Zetia can cause joint, muscle pain

Q. I have been taking Zetia for four months with dramatic results. My cholesterol count dropped from 240 to 183.
I am thrilled, but I have noticed pain in my legs. It is difficult to sleep as I massage them to make them feel better. The soreness and tiredness remind me of pain after strenuous exercise like running.
I would not agree to take statin drugs to correct my high LDL and low HDL levels because I know statin drugs can cause leg pain. Isn't Zetia different?
A. Zetia (ezetimibe) works differently from statin drugs such as Lipitor or Zocor. Instead of blocking the creation of cholesterol, Zetia interferes with absorption of cholesterol from the intestines. Despite this difference, people taking Zetia sometimes report muscle or joint pain. Please let your doctor know about this reaction.
Q. My question is about erectile dysfunction. My wife really turns me on, but I always lose my erections.
When I lose it, I have trouble getting another one. Often we do not finish because of my problem, and I get frustrated. She has a strong sex drive and gets frustrated, too. At times I give her excuses, like I'm tired or I don't feel well. She thinks I do not want to be with her, but I do. I'm just afraid of failing.
My wife would never cheat on me, but I don't want to frustrate her more so she considers it. Is there anything over the counter that would help?
A. You and 18 million other American men suffer from erectile dysfunction (ED). It is nothing to be ashamed of.
There are several medications that can help, but none is available without a prescription. When you see your doctor, make sure he checks your hormone and cholesterol levels. Sometimes ED can be a symptom of cardiovascular problems.
Drugs like Viagra, Cialis or Levitra might help, but are by no means the only solution. Your physician may prescribe another kind of medicine or even suggest a vacuum device that might help you maintain your erection.
A qualified sex therapist also can provide you and your wife with useful advice. Open communication will help her understand what you are going through.
Q. Your column about quinine really upset me. I have been taking it for leg cramps for many years, and it has helped me incredibly. I have none of the symptoms you described.
My doctor keeps renewing my prescription. I can't believe she would keep doing that if what you wrote is true. I am very skeptical about your information.
A. The Food and Drug Administration has decided that quinine is too dangerous to be used against leg cramps. Some people are susceptible to a life-threatening blood disorder triggered by quinine. As a result, doctors will soon be allowed to prescribe it only for malaria.
For the vast numbers of people like you who have taken quinine safely, the FDA's action will be painful. One reader suggested an alternative:
"At one time I used Legatrin, but it is no longer available. Now when I get leg cramps, I drink a small bottle of tonic water with quinine. Within a minute the cramps subside."
We are sending you our Guide to Leg Pain with other suggestions against cramps and restless legs.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or e-mail them via their Web site: www.PeoplesPharmacy.com.
& copy; 2007 King Features Syndicate Inc.