Q. I read in your column about nicotine patches helping with memory. I have been trying them, and I do feel sharper. I’m not sure if this effect is real or placebo. That said, my question is how long should I use the patches to get the maximum benefit? Will my brain fog return if I stop? Is this a lifetime commitment?

A. The data on nicotine helping memory are intriguing but still controversial. A meta-analysis of randomized clinical trials reported that “Nicotine patches boosted cognitive function in healthy adults” (Acta Neurologica Scandinavica, August 2021).

A small study of people with attention deficit hyperactivity disorder (ADHD) found that “Nicotine increased subjective concentration and alertness for participants with ADHD but not controls …” (Journal of Psychopharmacology, July 2025). On the other hand, in the MIND study (Memory Improvement through Nicotine Dosing) nicotine patches did not help people with mild cognitive impairment over two years.

As a result of conflicting data, we cannot make any recommendations. Please discuss your use of nicotine patches with your health care provider.

Q. My doctor urged me to take Jardiance for Type 2 diabetes. When I did some research on this medication, I found that it could cause “necrotizing fasciitis of the perineum.” This is a flesh-eating disease of the area from the vagina to the anus.

The commercials I’ve seen lately mention this side effect in a less threatening way as an “irritation.” That’s so misleading!

A. When we watched a current Jardiance commercial, we found this: “Serious side effects include increased ketones in blood or urine and infection between and around the anus and genitals, both may be fatal … Tell your doctor about lightheadedness, weakness, fever, pain, tenderness, redness, or swelling between the anus and genitals. You may have increased risk for lower limb loss.”

That is certainly a sobering prospect, even if it is relatively rare. The Food and Drug Administration warns that this entire class of medications (SGLT2 inhibitors) can cause life-threatening complications.

There are many other options for managing Type 2 diabetes. We have discussed them in detail in our “eGuide to Preventing and Treating Diabetes.” This online resource can be found under the Health eGuides tab at www.PeoplesPharmacy.com.

Q. You wrote in your column that using azelastine (Astepro) may reduce infections of flu and COVID-19. In addition, you suggested using it before being exposed to crowded places.

My question is whether this antihistamine could be used on an as-needed basis: a spray before going to the grocery store or concert or airport, for example. The study cited says the participants used the spray three times a day for a period of time.

I do not need this product for allergies and would not choose to use it on a regular basis but would definitely use it “as needed” for antiviral protection. If a single use now and then is not helpful, that would be worth knowing. The Astepro package warns users not to exceed usage guidelines. Are the protective benefits of Astepro only for regular users?

A. Researchers in Germany studied the topical antihistamine azelastine against COVID-19 infection (JAMA Internal Medicine, Nov. 1, 2025). 450 volunteers in the study used Astepro or a placebo nasal spray three times a day for about two months. Those using azelastine were 70% less likely to get sick.

Your question is excellent, but we don’t have the data to answer it. Because Astepro has antiviral activity, it might work “as needed,” but that approach has not yet been tested (Viruses, Nov. 23, 2023).

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 300 W. 57th Street, 41st Floor, New York, NY 10019, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”