’s Wort so you can learn more about these treatments. Anyone who would like copies may send $4 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. WVX-827, P. O. Box 52027, Durham, NC 27717-2027.
Q. What can you tell me about a new drug called Zetia? My doctor wants me to take it to lower my bad cholesterol. Have you heard of this drug? If so, is it safe and should I take it?
A. Zetia is new and works differently from other cholesterol-lowering medicines. It prevents cholesterol absorption from the digestive tract. This lowers total cholesterol as well as bad LDL cholesterol and triglycerides.
Side effects appear relatively uncommon, but some people experience cramps and diarrhea, sinusitis, muscle aches or fatigue. Only you and your doctor can determine if this medication is the appropriate way to lower your cholesterol.
Q. Last night I wasn’t paying attention and took a double dose of diphenhydramine (100 mg). It knocked me right out. What would happen if I made such a mistake again?
A. Diphenhydramine is an antihistamine found in Benadryl, Tylenol PM and sleeping aids like Nytol. The normal dose is 50 mg. Mild toxicity (sleepiness, dry mouth, rapid heart rate, nausea or vomiting) can occur at doses up to 300 mg. Higher doses can lead to confusion, anxiety, hallucinations and heart rhythm disturbances and require medical attention.