GRAEDONS | The People's Pharmacy Some side effects may accompany cholesterol drug

Q. I am an active woman with high cholesterol. I was on Lipitor, but it gave me bad muscle aches, which prevented me from exercising.
I am now taking a powder called cholestyramine (a packet in a glass of water a couple of times a day). Do you consider this a safe and effective drug?
A. Before statins such as Lipitor, Zocor or Crestor were developed, doctors prescribed medications such as Questran (cholestyramine) to lower cholesterol. It works by binding to the cholesterol in bile and preventing its reabsorption.
Cholestyramine lowers cholesterol 8 percent to 20 percent. Side effects may include constipation, heartburn and flatulence. The medicine might also block the absorption of fat-soluble vitamins such as A, D, E and K. Muscle aches are uncommon, but they have been reported.
Q. I am 73. My wife and I are retired teachers. About once a week we smoke pot and have sex. We have enjoyed this experience for almost 30 years.
I had a heart attack four years ago. I don't use heart medicines containing nitrates, but I do take Cozaar and atenolol daily. I am also now using Viagra. Do you see any problems with any of this?
A. No data suggest that atenolol or Cozaar would be affected by marijuana. Nevertheless, a number of other medications can interact with marijuana. In addition, we found one case report of a young man who had a heart attack after taking Viagra and smoking pot.
Some medications might contribute to erectile dysfunction. Although this reaction is not commonly associated with either atenolol or Cozaar, it has been reported with both of them. You might want to discuss this with your doctor.
We are sending you our Guides to Drugs That Affect Sexuality and Treating Sexual Dysfunction for more information on such adverse effects and on treatment options such as Viagra. Anyone who would like copies, please send $3 in check or money order with a long (No. 10), stamped (60 cents), self-addressed envelope to: Graedons' People's Pharmacy, No. YP-96, P.O. Box 52027, Durham, NC 27717-2027.
Q. I know it's unwise to become dependent on stimulant laxatives. But what about stool softeners? How often can they be taken?
A. Laxatives such as senna, cascara sagrada, bisacodyl or aloe stimulate fluid secretion into the colon and encourage the muscles of the intestinal wall to contract. The danger is that regular use could be habit-forming.
Docusate (Colace) is a common stool softener and can be used for a week at a time without medical supervision. After that, please check with your doctor.
Q. My doctor recommends that I take 81 mg of aspirin daily. Will this interfere with the effectiveness of vitamin supplements taken at the same time?
A. Aspirin might lower the amount of vitamin C that gets into white blood cells, but the significance of this interaction is unclear. We have not seen evidence of any other interactions between vitamins and aspirin.
Q. Is there anything that is safe to put on fingernails to inhibit biting?
A. Nail biting (onychophagia) can be a hard habit to break. Products exist that contain bad-tasting substances such as aloe or cayenne pepper. Brands to look for include Stop-Zit and Control-It.
The bitter taste reminds people that they might be unconsciously putting their nails in their mouths. Some individuals are able to get a similar result by coating nails with clear polish.
XIn their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features Syndicate, 888 Seventh Ave., New York, NY 10019, or e-mail them at pharmacy@mindspring.com or via their Web site: www.peoplespharmacy.org.
& copy; 2004 King Features Syndicate, Inc.