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People’s Pharmacy: Antibiotic caused long-lasting misery

UPDATED: Wed., Dec. 1, 2021

By Joe Graedon, M.S., </p><p>and Teresa Graedon, Ph.D. KING FEATURES SYNDICATE

Q. Recently my urologist prescribed ciprofloxacin for an infection. After a few days, I began having pain in one knee and both hip joints. The urologist told me to discontinue the drug.

The pain worsened, and I had to see my primary care physician. I could not sleep or walk without a cane. My doctor diagnosed tendinitis and referred me to an orthopedic doctor. His diagnosis was peripheral neuropathy.

Despite taking the prescribed anti-inflammatory, I kept getting worse and landed in the emergency room. The doctor there said the initial pain from the neuropathy had changed my gait, setting off back spasms. Along with prescribing a stronger pain medicine, a muscle relaxant and a steroid, he told me this probably started with the ciprofloxacin.

When I looked it up online, I found this medicine is known for causing symptoms like mine. It also has been associated with a risk of aortic aneurysm. Why do doctors keep prescribing it in light of these problems?

A. We are so sorry you have been put through the wringer. Your doctor was not following the official prescribing guidelines for ciprofloxacin.

The Food and Drug Administration requires a black box warning that states: “Because fluoroquinolones, including Cipro, have been associated with serious adverse reactions, reserve Cipro for use in patients who have no alternative treatment options …”

This medication class, which also includes levofloxacin (Levaquin), can cause tendinitis, tendon rupture, neuropathy (nerve pain), aortic aneurysm and psychiatric side effects. That’s just for starters. Recovery can be slow.

Q. My doctor prescribed Zytiga for prostate cancer. It worked amazingly well. My PSA went from more than 180 to less than 1 within a few months. The drug is incredibly expensive, though. Even with insurance, the co-pay is crazy.

A. Research has been accumulating that this anti-androgen oral medicine can make a big difference in the treatment of prostate cancer. Initially, it was recommended for late-stage metastatic disease. More recently, though, earlier treatment has been shown to be a game-changer.

Results from the “STAMPEDE” trial were presented this fall at an international oncology conference (ESMO 2021). Nearly 2,000 men with high-risk prostate cancer got either standard androgen depleting treatment or that plus abiraterone (Zytiga). Abiraterone-based treatment significantly improved survival and, according to the investigators, “should be considered a new standard of care.”

Brand-name Zytiga can cost as much as $11,000 a month with a coupon. Without the discount, GoodRx says the average retail price is more than $25,000 a month. The generic is also pricey, over $6,000, according to the same source.

Pharmacy coupons can help. So can ordering from legitimate Canadian online pharmacies. To learn more about such resources, consult our eGuide to Saving Money on Medicines. This online resource can be found under the Health eGuides tab at peoplespharmacy.com.

Q. I have hyperthyroidism. Is there a reason for treating it other than my typical symptoms? My hands do shake ridiculously, and I have insomnia. But my attitude is “so what”? Is there any more serious reason for concern?

A. Left untreated, an overactive thyroid gland can lead to some serious complications. Graves’ disease (an autoimmune condition that can cause hyperthyroidism) is associated with eye problems, heart rhythm disturbances and osteoporosis.

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.

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