People's Pharmacy


My doctor prescribed tramadol with APAP for headaches. He also wrote prescriptions for Lexapro and Effexor for depression and anxiety. He said that Effexor and Lexapro are antidepressants, but they work on different parts of the brain.

When I went to fill the new Lexapro and refill the tramadol prescriptions, the pharmacist would not fill them. She said the combination could cause side effects. What would those be?

Your pharmacist might have saved your life. The combination of Lexapro, Effexor and tramadol (Ultram) could have raised serotonin to dangerous levels (serotonin syndrome). In such situations, people may experience symptoms such as anxiety, agitation, muscle twitches, sweating, high blood pressure, confusion, hallucinations, convulsions and even coma.

Three years ago, you ran a letter from someone who said that patting cornstarch on her face with a cotton ball had helped her rosacea. I'd like to thank that person. I've tried many products through the years without much success, but the cornstarch works better than anything. What a simple, cheap remedy!

Thanks for sharing your interesting experience. Another reader reported: "I have had rosacea - dry, flaky reddened facial skin - for years. I decided to try vinegar as a facial cleanser. I dampen a cloth with it and wipe my face once daily. My facial skin has not felt this smooth or been this free of redness for a long time."

People who don't find such home remedies helpful might be pleased to learn that the Food and Drug Administration recently approved a new prescription drug for this hard-to-treat skin condition. Oracea contains a low-dose formulation of doxycycline (40 mg). Results from clinical trials indicate that Oracea has anti-inflammatory activity against the "pimples" of rosacea and does not seem to trigger antibiotic resistance or typical side effects. Oracea should reach pharmacy shelves next month.

My friend is diabetic and suffers from nerve pain in his legs. What are some ways to treat this problem?

Diabetic nerve pain (neuropathy) can be debilitating. The burning can be unbearable, and the loss of feeling in the feet is dangerous. A drug called Lyrica is approved for treating this condition. Side effects may include dizziness, drowsiness, weight gain, blurred vision, fluid retention and dry mouth. The antidepressant Cymbalta has also been shown to help ease diabetic neuropathy. Adverse reactions to watch for include nausea, dizziness, drowsiness, constipation, dry mouth and sweating.

Another option may be alpha-lipoic acid. This natural antioxidant, available at health food stores, has been shown to help reverse symptoms for some people.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or e-mail them via their Web site:

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