People’s Pharmacy: FDA won’t put drug advertising genie back in a bottle

Q. Thank you for writing about annoying TV commercials for prescription medicines. You are probably right that putting the genie back in the bottle is nearly impossible. Remember, though, the Food and Drug Administration let the genie out in the first place!

In the bad old days, drug sales reps would visit physicians, offering gifts and dinners to entice them to prescribe their newly approved products. Current rules forbid drug reps from offering anything. Most doctors, pushed for time, don’t waste it schmoozing with sales reps.

That’s why pharma turned to mass media. And what a bonanza it was!

Now patients drive prescriptions with pleas for drugs they’ve seen in ads. It’s easier to write a prescription than to coach patients on strategies to lose weight, eat healthier and exercise more.

A. Patients aren’t the only ones watching television. Some years ago, a drug company executive told us that prescriptions started to increase surprisingly soon after launching a new ad campaign. Most patients wouldn’t have time to make an appointment and see their doctors. The marketing team concluded that commercials also impact doctors and drive prescriptions directly.

As pricey as these ads are to produce and air, they are probably less expensive than sending sales reps around the country to sit for hours in doctors’ waiting rooms hoping for a few minutes of time with the prescriber.

Q. I take metoprolol for high blood pressure. When my dose was doubled recently to 50 milligrams a day, my hair started to fall out. Do you have any recommendations?

A. A surprising number of medications can trigger hair loss, but it’s not the sort of side effect that most prescribers consider worth discussing. Metoprolol and other beta blockers are known to cause this reaction. Other dermatological side effects may include psoriasis, Raynaud’s disease, vitiligo and dermatitis (Experimental and Therapeutic Medicine, August 2019).

Our free “Guide to Hair and Nail Care” provides a list of many medications that can cause hair loss. It also offers advice on treating dandruff, nail fungus and lice. This PDF may be downloaded from the Health eGuides tab at www.PeoplesPharmacy.com.

No one should ever stop using a beta blocker suddenly! Discontinuation could lead to serious heart complications. Some people may need to continue taking a beta blocker like metoprolol despite skin or hair problems.

Q. I have been using NasalCrom since it first came out in the 1980s. Antihistamines common then (Chlor-Trimeton, Benadryl) didn’t work for me. They didn’t even make me sleepy.

Steroids were the only thing that helped my severe seasonal allergies. Allergy desensitization shots did not work, but my allergist offered a prescription for a new drug, NasalCrom.

It changed my life! I use it when I know I’m going to be exposed, for example, before gardening or hiking.

I’m a holistic practitioner and I often recommend NasalCrom to my clients with allergies. It works well with Hesperidin, a capsule made from citrus that also stabilizes mast cells.

A. The FDA first approved cromolyn sodium for treating asthma in 1973. This prescription inhaler was marketed as Intal. In 1983, the agency approved a prescription nasal spray for allergies called NasalCrom.

Because it is considered very safe, NasalCrom has been available without a prescription for over two decades. It works best when it is used preventively, before exposure to allergens such as cat dander or pollen.

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.”