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Q. I think Praluent has been a lifesaver in my case.
My dad had a stroke, and with plaque in my carotid arteries, I feared I was headed for one.
My vascular doctor has done sonograms, and the plaque is less now since I started taking Praluent. I couldn't take statins because of side effects. And even though I don't like needles, I don't have any problem using the Praluent pens.
A. Thanks for sharing your experience. We'll never know whether you would have had a stroke, but reducing plaque in the carotid arteries seems like a helpful step. A meta-analysis shows that when 319 people take alirocumab (Praluent) for a year and a half, one of them will be able to prevent a stroke (Frontiers in Cardiovascular Medicine, Dec. 2, 2022).
The new pill enlicitide (Lipfendra) works on the same PCSK9 pathway as Praluent (alirocumab). There are not yet clinical trial data to show if or how well it may prevent strokes or heart attacks.
You can learn more about the PCSK9 inhibitors as well as inclisiran (Leqvio) in our "eGuide to Cholesterol Control & Heart Health." This online resource may be found under the Health eGuides tab at www.PeoplesPharmacy.com.
Q. You've written about the PM pain relievers making some people unable to sleep. I also had that reaction with the Benadryl cough syrup that my doctor recommended. It's a real problem.
A. It's not surprising that you experienced paradoxical excitation with Benadryl. The active ingredient, diphenhydramine, is the same ingredient in PM pain relievers. Although this old-fashioned antihistamine makes most people feel drowsy, some react to it by feeling restless or anxious. Those with restless leg syndrome often find that it exacerbates those sleep-wrecking symptoms.
Q. For many years, I suffered from urinary tract infections on a regular basis and was told the problem was my hygiene: I wasn't wiping correctly (in spite of my being very careful). I heard this answer for years, that the infections were my fault.
Finally, in 2019, I had surgery for a complete pelvic prolapse. My surgeon prescribed vaginal estrogen cream (Premarin). When I moved two years ago, my prescription changed to an estradiol cream, which I've used ever since. And, miraculously, I've not had a single UTI in all the years following my surgery. It is such a relief!
A. Recurrent urinary tract infections (UTIs) make some women miserable. This problem is particularly common after menopause.
Vaginal estrogen cream has been recommended. In one study, more than two-thirds of the postmenopausal women experiencing recurrent UTIs got good relief when they used vaginal estrogen cream (Female Pelvic Medicine & Reconstructive Surgery, March 1, 2021). An earlier study found that 45% of women with recurrent UTIs remained symptom-free while using the Estring vaginal ring compared to 20% of those in the control group (American Journal of Obstetrics and Gynecology, May 1999).
Q. I've read that GLP-1 drugs like Ozempic can cause vision problems. What do you know about that?
A. A study of 185,066 people with Type 2 diabetes found that those taking a GLP-1 agonist had a slightly higher risk of developing diabetic retinopathy but a lower likelihood of serious complications such as vision loss (JAMA Network Open, Aug. 11, 2025). The risk of nonarteritic anterior ischemic optic neuropathy (NAION) was not significantly different among those on GLP-1 drugs and those on other diabetes medicines.
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."