People’s Pharmacy: Cottage cheese reduced metallic taste of Paxlovid

Q. Last week, my husband and I came down with COVID-19 even though we’d had our shots and boosters. Both of us were given Paxlovid because we are older people. My husband has COPD, so he was also given a steroid pack.

I was told Paxlovid could leave a metallic taste in my mouth. It did for me, but not for my husband. Then I decided to put the pills into cottage cheese. BINGO. The metallic taste was substantially relieved. Others might like this tip.

A. Thank you for sharing your experience with the antiviral drug Paxlovid. We checked to make sure your strategy would not interfere with absorption. The official prescribing information states: “Take PAXLOVID with or without food.” It also states, however, “Swallow the tablets whole. Do not chew, break, or crush the tablets.”

Paxlovid can increase blood levels of some corticosteroids such as dexamethasone or methylprednisolone. If your husband needs another course of Paxlovid, his doctor should monitor his steroid dose carefully.

Q. I have never had high LDL cholesterol, but my doctors have prescribed statins for many years. I am currently taking atorvastatin.

Despite having taken these cholesterol-lowering drugs, I have coronary artery disease. I needed several angioplasties and stents placed after my heart attack. My cardiologist is now planning bypass surgery. In my case, lowering LDL cholesterol did not protect my heart.

A. Heart disease is complicated. Some people experience heart attacks even though their cholesterol levels are normal. Another blood lipid called lipoprotein a, abbreviated Lp(a), is rarely tested but may contribute to clogged arteries. This risk factor usually runs in families. Somewhat surprisingly, statins may actually increase Lp(a) rather than lowering it.

To learn more about the pros and cons of statins and other ways to reduce heart risks, you may wish to read our “eGuide to Cholesterol Control and Heart Health.” This online resource is available under the Health eGuides tab at PeoplesPharmacy.com.

Q. Do you have any information about the diabetes drug Farxiga, which I am currently taking? I’d like to know the pros and cons.

A. Farxiga is the brand name for dapagliflozin. It was approved to treat Type 2 diabetes in 2014. More recently, this medication has also received a green light from the Food and Drug Administration to reduce some of the complications of kidney disease and heart failure.

A study published in the Journal of General Internal Medicine (Dec. 14, 2023) found that Farxiga reduced the risk of premature death, cardiovascular complications and the worsening of chronic kidney disease. Even people in their 70s and 80s experienced benefit.

One of the drawbacks is a susceptibility to urinary tract and genital yeast infections. Television commercials mention a rare, life-threatening bacterial infection of the skin of the perineum (the area between the anus and the genitals). Because this is an especially sensitive part of the anatomy, any discomfort in that area must be reported promptly to the physician.

Other potential risks of Farxiga and similar drugs (Brenzavvy, Invokana, Jardiance, Steglatro) include nausea, dry mouth, fatigue, low blood sugar and ketoacidosis. This latter complication is rare but extremely serious. Symptoms can include nausea, vomiting, stomachache and trouble breathing.

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: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”