Ask pharmacist to use manufacturer’s expiration date

Q. I read your column about a person concerned about a prescription that was a couple of months past its use-by date. Whenever I receive a prescription from a pharmacy, I ask for the expiration date on the bottle the medication was dispensed from so I can record that date on my prescription bottle and prescription documents. That way, I’m not constrained by the one-year time frame most pharmacists put on the customer’s bottle.

I also save money because I’m not throwing away perfectly good medication and getting new prescriptions filled. I hope others find this helpful.

A. Thank you for the suggestion. If you make your request at the time you submit your prescription, the pharmacist can allow for the extra time it takes to note the manufacturer’s expiration date. In some states, pharmacists are legally required to display a one-year use-by date, but they are not forbidden to give you the additional information you request.

Q. I have been on thyroid hormone replacement for more than 20 years. Now I have been diagnosed with osteoporosis.

My doctor prescribed Fosamax and then Actonel. I have heard that such drugs can cause jawbone deterioration. This happened to a friend of mine, and I am quite concerned.

What other options are available for treating osteoporosis?

A. Too much thyroid hormone can weaken bones. Although medications like Fosamax and Actonel are popular treatments for osteoporosis, they have been linked to osteonecrosis of the jaw. Jawbone death does not seem to be common, but it is a frightening side effect and extremely difficult to treat. It appears to be triggered by dental extractions or other invasive procedures. People with known dental problems should have them taken care of before starting such medication.

There are a number of other medicines that can strengthen the bones. Ask your doctor to discuss Menostar, Evista, Miacalcin and Forteo as possible alternatives. Each of these works differently from Fosamax, and all are used to treat osteoporosis.

There is lots more information about treatments for osteoporosis and hypothyroidism in our new book, “Best Choices From The People’s Pharmacy.” You can find it in your library, local bookstore or online ( www.peoplespharmacy.com).

People with low bone density should be sure to get adequate vitamin D along with calcium and magnesium. That would be at least 1,000 IU vitamin D a day.

Q. I have battled toenail fungus off and on for the past 25 years. I have been on Lamisil three times and tried all sorts of OTC and prescription topical medicines.

I decided to try two of the remedies I read about in your articles. I apply hydrogen peroxide with a cotton ball to my toenails after I bathe daily. Then I apply Vicks VapoRub to my feet and toenails and put on socks to sleep in.

Within a month, I had no more toenail fungus. I have the most beautiful toenails I have ever had in 25 years. I also like the fact that I can polish my toenails and still use these remedies. Thank you!

A. Toenail fungus can be tough to treat. Prescription medicines like Lamisil are expensive and require medical monitoring for liver problems and other potential side effects.

Success with home remedies like the ones you are using requires patience and persistence. Not everyone will benefit, but we are pleased that the remedies are working for you.