Steroid inhaler for asthma tied to several side effects

Q. I am a singer, so my voice is critical to both my livelihood and my sense of well-being. I was recently diagnosed with mild asthma, and my doctor prescribed an inhaler called Flovent.

I am fairly certain that this medicine is affecting the quality of my voice. Is this my imagination, or could this be a side effect? Are there any other complications I should know about?

A. Fluticasone (found in Flovent and Advair) is an inhaled steroid. Such cortisonelike drugs calm inflammation in the lungs with fewer systemic side effects than oral steroids. Nevertheless, hoarseness, throat irritation, sinusitis, oral yeast infections and voice problems are not uncommon.

One reader was livid that she was not informed of any fluticasone side effects. After years of regular use, she had developed cataracts, headaches and osteoporosis. Discuss your concerns with your doctor.

Q. I started working as a substitute teacher three years ago. Ever since, I’ve been getting frequent colds that often turn into bronchitis. Then my doctor prescribes antibiotics.

I am now suffering with my second cold in a month. I wash my hands frequently, exercise daily and take vitamins, minerals and herbs. Right now I’m taking goldenseal, Echinacea and zinc.

Do you have any suggestions for me to bolster my immune system? I’d also appreciate a suggestion for shaking the current cold. I’m getting exhausted.

A. You haven’t mentioned taking vitamin D, which might be a factor. People with low levels of vitamin D are more susceptible to colds and flu (Archives of Internal Medicine, Feb. 23, 2009).

We are sending you our brand-new Guide to Fighting Colds and Flu for more information on vitamins and herbs such as andrographis and astragalus that may help you fight off infection. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (59 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. Q-20, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our Web site: www.peoplespharmacy.com.

Q. My husband was taking amiodarone for a heart-rhythm problem. He developed pulmonary fibrosis as a side effect and died last November. I just can’t understand why this dangerous drug is still on the market.

A. We are so sorry to learn of your loss. Amiodarone (also available under the brand names Cordarone and Pacerone) is used to treat heart-rhythm disturbances that don’t respond to other medications. A “black-box” warning in the prescribing information tells doctors: “Amiodarone hydrochloride is intended for use only in patients with the indicated life-threatening arrhythmias because its use is accompanied by substantial toxicity.” The most important of these is pulmonary (lung) toxicity, but it also can have negative effects on the liver and the thyroid.

The warning continues, “amiodarone poses major management problems that could be life-threatening in a population at risk of sudden death, so that every effort should be made to utilize alternative agents first.”

We recommend that anyone who receives a prescription for amiodarone discuss the benefit/risk ratio of this drug with the doctor in detail, so that it is used only when appropriate.

XIn their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of The Vindicator or e-mail them via their Web site: www.PeoplesPharmacy.com. Their newest book is “Favorite Home Remedies From The People’s Pharmacy.”

2009 King Features Syndicate Inc.