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Generics don't always equal original



Published: Sat, April 9, 2005 @ 12:00 a.m.



Q. My husband has been taking Prozac successfully for years. He was recently switched to generic fluoxetine. In the past several months he has become much the same person he was before Prozac -- angry, depressed and easily irritated. The pharmacist says the generic is the exact same ingredient. Would it help for him to go back to Prozac?

A. It might be worth a try. Another reader had a similar experience with fluoxetine: "My husband has taken Prozac faithfully for about three years. We get our prescriptions through a mail-order pharmacy.

"He sent in a new prescription for Prozac because all his refills had run out. Four to five days after the new bottle arrived, I noticed a lot of his old symptoms reappearing. He said he was taking the medicine but the capsules looked different.

"The bottle was labeled fluoxetine. The mail-order pharmacy told him that unless the doctor wrote 'Dispense as Written,' they would send this generic.

& quot;The doctor wrote him another prescription for Prozac with a note not to substitute. Within a few days of starting back on Prozac, we both could tell that the drug was working again."

Q. I've been reading about athletes taking steroids. It confuses me that people think this is terrible. My doctor prescribes Flonase for my allergies. This is an inhaled steroid. What's the difference?

A. Some athletes have been abusing anabolic steroids. These are male hormones related to testosterone.

Corticosteroids, like Flonase or prednisone, are related to cortisone, a natural anti-inflammatory compound. They are used to treat conditions such as asthma, allergy or arthritis. The benefits and risks of corticosteroids are SO different from those of anabolic steroids.

Q. I had a terrible experience with naproxen (Aleve). I am healthy but have a touch of arthritis pain in the knee. I bought some Aleve and read the label. It said not to take it if you've had allergic reactions to any other pain reliever or if you take more than three alcohol drinks daily.

I am not allergic to anything and do not drink alcohol. But just one pill made me itch and break out in hives. My lips and face swelled and turned bright red, and I was too dizzy to stand.

I am amazed that this medication is available over the counter. I hate to think what would have happened if I had taken two pills instead of one!

A. Allergic reactions like yours have been reported with Aleve and other pain relievers, but they are uncommon. You will need to avoid other drugs in this class, like aspirin and ibuprofen. Be sure to alert your doctor to this situation.

Q. I've been using Afrin nasal spray because of a cold. Now I can't breathe through my nose when the Afrin wears off. Is there something I can do to begin breathing naturally?

A. Long-term use of decongestant nasal sprays can lead to rebound congestion when they are stopped. To get around this, try discontinuing use of the spray in just one nostril at a time. You can also dilute the Afrin progressively with saline nasal spray.

XIn their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features Syndicate, 888 Seventh Ave., New York, NY 10019, or e-mail them at peoplespharmacy@gmail.com or via their Web site: www.peoplespharmacy.org.

& copy; 2005 King Features Syndicate Inc.




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