Q. I have no confidence that any generic drug actually contains its active ingredient in the right amount and is not contaminated. I recently had bronchitis and took the generic antibiotic doxycycline. It had no effect.
Then I read the People’s Pharmacy article about authorized generics and got the authorized generic of doxycycline. That worked. Amazing. Recently, my pharmacy told me that the authorized generic of doxycycline has been discontinued.
The new book “Bottle of Lies,” by Katherine Eban, is a well-researched story of how Food and Drug Administration inspectors in India and China found repeated pharmaceutical company deception, failure and contamination. The FDA repeatedly failed to take action.
Generic drugs were a great idea, an appropriate public service. That idea has been corrupted by greed and helped along by FDA inaction. Americans no longer benefit; it seems that only the brand-name pharma companies benefit from the current situation.
A. Authorized generic drugs are made with the same “recipe” as their brand-name counterparts. Sometimes they are even made on the same factory line. We encourage people to request an authorized generic if they have concerns about their medication.
We are glad you found Katherine Eban’s book helpful. We recommend it highly for anyone who wants to understand the problems with generic drugs.
One pharmacy that tests every lot of medicine it dispenses is www.Valisure.com. That way, you can be assured there are no contaminants and that the product contains the right amount of medicine.
Q. Is there an alternative to amitriptyline? I often have trouble getting to sleep, and when I do get to sleep, I keep waking up. My doctor prescribed amitriptyline, but I have read that it has anticholinergic activity. I worry about this, as I do not want to develop dementia.
A. People who take drugs with anticholinergic activity do have a higher risk for developing dementia (JAMA Internal Medicine, June 24, 2019). As a result, it makes sense to avoid taking them when possible.
One alternative to sleeping pills of any sort is cognitive behavior therapy for insomnia (Systematic Reviews, Nov. 15, 2019).
We discuss nondrug approaches to overcoming insomnia as well as the pros and cons of sleep medicines in our eGuide to Getting a Good Night’s Sleep. You will find it in the Health eGuides section of www.PeoplesPharmacy.com.
You may find that acupuncture can help you sleep better (Evidence-Based Complementary and Alternative Medicine, June 13, 2019). Other approaches that can be helpful are physical activity during the day and a hot bath about an hour before bedtime.
Q. I take Trelegy daily for COPD. This drug has made me hoarse, but I am reluctant to take more medicine to treat a side effect. Is there a natural remedy?
A. Trelegy is an inhaler that contains three medications: fluticasone, umeclidinium and vilanterol. Fluticasone is a corticosteroid drug that can cause hoarseness when it is inhaled. Unfortunately, the only sure-fire way to overcome the hoarseness is to discontinue the drug. Since you need the medicine for your COPD (chronic obstructive pulmonary disease), dropping the drug is not an option.
The manufacturer suggests that you rinse your mouth after using the inhaler. That may somewhat reduce the likelihood of hoarseness.
(In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, Fla. 32803, or email them via their website: www.PeoplesPharmacy.com.)