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Sunday, December 15, 2019  Spokane, Washington  Est. May 19, 1883
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People’s Pharmacy: Fish oil finally is getting respect

This undated photo provided by Amarin in November 2018 shows capsules and packaging for the purified prescription fish oil Vascepa. Although fish oil taken by healthy people, at a dose found in many supplements, showed no clear ability to lower heart or cancer risks, higher amounts of a purified prescription fish oil, such as Vascepa, slashed heart problems and heart-related deaths among people with high triglycerides, a type of fat in the blood, and other risks for heart disease. (AP)
This undated photo provided by Amarin in November 2018 shows capsules and packaging for the purified prescription fish oil Vascepa. Although fish oil taken by healthy people, at a dose found in many supplements, showed no clear ability to lower heart or cancer risks, higher amounts of a purified prescription fish oil, such as Vascepa, slashed heart problems and heart-related deaths among people with high triglycerides, a type of fat in the blood, and other risks for heart disease. (AP)
King Features Syndicate

Q. I’ve taken fish oil successfully for years for lupus, osteoarthritis, dry eye and cardiovascular benefits. Three specialists recommended it. Even if they changed their minds about it tomorrow, their updated opinion wouldn’t alter my opinion on the benefits of fish oil.

I’ve found that quality matters for fish oil, as it does in many things in life. The amount and ratio of EPA and DHA also are important.

A. A recent review of three large randomized controlled trials concluded that marine omega-3 fats (fish oil) can reduce the risk of cardiac complications and death from cardiovascular causes (Mayo Clinic Proceedings, online, Oct. 15). One of these trials (REDUCE-IT) used a prescription pharmaceutical EPA product, Vascepa.

A different meta-analysis published in the Journal of the American Heart Association (Oct. 1) also concluded that fish oil supplements can reduce the risk of heart attacks and death from cardiovascular disease. In addition, there is evidence that omega-3 fats have potential in treating autoimmune diseases like yours (Frontiers in Immunology, Sept. 27).

Q. I have been on clonazepam, amitriptyline, levothyroxine, atorvastatin, atenolol and warfarin since 1994. Last Christmas, I received my first generics from Indian manufacturers. This has been a nightmare, so I now buy brand-name Klonopin and attempt to get as many of my drugs as possible from Canada.

Too many generic drugs are not working because the Food and Drug Administration cannot monitor all offshore Indian and Chinese manufacturers. I have had credible sources tell me that drug companies overseas check flight manifests to see when FDA inspectors are coming.

Please send letters to the FDA to try to effect change. Bring drug manufacturing back to the U.S. where the agency can monitor it properly!

A. You will be very interested in Katherine Eban’s new book, “Bottle of Lies: The Inside Story of the Generic Drug Boom.” She covers the FDA’s ineffectual struggles to oversee generic drug manufacturing outside the country, especially in India and China.

Others may wish to know how to buy medications from Canada. Brand-name drugs are frequently much more affordable at reputable Canadian pharmacies.

To learn more about how to distinguish legitimate Canadian online pharmacies from counterfeit operations, you may wish to read our eGuide to Saving Money on Medicines. You can find this electronic resource at peoplespharmacy.com in our Health eGuides section.

Q. Recently my wife had revision hip surgery. The orthopedic surgeon prescribed a single 325-mg aspirin tablet a day.

In a previous episode, she was prescribed Lovenox, an injectable blood clot preventive. The Lovenox cost $750, whereas the aspirin was just pocket change. Maybe doctors are starting to move away from high-cost drugs.

A. After joint replacement surgery, doctors often prescribe an anticoagulant to prevent life-threatening blood clots. A study in JAMA Surgery (January) demonstrated that aspirin was comparable to far more expensive anticoagulants.

A new study in Orthopedic Surgery (October) compared aspirin to rivaroxaban (Xarelto) after hip fracture surgery. The surgeons concluded that “Aspirin may be an effective, safe, convenient and cheap alternative for extended prophylaxis after hip fracture surgery.”

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website peoplespharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”

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