The People's Pharmacy

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

Q. My primary care doctor prescribed Voltaren Gel last year when he diagnosed me with arthritis in my thumb. I was having trouble sleeping at night because it was throbbing so badly.

I can’t take oral NSAIDS, but I’m super pleased with how this gel works. Within a few minutes of application, my thumb is pain free. The relief lasts for hours. I usually apply it only at night.

In my opinion, this should be taken off the prescription list here in America. It should be more readily available, as the only downside is the expense.

A. Good news. The active ingredient diclofenac is now available without a prescription as Voltaren Arthritis Pain Gel.

The prescription that your doctor wrote was likely for a 100-gram (3.5 ounce) tube of 1% diclofenac. It costs around $70. The OTC product costs about $10 for a tube half that size. That means the nonprescription gel costs less than a third as much as the prescription product.

We are glad to learn that you have not experienced side effects. Some people are so sensitive to NSAIDs that even a topical gel causes them digestive distress.

To learn more about the pros and cons of topical NSAIDs like Voltaren, you may wish to read our book “Alternatives for Arthritis.” It describes many other treatments for joint pain, including nondrug natural options. You can also order it online in the Books section of the store at www.peoplespharmacy.com.

Q. I had been taking the blood pressure pill amlodipine for five years. Then, about three months ago, my feet and ankles swelled up like tree trunks all of a sudden.

My doctor didn’t think amlodipine would do that after so much time, but I convinced him I should quit taking the medicine. The swelling has gone down completely now. How common is this side effect?

A. Amlodipine (Norvasc) is a popular blood pressure pill in the calcium channel blocker (CCB) category. Women may be more susceptible than men to swelling of the legs and feet due to this medication.

A review of more than 100 studies concluded that the longer people take CCBs, the more likely they are to experience this type of edema (Journal of Hypertension, July 2011). Up to a quarter of patients may eventually develop this complication. We hope your doctor has found a different kind of medication to help you control your blood pressure without unpleasant side effects.

Q. Why don’t you recommend baking soda for heartburn? I haven’t seen it in your columns, but it gives me fast relief with no side effects. I don’t have heartburn every day, but when it hits me at night, I don’t want to suffer for any length of time.

A. Baking soda (sodium bicarbonate) is an old-fashioned antacid. How old? Some medical historians trace its origins back to 3000 BC and the ancient Sumerians. They used burned seaweed containing sodium carbonate to ease indigestion.

Modern baking soda is not derived from plants, though. It is still used for heartburn. The directions on the box recommend 1/2 teaspoon dissolved in 4 ounces of water. Relief is fast but temporary. People with high blood pressure should be cautious about the sodium content of this home remedy.

(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.)

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