The People's Pharmacy

Joe Graedon, M.S.,and Teresa Graedon, Ph.D.

Q. What do you think of Vascepa? I understand it is a kind of purified fish oil with only EPA. That means it has no contaminants, such as mercury.

EPA is a strong anti-inflammatory. It contains no DHA and there’s no risk of it being rancid.

A. Vascepa (icosapent ethyl) is a highly purified form of the omega-3 fatty acid, eicosapentaenoic acid (EPA). Doctors prescribe it to lower triglyceride levels and reduce the risk of heart attacks and strokes.

Many consumers opt for over-the-counter fish oil capsules to reduce inflammation. Such products often contain both EPA and DHA (docosahexaenoic acid). A new study suggests that EPA-rich supplements improve performance on tests of verbal fluency, word recall, reaction time and numeric working memory as well as rapid visual information processing (American Journal of Clinical Nutrition, September 2021). This study was conducted with fish oil from BASF and not with Vascepa.

Side effects of Vascepa include an increased risk of atrial fibrillation or of excessive bleeding. Other complications may include muscle and joint pain, gout, edema and constipation.

Q. Have you heard of any Food and Drug Administration concerns with Revlimid coming from pharmaceutical companies in India? The price in the U.S. is outrageous, especially for a senior citizen.

A. We understand your dilemma. Revlimid (lenalidomide) is a critical medicine for the treatment of the blood cancer multiple myeloma. In the U.S., each pill can cost as much as $800. The normal cycle requires 21 days of treatment a month. That could lead to a bill of around $17,000. Even if you have insurance, the copay might be huge.

The FDA has not been able to inspect most foreign manufacturing plants since early in the pandemic. As a result, it’s hard to verify the quality of many medications made abroad. Your physician will need to monitor your progress carefully to make sure the medicine is working as anticipated.

One other option may be to seek financial help. Several patient assistance programs provide significant discounts for underinsured or low-income individuals on Revlimid. Each has its own eligibility requirements, but your oncologist might have someone on staff who could help you sort through them.

Q. I took lisinopril for three days and had an angioedema reaction. Luckily, the doctors in the emergency room diagnosed it quickly. They said they see this kind of reaction from lisinopril quite often.

This is one of the most frightening experiences I’ve ever had. My throat swelled shut. They pumped me full of steroids and kept me overnight for observation. The specialist I saw afterward said he also sees this pretty often.

A. Lisinopril is the most commonly prescribed blood pressure medicine in the U.S. Many people tolerate it reasonably well. The most common side effect is a persistent cough that does not respond to treatment. It can be incredibly disruptive and keep people awake at night.

The angioedema complication you experienced is indeed potentially life threatening, as it can interfere with breathing. When the swelling occurs in the digestive tract, it can cause intestinal obstruction.

(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:

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