Q. I was prescribed finasteride because I had to get up many times each night to urinate. Finasteride was effective for the nocturia caused by my enlarged prostate gland.
Unfortunately, I had side effects that diminished my sexual experience. Hoping to recover my sex drive and erectile function, I started cutting the tablets in half. I took that half dose for about six months, with no abatement of the side effects.
I've now been off finasteride for three months, but I still have sexual problems. At this point, I would trade a little nocturia for a better sexual experience.
A. Research published in the journal PeerJ (March 9, 2017) reports that sexual side effects are a risk with drugs like dutasteride (Avodart) and finasteride (Proscar). The longer men take such drugs, the greater the chance of persistent erectile dysfunction.
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Even after discontinuing these prostate medications, some men continue to have difficulty with libido and erections. A few report that sex is no longer pleasurable.
Q. My doctor prescribed Lovaza for high triglycerides and cholesterol. To my amazement, it also helped with some other unrelated problems ranging from pain on the soles of my feet to stiff neck and joint mobility.
I even noticed effects on the texture of my skin. This is the first natural medication I have received from my physician, and I am very pleased.
A. Lovaza (omega-3 acid) is highly purified and concentrated fish oil. The Food and Drug Administration approved this prescription product to lower high triglycerides.
Fish oil has anti-inflammatory activity (Annals of the Rheumatic Diseases, January 2016). Although well-controlled trials have not confirmed benefits against arthritis symptoms, you are not the first to report reduced joint pain from taking fish oil.
For those who would like to learn more about natural approaches to controlling arthritis, we offer our expanded and revised Guide to Alternatives for Arthritis. This online resource is available at www.PeoplesPharmacy.com.
One disadvantage of Lovaza is the cost. The standard dose is 4 grams (four pills daily). A month's supply (120 capsules) could cost more than $250 if your insurance company doesn't pay for it.
Q. My doctor prescribed Xyzal for allergies. When I stopped this antihistamine a few days ago, I started to itch. This is unbearable. Is there an antidote?
A. Levocetirizine (Xyzal) is, like its cousin cetirizine (Zyrtec), used to control seasonal allergies. Some people report unbearable itching that lasts for several weeks when they stop either medication. This appears to be a rebound histamine reaction (Drug Safety Case Reports, December 2016). Xyzal is now available without a prescription.
Q. I have been taking Zetia together with simvastatin, and my cholesterol is under control.
Months ago, I started getting floating stool. I think Zetia works by limiting the intestine's ability to extract fat from the stool. I imagine that would make the stool lighter than water, causing it to float. My floating stool is constant, and I have gas every day no matter what I eat. I have no discomfort or any other negative symptom. Is this floating stool an unadvertised side effect of Zetia?
A. Your floating stool may not be a problem. On the other hand, you might ask your doctor to evaluate your pancreatic function. There are reports of inflammation of the pancreas (pancreatitis) associated with ezetimibe (Zetia) and statins like simvastatin (World Journal of Gastrointestinal Pharmacology and Therapeutics, August 2014). One symptom of pancreatitis is fatty stools that float (steatorrhea).
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 at Questions@PeoplesPharmacy.com. Their newest book is "Top Screwups Doctors Make and How to Avoid Them."