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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Wrong dose of Remeron could be trouble

Joe Graedon and Teresa Graedon, Ph.D. King Features Syndicate

Q. I take 15 milligrams of Remeron daily for depression. Recently I called in a refill. When I opened the bottle, I noticed that the pills were much larger and a different color than before.

To check on this, I took the new pills to my pharmacy along with a sample of the original prescription.

Someone had inadvertently given me 45-milligram pills rather than 15-milligram. The pharmacist made the change quickly and apologized. I’m glad I checked. I urge readers who notice any change in their medications to talk with the pharmacist.

Drugstores are often understaffed and busy, so it’s understandable that mistakes happen. My experience enforces the idea that we must be our own health-care advocates and not just assume we’ve been given the right medication.

A. Thank you for reminding us that it is crucial to double-check medications before leaving the pharmacy. By accidentally tripling the dose, the pharmacist put you at risk of reactions to Remeron, including drowsiness, disorientation, dizziness, impaired memory, dry mouth, constipation, weight gain and irregular heartbeats.

Q. My husband and I take a lot of medicine but have no drug coverage. He is a diabetic on five different medications. Two weeks ago he was hospitalized with an irregular heart rhythm. The bill came to $20,000, and our insurance would not cover it.

We live frugally, but paying for the medicines and the hospitalizations is just too much. Is there any way to get help with these bills from the drug companies?

A. Most pharmaceutical companies offer patient-assistance programs for those with low incomes. Go to the Web site www.helpingpatients.org or call (888) 477-2669. Your doctor will have to help with your application.

In the meantime, ask your doctor whether buying prescriptions from a reputable online Canadian pharmacy makes sense. A new study in the Annals of Internal Medicine (Sept. 20) reported that the average savings per prescription is about 24 percent over online drugstores in the U.S.

We are sending you our Guide to Saving Money on Medicine, with more information on accessing free drugs and finding reliable Canadian pharmacies. Anyone who would like a copy, 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. CA-99, P.O. Box 52027, Durham, NC 27717-2027.

Q. I read your article about the dangers of driving while drowsy. Why didn’t you recommend NoDoz or similar products? I find that when I start to feel drowsy behind the wheel, a NoDoz makes me alert.

A. Products such as NoDoz, Caffedrine, Lucidex, Keep Alert and Vivarin contain 100 or 200 milligram of caffeine. That much caffeine could be found in one to two cups of coffee.

Although caffeine is a nervous-system stimulant, it won’t necessarily make people safer behind the wheel. The effects are short-lasting, and anyone who is overtired might still have poor judgment and delayed reaction time.

Q. I know you say to store medicines away from heat and humidity. Is it OK to store vitamins (multi, C, fish oil and calcium) in the refrigerator?

A. Vitamins should be stored in a cool, dry place. The refrigerator is cold, but not dry. They will be fine at room temperature in a kitchen cupboard.