Question: I’ve taken fish oil successfully for years for lupus, osteoarthritis, dry eye and cardiovascular benefits. Three different specialists recommended it. Even if they changed their minds about it tomorrow, their updated opinion wouldn’t alter my opinion on the benefits of fish oil.
I’ve found that quality matters for fish oil, as it does in many things in life. The amount and ratio of EPA and DHA are also important.
Answer: A recent review of three large randomized controlled trials concluded that marine omega-3 fats (fish oil) can reduce the risk of cardiac complications and death from cardiovascular causes (Mayo Clinic Proceedings, online, Oct. 15, 2019). One of these trials (REDUCE-IT) used a prescription pharmaceutical EPA product, Vascepa.
A different meta-analysis published in the Journal of the American Heart Association (Oct. 1, 2019) also concluded that fish oil supplements can reduce the risk of heart attacks and death from cardiovascular disease. In addition, there is evidence that omega-3 fats have potential in treating autoimmune diseases like yours (Frontiers in Immunology, Sept. 27, 2019).
Question: I have been on clonazepam, amitriptyline, levothyroxine, atorvastatin, atenolol and warfarin since 1994. Last Christmas, I received my first generics from Indian manufacturers. This has been a nightmare, so I now buy brand-name Klonopin and attempt to get as many of my drugs as possible from Canada.
Too many generic drugs are not working because the Food and Drug Administration cannot monitor all offshore Indian and Chinese manufacturers. I have had credible sources tell me that drug companies overseas check flight manifests to see when American FDA inspectors are coming.
Please send letters to the FDA to try to effect change. Bring drug manufacturing back to the U.S. where the agency can monitor it properly!
Answer: You will be very interested in Katherine Eban’s new book, “Bottle of Lies: The Inside Story of the Generic Drug Boom.” She covers the FDA’s ineffectual struggles to oversee generic drug manufacturing outside the country, especially in India and China.
Others may wish to know how to buy medications from Canada. Brand-name drugs are frequently much more affordable at reputable Canadian pharmacies.
To learn more about how to distinguish legitimate Canadian online pharmacies from counterfeit operations, you may wish to read our eGuide to Saving Money on Medicines. You can find this electronic resource at www.PeoplesPharmacy.com in our Health eGuides section.
Question: Recently my wife had revision hip surgery. The orthopedic surgeon prescribed a single 325-mg aspirin tablet a day.
In a previous episode, she was prescribed Lovenox, an injectable blood clot preventive. The Lovenox cost $750, whereas the aspirin was just pocket change. Maybe doctors are starting to move away from high-cost drugs.
Answer: After joint replacement surgery, doctors often prescribe an anticoagulant to prevent life-threatening blood clots. A study in JAMA Surgery (January 2019) demonstrated that aspirin was comparable to far more expensive anticoagulants.
A new study in Orthopedic Surgery (October 2019) compared aspirin to rivaroxaban (Xarelto) after hip fracture surgery. The surgeons concluded that “Aspirin may be an effective, safe, convenient and cheap alternative for extended prophylaxis after hip fracture surgery.”
Question: Can you tell me about Repatha? Are the people who take it actually helped by it? What about side effects? Is lowering cholesterol worth the risks of taking this?
Answer: Evolocumab (Repatha) is an injectable medication used to lower LDL cholesterol even more than statins alone. In one major study, people taking Repatha were less likely to suffer heart attacks or strokes but no less likely to die prematurely (New England Journal of Medicine, May 4, 2017).
Upper respiratory tract infections, including flu, were reported more often by people taking Repatha. Other side effects may include sore throat, sinusitis, gastroenteritis and injection site reactions.
You should discuss the pros and cons of this medication with your doctor. If you have heart disease and are at high risk of a heart attack or stroke, this drug might offer benefit.