People’s Pharmacy: Preparation H may raise blood pressure

Q. Can Preparation H raise blood pressure? I have been using Preparation H for a few weeks for a hemorrhoid problem. During that time, it seems that my blood pressure has been going up.

My pressure has always been in the normal range of 120/80 or lower, but now I’m seeing systolic numbers in the 130 to 140 range. I noticed that in the Preparation H warning it mentions to ask your doctor before using it if you have high blood pressure.

A. One of the active ingredients in Preparation H is phenylephrine, a vasoconstrictor. This is the same drug that is used as a decongestant in some nasal sprays and oral cold medicines.

Vasoconstrictors work by contracting blood vessels and shrinking swollen tissues. One possible side effect is increased blood pressure. Anesthesiologists sometimes use phenylephrine to raise blood pressure during surgery if a patient’s blood pressure drops too low.

The rectum is well-supplied with blood vessels. That is why suppositories are effective for delivering drugs into the bloodstream. When phenylephrine is absorbed from these delicate tissues, it may raise blood pressure. One reader ended up in the ER with a blood pressure of 206/98 after using Preparation H for several days.

Q. My husband has taken Zocor to lower cholesterol since he was 48. In 2006, he started to notice problems. His feet became numb, and he had trouble writing. He believed that he was less sharp mentally. I could see that his muscle strength was waning, too. I excused this as growing older, but he was just in his early 50s.

The problems became more obvious starting in January 2007. Now it’s February 2008, and he’s 55.

He can’t communicate with customers in the business he started 30 years ago. His writing can’t be read even when he tries his best to print.

He has trouble walking. He loses his balance easily. It is very difficult for him to get up when he falls. He has very little body strength, and he can’t walk up stairs. He has no feeling in the bottom of his toes.

He has trouble expressing his thoughts, and his speech pattern is halting. He has a lot of trouble sleeping.

He’s made numerous trips to his internist and a neurologist. They have recommended that we see a dementia psychiatrist. I feel I need to look elsewhere for help – but I don’t know where to go. Could any of this be related to Zocor?

A. We have heard from hundreds of people who have developed memory, nerve or muscle problems while taking statin-type cholesterol-lowering drugs (Lipitor, lovastatin, simvastatin, Zocor, etc.). People frequently complain that they have trouble remembering words and names. In a recent article in The Wall Street Journal (Feb. 12, 2008), a doctor observed, “This drug (Lipitor) makes women stupid.”

We have discussed this issue in great detail with several experts on our radio show. We are sending you a one-hour CD of “The Dark Side of Statins,” an interview with Beatrice Golomb, M.D., Ph.D., and colleagues. Anyone who would like this CD may send $16 to: Graedons’ People’s Pharmacy (CD-523), P.O. Box 52027, Durham, NC 27717-2027. It is also available at www.peoplespharmacy.com.

Q. How much calcium is too much? I take 1,500 mg/day, and my doctor wants me to add another 500 mg for my thinning bones. I drink milk and wonder if I may be overdosing.

A. Too much calcium (2,000 mg/day) can lead to “milk-alkali syndrome.” The extra supplement might make you vulnerable to this complication, which increases the risk of bone fractures and kidney stones.