Drug sapped sex drive

Q. After my doctor prescribed simvastatin, I gradually began to lose my libido. I didn’t realize that this medication was responsible, but after I dumped the drug because of severe muscle pain, my sex drive came back. Do doctors know about this side effect?

A. We suspect that relatively few physicians are aware of this potential complication. The official prescribing information for simvastatin (Zocor) does not mention lowered libido.

There is a surprising lack of research regarding sexual function and statin-type medications like atorvastatin (Lipitor), rosuvastatin (Crestor) and simvastatin. Because cholesterol is a building block for testosterone, drugs that interfere with cholesterol production can lower levels of this hormone (Journal of Sexual Medicine, April 2010). French and Dutch researchers have reported that decreased libido and erectile dysfunction may be associated with statin-type drugs (British Journal of Clinical Pharmacology, September 2004; Drug Safety, July 2009).

Niacin, a different kind of cholesterol-lowering drug, does not appear to have this side effect. In fact, a recent study found that niacin might actually improve erectile function (Journal of Sexual Medicine online, Aug. 2, 2011).

Q. As a nurse, I’m concerned about the widespread use of acid-suppressing drugs like omeprazole.

I’ve heard many patients talk about how bad their reflux is when they stop these drugs. Until recently, I was not aware that there is a rebound effect.

Do you have any suggestions about how people can discontinue such medicine?

A. Rebound hyperacidity is now recognized as a potential complication of stopping many powerful acid-suppressing drugs. Proton pump inhibitors (PPIs) such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix) and rabeprazole (Aciphex) can trigger severe heartburn symptoms when people stop them suddenly (American Journal of Gastroenterology, July 2010).

One reader noted: “I have been taking Nexium for about three years. I tried to get off it and got the rebound effect. Now what do I do?”

Gradual tapering might be beneficial. Less potent acid-reducing approaches including antacids or natural compounds also may help get someone past the most difficult stage.

We are sending you our Guide to Digestive Disorders for more details on getting off PPIs and other ways to deal with heartburn. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (64 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. G-3, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.

Q. Thank you for your recent column suggesting taking prescription pills with water instead of juice.

I asked my doctor about this, and he agreed with the idea.

Since I switched to water, I’ve noticed a definite lowering of my blood pressure numbers.

A. Certain fruit juices can reduce the blood levels of a variety of drugs. To avoid this problem, take your pills with water.

2011 King Features Syndicate Inc.