Question: My husband, son and I all have been diagnosed with major depression and prescribed Wellbutrin XL. We can’t afford the brand name for all of us, so I’ve looked for an authorized generic. I couldn’t find it. Is there one?
Recently, my son’s prescription was filled with bupropion from an Indian manufacturer. After reading Katherine Eban’s book, “Bottle of Lies,” I’d like to return the generic drug. But I don’t know which manufacturer to request instead.
Answer: As far as we can tell, there is no authorized generic version of Wellbutrin XL. An authorized generic drug is manufactured with the same formulation as the brand-name medicine, frequently on the same production line. That is why people who are concerned about generic drug quality often request the authorized generic, if there is one.
You may still be able to save money on your antidepressant, however. Although Wellbutrin XL 300 could cost more than $2,000 for a month’s supply in the U.S., ordering this brand-name medicine from a legitimate Canadian pharmacy would result in a monthly bill between $43 and $60 for 30 pills.
Question: If you know you have been exposed to influenza, start taking an antiviral drug immediately. If you begin the drug as soon as you are exposed, you will significantly lower your chances of getting sick at all.
I was in a situation where four people (three adults and an infant) were exposed to a confirmed case of influenza. We all got prescriptions for Tamiflu, and three of us started taking it immediately. One adult decided to skip the Tamiflu. The people who took the medicine never had any symptoms at all. The one who did not came down with a miserable case of influenza and took a month to recover from it.
Answer: The Centers for Disease Control and Prevention states: “Antiviral medications are an important adjunct to flu vaccine in the control of influenza. Almost all (greater than 99%) of the influenza viruses tested this season are susceptible to the four Food and Drug Administration-approved influenza antiviral medications recommended for use in the U.S. this season.” Drugs like oseltamivir (Tamiflu) or baloxavir (Xofluza) work best when taken within 24 to 48 hours of exposure.
Question: After applying sunscreen to my face, my eyes get irritated within 30 minutes. It doesn’t matter whether I sweat or not.
Over the past two years, I’ve had four surgeries and one cauterization for basal and squamous cell growths. In the past 10 years, I’ve had more actinic keratoses frozen than I can count. But I can’t manage without some sun. Do you have any recommendations on sunscreen that won’t be irritating?
Answer: We’d suggest looking for a sunscreen with zinc oxide or titanium dioxide as the active ingredient. The nonprofit Environmental Working Group rates these as safe and effective. They caution that safety data on other compounds, such as oxybenzone, are incomplete. A recent study showed that people absorb such chemicals into their bloodstreams (JAMA, Jan. 21, 2020).
Other readers have found that mineral-based sunscreens are less irritating to the eyes. One wrote: “I use only products containing zinc oxide and/or titanium dioxide. If I apply products with other ingredients to my face, my eyes are irritated for hours afterward.”
Question: When I’ve asked health professionals to wash their hands before touching me, most of the time they say they have used the hand sanitizer outside the door, then opened the door. It is sad there are no longer sinks with soap dispensers and water in the exam rooms to save costs and time while putting us patients at risk.
Answer: We agree that soap and water might be better than hand sanitizer, especially if someone has to touch the (potentially contaminated) doorknob after using the sanitizer. Alcohol-based sanitizers seem to work against many bacteria but are less effective against viruses (Journal of Food Protection, June 2016).
Recent research on the drug-resistant fungus Candida auris suggests that first washing with soap and water, drying the hands, then applying alcohol-based gel works to remove the microbe (Journal of Infection and Public Health, Jan. 28, 2020).