Sunday, September 11, 2005
Q. I have fibromyalgia, and it disturbs my sleep. I take Lunesta for sleep every night (in addition to practicing healthy sleep habits). What is your opinion of the new medication Rozerem?
A. Lunesta (eszopiclone) was hailed as the first sleeping pill to be approved for long-term use. It is being widely advertised on TV and in print. Side effects may include headache, dry mouth, drowsiness, indigestion and an unpleasant taste in the mouth.
Rozerem (ramelteon) is new and should start showing up in pharmacies over the next several weeks. It is the first sleeping pill to act on melatonin receptors. While more effective than the natural sleep hormone melatonin for helping people get to sleep, it doesn't seem to help them sleep longer.
Side effects of Rozerem may include headache, daytime sleepiness, nausea, dizziness, fatigue, worsening insomnia and colds.
Medication problems
Q. My husband had open-heart surgery last spring. Since the surgery, even putting his clothes on makes him so breathless he can barely speak. He is weak and exhausted all the time.
His doctor pooh-poohs the idea that this might be due to any of the drugs he's taking. I checked online and found that metoprolol has a warning to contact the doctor immediately if you experience wheezing, shortness of breath or swelling of hands and feet. He has all those symptoms.
Can this medication cause these symptoms? If so, what should we do?
A. Metoprolol is a beta blocker that helps prevent the heart from overworking. It can also lower blood pressure.
Some people are sensitive to such medications and develop wheezing or difficulty breathing. This is a serious reaction that deserves immediate medical attention. Your husband should consult a lung expert (pulmonologist) as soon as possible. The swelling of hands and feet is also disturbing and merits a prompt evaluation by a cardiologist.
No grapefruit
Q. What is the interaction between statin drugs and grapefruit? I have read the labels and looked on the Internet, but I'm still confused.
Are statin users not supposed to eat any grapefruit at all, at any time of day? Or can you eat grapefruit in the morning and take your medication in the evening?
I happen to be taking Lipitor now. But I wonder if the grapefruit interaction is different for the other statins.
A. Grapefruit slows elimination of some statin drugs (Mevacor, Lipitor and Zocor). That means that if you eat grapefruit or drink grapefruit juice, it is likely that blood levels of your cholesterol drug will be higher than normal. This may increase the risk of side effects.
The grapefruit effect is long-lasting. Reported effects may linger for up to 48 hours, so eating your grapefruit in the morning will not protect you from an effect in the evening.
We are sending you our Guides to Grapefruit Interactions and Cholesterol-Lowering Drugs for more details. Anyone who would like copies, please send $2 in check or money order with a long (No. 10), stamped (60 cents), self-addressed envelope to: Graedons' People's Pharmacy, No. JL-97, P.O. Box 52027, Durham, NC 27717-2027.
Certain statin drugs (Crestor, Lescol and Pravachol) are processed through different enzymes and do not interact with grapefruit.
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 peoplespharmacy@gmail.com or via their Web site: www.peoplespharmacy.org.
& copy; 2005 King Features Syndicate Inc.