Q. While searching for treatments for shingles, I found your website. One article described the heartburn medicine Tagamet as having a positive impact. You did not mention anything about the correct dose. Can you give us any more information about how much Tagamet to take for shingles?
A. It will come as a shock to most health care practitioners to learn that the heartburn medicine cimetidine has shown activity against shingles. This painful skin condition is linked to infection with chickenpox (varicella-zoster) earlier in life.
When the immune system weakens, the virus can be reactivated and cause a rash. Antiviral drugs such as acyclovir (Zovirax), famciclovir (Famvir) and valacyclovir (Valtrex) can discourage viral replication and speed healing if given as soon as the rash appears.
A reader of this column notified us several years ago that his medical colleagues in Europe prescribed cimetidine off-label to treat shingles and zoster-associated pain (ZAP). Unlike antivirals, this ulcer drug affects the immune system (Canadian Family Physician, February 1994). The authors cite a study using 400 milligrams of cimetidine three times daily, which is much higher than the heartburn dose.
Researchers offering case reports of success with cimetidine against shingles have called for robust clinical trials. To date, however, such studies do not appear to have been conducted.
Q. I have begun taking Wegovy for weight loss. The only real side effect is nausea. It can hit me at any time, and though unpleasant, it isn’t severe. I heard that ginger helps to combat nausea, so I picked up some ginger chews at my pharmacy.
This has helped somewhat, but I am concerned that I cannot find how much ginger is actually in each chew. Are there other options that specify the quantity of ginger?
A. Ginger cookies or candy are unlikely to reveal dose strength. Ditto for chews or teas. You can probably find ginger capsules in a health food store. A typical dose of ginger (Zingiber officinale) for nausea is 1,000 milligrams (Integrative Medicine Insights, March 31, 2016).
Another option you might consider is sniffing alcohol wipes. These are used to clean the skin before an injection, so you probably already have some. A Dutch study found that nauseated patients who sniffed isopropyl alcohol in the emergency room were less likely to require anti-emetic medication (International Journal of Emergency Medicine, Feb. 24, 2021).
You can learn more about ginger and other natural approaches to common problems in our book, “The People’s Pharmacy Quick & Handy Home Remedies.” Your local library may have a copy. If not, it is available in the store at www.PeoplesPharmacy.com.
Q. I was taking lisinopril for high blood pressure. When I went back to the clinic, my pressure was still too high.
They prescribed clonidine. I’ve been taking it for a little more than a year, but I am getting severe side effects of dryness and abdominal pain.
I’m trying hard to wean off this medication without success. Is there somebody who could help with this? I have never felt so sick in my life.
A. Clonidine (Catapres) must never be stopped abruptly. Withdrawal symptoms include a rapid rise in blood pressure, digestive distress, agitation, anxiety, dizziness, headache and tremor.
Your doctor should supervise a gradual reduction in dose to avoid such complications.
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: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”