Question: I love the down-to-earth drug information in your columns, with the pros and cons of various medications.
After reading about the “new” wonder drug aspirin, I started taking an enteric-coated low-dose tablet a few times a week. My concerns are stroke and cancer, but I have a history of GERD (gastroesophageal reflux disease) and ulcers.
Recently I read that enteric-coated tablets could burn holes in my intestines. Not good! Is there any way to safely ingest aspirin and get the health benefits without suffering intestinal issues?
Answer: You are right that aspirin can be very irritating to the digestive tract. Ordinary aspirin tablets are notorious for causing stomach ulcers. Even enteric-coated tablets may damage the lining of the small intestines (International Journal of General Medicine, Aug. 24, 2021).
We recently learned about a new aspirin formulation. It provides a liquid inside a capsule that releases the aspirin in the small intestine. The aspirin is complexed with a phospholipid that hangs on to it so long as the environment is acidic -- which the stomach is.
This unique aspirin product is sold under the brand name Vazalore in both low-dose (81 mg) and regular-strength (325 mg) capsules. One study in the American Journal of Gastroenterology (February 2011) suggests that this lipid-complex aspirin formulation may be less likely to damage the gastrointestinal tract.
Before undertaking long-term aspirin use, however, you should talk with your doctor about the pros and cons. The U.S. Preventive Services Task Force recently issued recommendations discouraging the routine use of aspirin to prevent initial heart attacks, strokes and cancer.
Question: Thank you for writing about home tests for COVID-19. I developed a headache and sore throat while at work (at a school). Because it took two days to get a PCR test and another three days to get the results, I ended up taking several days off work. Meanwhile, my symptoms quickly abated.
When I was later exposed repeatedly to a student who then tested positive, I opted for the home tests. Since I got negative results on both tests 24 hours apart and had no symptoms, I did not need to take time off. That was well worth the $24!
Answer: There are now several Food and Drug Administration-approved home tests for COVID-19. While not as accurate as the PCR test, they are much faster and more convenient.
The way you used your at-home diagnostic kit, taking two tests a day apart, is recommended. This reduces the chance that the initial negative test was inaccurate.
If more people used such a strategy before interacting with others who might be vulnerable, it could reduce the spread of COVID-19. This would be especially helpful before gathering for family get-togethers over the upcoming holidays.
Question: I am prone to cold sores/fever blisters and find that acyclovir works very well. Before that I took L-lysine for several years hoping to prevent outbreaks. However, I discovered that L-lysine caused me nightly leg cramps.
My internist, who wasn’t familiar with acyclovir until I told her about it, will not give me a refill without my calling for it. Consequently, I am very careful to call for a refill as soon as I am finishing a prescription, because I need to take the pills at that very first tingle. People who haven’t had fever blisters might not understand that urgency.
Answer: There are several antiviral medications that work quite well against herpes simplex, the virus that causes cold sores. Acyclovir (Zovirax) was the first to be developed, but doctors can also prescribe famciclovir (Famvir) or valacyclovir (Valtrex). We’re a bit surprised that your internist was unaware of such medications.
Taking any of these herpes drugs at the earliest hint of an outbreak works best. That is also true of other antiviral drugs such as oseltamivir (Tamiflu) or baloxavir (Xofluza) against influenza.
Question: If I feel a cold coming on, I take zinc. I myself don’t have any side effects from it.
However, I recommended it for my son once, and it made him very nauseated. Now, of course, he won’t take my advice for any remedy. The nausea side effect of zinc is real, but not everyone suffers from it.
Answer: Doctors have been debating the pros and cons of zinc to prevent or treat common colds for a long time. However, the scientific evidence keeps building that zinc can help fight these respiratory tract viral infections.
The most recent research is a meta-analysis of 28 randomized, controlled trials published in BMJ Open (Nov. 2, 2021). In comparison with placebo, zinc prevented five colds per 100 person-months. When people took zinc to treat rather than prevent a cold, they got better about two days sooner, on average.
Some people reported nausea as a reaction. As your son can attest, nausea may be more of a problem for some than for others.
Joe Graedon is a pharmacologist; Dr. Teresa Graedon is a medical anthropologist and nutrition expert. Questions for the Graedons can be sent to them using their website, www.peoplespharmacy.com, or by writing to the following address: Graedons’ People’s Pharmacy, King Features, 628 Virginia Drive, Orlando, FL 32803.