Q. I never had to buy medicine before, but now I am in college and responsible for myself. I was shocked when I picked up two prescriptions recently, and even with my insurance card it cost $80. I take Claritin for hay fever and need Ambien to get a good night's sleep before an exam.
I had heard that older people were upset about the high cost of medicine, but it didn't affect me, so I didn't pay that much attention. Now I wonder how older people ever afford their prescriptions. Without insurance, I would have had to pay almost twice as much. I could never come up with that kind of money.
A. A co-pay of $40 per brand-name prescription seems pricey, but insurance companies are now passing on their high costs to patients. Many plans have a three-tiered system of co-pays. The lowest cost is for generic drugs. Then an intermediate co-pay is required for brand-name medications on the company's preferred list. The highest co-pays are for drugs like yours that are not on the list.
Older people on Medicare and those without insurance must pay full price for their medicine. You wonder how they can afford their prescriptions. Many tell us that they can't.
Q. I am an internist and prescribe a number of different blood pressure medications as well as drugs for cholesterol control. Some patients who read your column ask me whether they can take their medicines with grapefruit juice. I do not have a handy reference to check on interactions with foods like grapefruit. Is there a book or a list that I can check?
A. Food and drug interactions are not easily located in official prescribing information, so we are not surprised that you have had difficulty finding a quick reference. Grapefruit affects a wide range of medications, including estrogen, many blood pressure medicines (Adalat, Coreg, Plendil, Procardia, Sular, verapamil) as well as cholesterol-lowering drugs such as Lipitor, Mevacor and Zocor. Blood levels of such compounds might be higher than expected and last longer than usual.
We are sending you our Guides to Food, Drug and Grapefruit Interactions, which provide ready reference to some of the most important problems. Anyone who would like copies, please send $2 in check or money order with a long (No. 10), stamped, self-addressed envelope to: Graedons' People's Pharmacy, No. FJ-19, P.O. Box 52027, Durham, N.C. 27717-2027.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of the People's Pharmacy, P.O. Box 52027, Durham, N.C. 27717, or e-mail them via their Web site (www.peoplespharmacy.com) on the HealthCentral.com network.
King Features Syndicate