Q. I was prescribed pantoprazole for problems with Gastroesophageal reflux disease. When I took the first dose, it was like a miracle — my reflux symptoms disappeared overnight.

The relief continued until I refilled the prescription. On the new refill, my daily symptoms resumed immediately. My doctor couldn’t explain why my heartburn returned.

It then occurred to me that my problems started right after the refill. I spoke to my pharmacy and received a new 30-day supply. After taking the first dose, my symptoms again disappeared completely.

The pharmacy said they had no way to verify whether the pills from the previous refill were defective. I filed a complaint with the Food and Drug Administration on Form 3500 reporting the lack of efficacy with the drug I received. A few days later, the drug manufacturer sent me a questionnaire.

It bothers me that the FDA is asking the drug company to investigate itself. It also bothers me that my pharmacist did not know to direct me to FDA Form 3500. Apparently, no one is really looking out for the millions of generic drugs being administered.

A. We have been alarmed about the FDA’s lax oversight of generic drug quality for many years. Investigative reports from ProPublica and Bloomberg have revealed a shocking lack of federal concern about quality. We are also disturbed that many pharmacists and physicians have seemingly ignored this problem.

To learn more about this serious situation, you may want to read our book, “Top Screwups Doctors Make and How to Avoid Them.” It provides practical information for patients and encourages health professionals to take this crisis seriously. You can find “Top Screwups” in the book section of the store at www.PeoplesPharmacy.com. Consider giving a copy to your doctor or pharmacist.

Q. I have suffered for years with dry, cracked, split fingertips both in winter and summer. Gardening really dries my hands out. The splits make normal daily activities very painful. Until this started, I never realized just how many activities involve using the hands, especially the fingertips and thumbs.

I have used hand lotions and petroleum jelly and nothing helped. Finally, I stumbled on nystatin. After six years of being in misery, I am finally healed. Perhaps others will also benefit.

A. Nystatin is a prescription antifungal medication. The fact that it worked for your sore split fingertips suggests that the skin was infected with fungus. Such fungal infections can resemble the irritation of eczema, but they are more persistent.

Others who might want to consider your approach could try an over-the-counter antifungal cream such as terbinafine or tolnaftate. As a prescription antifungal, however, nystatin is more potent.

Q. Years ago, I had huge problems getting a good night’s sleep. When my doctor ordered a sleep study, I was informed that my breathing stopped around 25 times an hour! The diagnosis was sleep apnea, even though I was young, thin and didn’t snore.

A CPAP machine changed my life. I would encourage folks with persistent insomnia to ask about a sleep study.

A. Untreated obstructive sleep apnea can lead to health problems such as high blood pressure or diabetes as well as fatigue.

The usual treatment is, as you have outlined, continuous positive airway pressure. This is delivered through a CPAP machine that simply doesn’t let you stop breathing. A sleep doctor can also prescribe other options such as lifestyle changes or oral devices.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”