People’s Pharmacy: New worries surface about heartburn drugs and kidney damage

Q. I have been taking various PPIs for a decade. I am 76, and my creatinine is creeping up in the blood tests at my regular checkups. This could be my age, but I worry that the PPI I take for heartburn might be making it worse.

My doctor says not to worry; he also is taking one. But as I age, I am concerned about drug side effects. I decided to go off these pills.

I started by cutting them in half, then taking half every other day. I was able to take that half dose just a couple of times a week, and now I’m off altogether.

I am careful about what I eat. I drink cold water if I get a little heartburn. Sucking on a hard candy increases saliva, and that also helps with reflux.

A. A creatinine blood test helps doctors assess kidney function. Rising levels could be an early indication of kidney damage.

There is evidence that long-term use of proton-pump inhibitors (PPIs) may be harmful to the kidneys (Kidney International, Feb. 22, 2017). Other side effects associated with PPI use include pneumonia, intestinal infections, hip fractures, nutritional deficits and dementia.

Suddenly stopping a PPI such as omeprazole can cause rebound hyperacidity. Tapering the dose gradually makes sense. Our Guide to Digestive Disorders offers other ways of dealing with heartburn and easing off PPIs. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (70 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. I recently asked my doctor for a prescription for tetracycline to clear up my skin. Years ago, when I was 19 and my face looked like raw hamburger, this medication worked a miracle and was not at all expensive.

When I got to the pharmacy to pick up my new prescription, I was told my out-of-pocket cost for a 30-day supply would be $900, even though I have insurance. I can’t afford that! I don’t know anyone who could. What happened to tetracycline?

A. Like you, we were shocked at the price of this old generic antibiotic. Forty years ago, the brand-name form of tetracycline (Achromycin V) cost just over $10 for 100 pills (500 mg). The cash price today for 60 tetracycline pills is over $900. In Canada, the price for 100 pills is under $50. We cannot explain why Americans pay so much more for this old medication.

Q. Years ago, while working in accounts payable at Texas A&M University, I would see bills for cases of Massengill douche powder for the vet school. Curious, I asked what in the world the vet school did with it.

I was told that when students had to deliver a dead calf, the odor was indescribable and pervasive. Massengill would cut it. How they discovered this, I do not know.

When I moved to the country, I had two dogs get too friendly with a skunk, remembered this and tried the Massengill. It works!

A. We first heard about using diluted Massengill feminine hygiene solution to remove skunk smell several years ago.

Another popular remedy for this problem is a homemade solution developed by chemist Paul Krebaum in 1993: 1 quart of fresh 3 percent hydrogen peroxide, 1/4 cup baking soda and 1 or 2 teaspoons of liquid dishwashing detergent. The ingredients should be mixed in an open container. It will foam and should be applied to the affected areas while still foaming. Don’t try to store it: this mixture could explode if contained.