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People’s Pharmacy: Stopping Xyzal led to ‘crazy’ itching

Feb. 7, 2023 Updated Tue., Feb. 7, 2023 at 5:59 p.m.

 (The Spokesman-Review)
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By Joe Graedon, M.S., and Teresa Graedon, Ph.D. Kings Features Syndicate

Q. I have been taking Xyzal, and it’s only recently that I figured out what the crazy itching is from. I stopped the drug three days ago and have been suffering since.

Before that, I was taking it for about a year. Whenever I missed, I would itch, but taking it again stopped the itching. I did not realize that it was withdrawal itching. I have missed work, lost sleep and was once misdiagnosed with shingles because of this. I appreciate knowing this too shall pass.

A. We encouraged the Food and Drug Administration to investigate “withdrawal itching” with both cetirizine (Zyrtec) and levocetirizine (Xyzal). The agency acknowledged this reaction in the journal Therapeutic Advances in Drug Safety (July 5, 2019). Gradual tapering over several weeks may reduce the discomfort.

Q. I have had severe scalp psoriasis for many years. Home remedies, injections, UV light therapy, medications and shampoos have not helped.

My dermatologist recently prescribed Sotyktu. Do you think this is safe for me to use?

When I read the info included with the medication, I saw a couple of red flags. I am over 50, and I have had high blood pressure that I keep under control with medication.

A. Sotyktu (deucravacitinib) is a relatively new psoriasis medicine. It is in a somewhat similar category as some other biologic medications such as upadacitinib (Rinvoq) or tofacitinib (Xeljanz).

In a four-month trial of this drug for psoriatic arthritis, the most common side effects were sore throat, respiratory infection, sinusitis, bronchitis, rash, headache and diarrhea (Annals of the Rheumatic Diseases, June 2022). Sotyktu lowers the ability of the immune system to fight infections and must not be used in combination with other drugs that affect immune response. Some people react to this drug by developing angioedema (which can be life threatening). There are also concerns about serious infections such as tuberculosis as well as the blood cancer lymphoma.

The price also might be a worry, unless your insurance plan will cover Sotyktu. GoodRx reports the monthly price without coverage or coupons is more than $11,000.

Q. I developed diabetes 25 years ago. After suffering several years with the side effects of metformin, the doctor put me on insulin.

I fingerstick at least twice a day or more. The doctor who diagnosed me said that if I could keep my blood sugar numbers around 126, she would be happy. I think that equates to an A1c of 6.0. At the time of diagnosis, my A1c was closer to 8.0. So, for the past 20 years, the goal was 6.0.

My primary care provider retired last year, and my new PCP is not happy with 6.0. She said it’s too low. She told me to reduce the insulin dose, which I did. Despite that, and eating more “forbidden” carbs, my most recent A1c was 5.7. I have lowered my insulin dose again. I did add CoQ10 to my supplements, which has lowered my blood pressure significantly.

Why does my new doctor think 6.0 is too low for a diabetic, when that has been the magic number for every other doctor for the past 20 years?

A. We are puzzled. The Centers for Disease Control and Prevention considers an A1c “normal” if it is below 5.7. Prediabetes is 5.7 to 6.4 and diabetes is a reading over 6.5. Trying to raise your HbA1c seems counterproductive.

A second opinion from a diabetes expert might be advisable. To help you prepare, you may find it helpful to read our “eGuide to Preventing and Treating Diabetes.” This online resource can be found under the Health eGuides tab at

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

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