Question of the Day
You’ve heard it before but it bears repeating – there are no stupid questions. We thought it would be fun to post random questions that we are asked throughout our work days and from this site. So, if you have any random questions J please leave us a comment or send us an email – nova@getpharmacyadvice.com or cate@getpharmacyadvice.com . We will talk about whatever you are interested in!
I ate my Chia Pet’s sprouts on a dare -is that bad?
Not at all! Actually Chia sprouts and chia seeds are edible and good for your health! If you want to learn more -please read Chia for Your Health.
Is there a substitute for Xyzal 5mg?
Currently, there is not a generic available for Xyzal 5mg but there are some alternatives. Xyzal works similarly to Allegra (fexofenadine) which is a prescription antihistamine (available in generic). OTC generics include Claritin (loratadine) or Zyrtec (cetirizine). There are also some antihistamine eye drops and nose spray that often are used along with an oral antihistamine.
A woman asked via email, “I read your article on the Neti Pot. I’ve always had low blood pressure but just found I am now borderline (140/80). Only change in life is using the Neti Pot daily for 1 year -could that cause it?”
No, there is no known link between use of the Neti Pot and high blood pressure. Your question does make me wonder what led you to use the Neti Pot daily for the last year -perhaps it is related to the bump in blood pressure…?
Sometimes people are concerned with the “salt water” used in the Neti Pot being able to raise blood pressure. This is a false concern because 1. Very little of the irrigation solution is absorbed into the body and 2. The salt level in the irrigation solution is equal to the body’s salt level so the salt can not pass into the body due to osmotic pressure.
A mom wrote in a recent email, “Can I give my daughter Mucinex for Kids and Children’s Motrin at the same time?”
Yes -it is okay to give the Mucinex and Motrin at the same time. There are different medications in each. It is good to ask and be cautious, especially with combination products.
A patient came into the pharmacy this morning and asked, “My doctor told me once I take Nexium for a few weeks, I no longer need to take it on an empty stomach…is that right?”
First, a little background info -Nexium along with Prilosec (omprazole), Aciphex and Prevacid (lansoprazole) -and a couple others- are in a class of drugs called proton pump inhibitor (PPI). PPIs are used to treat issues related to acid in the stomach (like GERD or heartburn).
A popular false rumor was started that once a PPI is taken for a few weeks, timing doesn’t matter.
Untrue! Just remember, PPIs are most effective if taken on an empty stomach 30 to 6o minutes before eating.
A dad wrote, “I’ve been surfing (and surfing), looking for an answer to (what I thought) was a simple question, so I’m hoping you can advise: My daughter had an upset stomach (vomiting), so I gave her some Pepto. I then discovered it had expired by about a year. Is there any danger in this? I’ve since thrown it out once I realised, but just wanted some reassurance that there was no serious danger.”
Taking expired Pepto is not known to cause any issues -so I would not worry. However, Pepto is not good to give to kids under 12 years of age. Pepto contains bismuth salicylate which is like aspirin. Aspirin (and Pepto) can cause Reye’s Syndrome in children -it is a very small but serious risk. There is Children’s Pepto that contains calcium carbonate (like Tums) -and does not have any risk of causing Reye’s.
If you want some more info on expired meds please read Expired Medications.
“Can I make my own boric acid capsules at home?”
Yes, technically you can make vaginal boric acid capsules at home. However, it is often difficult to find boric acid and 00 capsules. More importantly, measuring and packing capsules at home can be very inaccurate (even with the proper scale).
It would be really helpful to talk with your physician first because boric acid is typically used only for persistent infections that have already been treated with antifungal and antibacterial medications.
If you would like to learn some background info about this question, please see Boric Acid for Yeast Infection.
We received this question on the site, “I have a red rash. I used Benadryl for 2 weeks, temporarily relieves the itch. But the rash does not go away. I tried loratadine but it did not help. Any suggestions?”
It is hard to answer this question without knowing more about the rash -however, assuming that it is contact dermatitis (fancy way of saying your skin came into contact with something it didn’t “like”). I am further assuming that the rash is not wide spread, on the face or the groin.
Benadryl (diphenhydramine) is often the first step to treating a rash. I also recommending using Benadryl + Zantac (ranitidine) -it blocks all the histamine that could be causing the itchy, red rash.
If that doesn’t work -he will most likely need to see his physician for a prescription for prednisone. A few days of an oral steroid should clear the rash.
A woman recently emailed us and asked about taking expired medication. She said she had taken expired erythromycin about 3 months ago and is now having back pain. She had read about the risk of taking expired tetracycline and was wondering if her back pain could be due to the expired erythromycin.
Most medications will just not work as well when they are expired. However, there are some expired medications that can cause real problems. Expired tetracycline can cause Fanconi Syndrome that can lead to kidney damage.
As for expired erythromycin -although it will probably not work very well, it is extremely unlikely that it is causing her back pain.
If you would like to learn more, Catie wrote an interesting article about taking expired meds.
“What the *bleep* is a prior authorization?” A woman asked me over the past weekend. This is actually the most polite thing she said during our discussion 
Simply put -pharmacies interact with insurance electronically, when we send the prescription through the insurance the insurance says, “Not covered -needs prior auth.” Which means that your doctor needs to contact your insurance company and answer some questions and/or fill out a form before you insurance company will pay for your prescription. Of course, there is a bunch more steps then that and so I wrote a 3 part report on prior auths -I promise it will teach you mucho!
“Is this a cold sore, fever blister or a pimple?” A woman asked me on Monday about a sore near her lip.
Cold sores and fever blisters are actually the same thing. Quite often the cold sore can look like a pimple when it first starts. Usually a tell-tale sign that it is not a pimple is when it is right on the lip line (almost on the lip) because how often do you get pimples on your lip? So, if it is on your lip or lip line it is usually a cold sore. Either way, it does not hurt to apply some ice to it right away. I am going to post some pictures so you can see what cold sores look like.
“My son was prescribed Vigamox eye drops for pink eye. It is crazy expensive -is there something less expensive?”
Yes! Vigamox is overkill 99.9% of the time when prescribed for pink eye in kids. Most of the time erythromycin ointment or Polytrim drops will do the job and at a fraction of the price! Just a side note -quite often the pink eye is actually viral and doesn’t need any treatment at all. Want to learn more about Vigamox? Please see Vigamox for Pink Eye in Kids.
“I am using Mirena and my doctor said I need to check to make sure it is there. How often should I do that?”
Mirena is an intra-uterine device used to prevent pregnancy. You should check every month after your period. Catie just posted about the placement of Mirena if you want more info on it!
“Why does eating eating food in the morning after a night of drinking make me feel better?”
A couple of main reasons are…
1. Once people start drinking, their appetite is suppressed -so it could be that you are just wicked hungry from not eating last night.
2. Alcohol causes dehydration and your blood sugar to drop…so in the morning quite a bit of the “hangover” is due to dehydration and very low blood sugar -eating and drinking (non-alcohol) helps!
Hey, Cate posted a video on some hangover home remedies – check it out!
On an internet Q&A forum, a woman asked, “A friend of mine ran out of the testing needles and has been using 2 until she can get more. Wouldn’t her numbers be off by re-using a needle , the ones for testing devices. I would think , they are sterile until you pop the top , wondering.”
There are lancets -the sharp thing that pokes the skin and makes it bleed…then there are test strips -the thing that you put in the machine and put blood on for the machine to test. If she is reusing the test strips then yes her numbers will definitely be way off. Test strips can not be used more than once.
If she is reusing the lancets then that isn’t so bad (not great either). It is possible to reuse them but it will be more painful (because they become dull with use) and can possibly (long shot) cause infection. If she is going to reuse them -she should wipe them with alcohol and let them dry first.
“What happens when you refill a prescription and don’t pay for it?” A woman asked on a Q&A site on the web. “I recently lost my health insurance and refilled my prescription anyway, not realizing the price more than quadrupled (from $15/month to $89/month). I told the pharmacist I didn’t have enough money to pay for it that day. She said they would hold on to it for 14 days. What happens after that? Will I be billed?”
When the pharmacist said that she will hold it -she meant that it will be ready for you to pick up for the next 14 days. After that, we return it in our system and put the medicine back on the shelf. If you need it filled later, you will just need to call and ask for it to be filled. You are not responsible for payment unless you actually take the medication. If you do not want to pick up a medication -you never have to.
As for the price, I would call around to a few local pharmacies. Just say you want a price check on Drug_____ and quantity_____. Prices can vary a lot from pharmacy to pharmacy!
“I take Zocor. Should I take CoQ10?” A 52 year old man at the pharmacy on Friday.
Zocor (simvastatin) is a “statin” medication used to treat high cholesterol. Statin medications blocks the body from making cholesterol -they also block the body from making CoQ10 (coenzyme Q10). CoQ10 is used in our body at the cellular level. The pill form of CoQ10 is used in Europe to treat many issues -from high blood pressure , diabetes to periodontal disease. Signs of low CoQ10 levels? -high blood pressure, angina and even periodontal disease. Ask us, your local pharmacist of physician first because it does interact with some drugs and disease states.
“What is ring-worm? Please, please, please don’t tell me it is actually a worm.” A 17 year old girl said after I told her the rash on her arm was most likely ringworm.
Ringworm is not a worm. It is a fungal infection on the body that normally shows up in the shape of a ring. Back in the olden, olden days (way before T.V.) it was wrongly thought to be caused by a worm. It is actually a fungal infection. You treat it with the same kinds of medicine you use to treat jock itch, athlete’s foot and yeast infections.
“Yuck-This tastes gross!!” -a 7 year old boy with a batman outfit/costume (for July 4th -of course!) said when his mama gave him his amoxicillin at the pharmacy.
Well, let me give you a little hint- almost all pharmacies have Flavor-Rx. We have this amazing recipe book and tons of flavours and we can flavor most liquid medications (OTC ones too!). So ask your pharmacist about flavoring your kids medications -it will go down much easier! (Just so you know, some pharmacies do have an extra charge). (Helpful Hint: If your kid/baby is taking Zantac (ranitidine) -it can only be flavoured grape but it makes it much better!)
Why does my Lipitor prescription label say to take it at bedtime?
Lipitor (atorvastatin) is a statin medication that lowers “bad” cholesterol. We get our cholesterol from two main sources -food that we eat and our bodies produce it. The cholesterol that our bodies make is mostly made while we sleep…so it is best to take most statin medication soon before you go to bed. However, because Lipitor and Crestor work slightly differently, you can take those any time during the day.
I had a very tired mom come into the pharmacy and ask, “Benadryl puts me to sleep. I gave it to my 6 year old daughter last night for her runny nose. She would NOT go to sleep, is that normal?”
Benadryl (diphenhydramine) causes most older kids and adults to become wicked sleepy. However, with younger kids, it is a toss up -The medicine will often have a reverse effect and cause the little tyke to become hyper!
I had a man come to the pharmacy determined to find baby aspirin -but with no luck! He asked, “What is baby aspirin and where the heck is it?”
First off, there is no aspirin for babies -actually, aspirin is usually AVOIDED in children younger than 15 years old. The term “baby aspirin” is the low dose aspirin which is aspirin 81mg. It is located in the pharmacy area, near the pain medications.
When I stay up late, I have red eyes the next morning. Is Visine the best thing to use?
Regular Visine will “get the red out”. It is okay to use them occasionally for a quick fix. If you use them regularly, they can actually irritate your eyes and CAUSE red eyes. The best way to treat red eyes is re-wetting drops (Visine Tears-Dry Eye Relief). You can use any kind -just look at the “active ingredients” and make sure they are all “lubricants” and avoid “redness relievers.”
What is the maximum daily dose of Tylenol (acetaminophen, APAP)?
The maximum daily dose of Tylenol is 4,000mg – that’s 8 tablets of the extra strength Tylenol (500mg per tab) taken during a 24-hour period. ***Tylenol update info***
Catie and I were watching “True Blood” season 1 and one of the characters had priapism. What is priapism?
Priapism is a prolonged, painful erection lasting more than 4 hours without sexual stimulation. It is due to blood being trapped and unable to drain from the penis. Some causes of priapism are medications, illicit drugs, sickle cell anemia, diabetes and scorpion bites. It can be permanently damaging to the penis if not treated. Priapism must be treated by a physician immediately.
A mom called me today and asked, “What are cc’s?”
She had picked up her son’s amoxicillin prescription earlier in the day and the directions were written as -5 cc by mouth twice daily. CCs are exactly the same as mL (1 cc = 1 mL), so he was to take 5 mL twice daily. As a side note, 5 mL = 1 teaspoon, 15 mL = 1 tablespoon and 30 mL = 1 fluid ounces.
My dad asked me the other day, “Why does it say not to take Afrin for more than 3 days?”
When nasal sprays (like Afrin) are taken for more than 3 days, it can cause rebound congestion. Which means, it actually can make your congestion worse! If you are still congested after 3 days or if you have become “addicted” to a nasal spray, start taking an oral decongestant (pseudophedrine -take care if you have high blood pressure) and stop taking the nasal spray. Feel free to use all the Ocean Spray (salt water spray) ya want! Want the 4-1-1 on cold meds? See the Cold and Allergy article.
What is the maximum adult dose of ibuprofen (Advil, Motrin)?
The max dose of ibuprofen for an adult is 3200mg per day (over a 24 hour period). That’s 4 tablets of the OTC product taken every 6 hours. However, to be on the safe side, the FDA indicates that you should not take more than 1200mg per day of the OTC ibuprofen products (2 tablets every 6 hours) – use your best judgement!
Why are medicines so expensive?
Prescription drugs take a lot of time and money to find, test, make and market. One drug can take 10-15 years and over 500 million dollars to be approved and released. The drug companies need to recoup this expense plus all the money spent on failed drugs (there are a lot -only 5 out of 10,000 compounds found will become an approved prescription drug).
My mom keeps talking about VD….what is it?
VD is a short term for venereal disease. VD was renamed to the more general term STDs (sexually transmitted diseases). STDs are a group of diseases that can be spread through sexual contact. Some examples are gonorrhea, syphilis, HIV/AIDS and genital herpes.
I have a cold sore and my brother said it is the same as genital herpes, is that true?
Cold sores (fever blisters) and genital herpes are both caused by the Herpes virus. Cold sores are typically caused by the Herpes simplex virus 1 (HSV1) and genital herpes is usually caused by Herpes simplex 2 (HSV2). However, through oral sex, cold sores (HSV1) can be transmitted to the genital area and genital herpes (HSV2) can be transmitted to the mouth.
I hear all this talk about people eating too much salt. I don’t usually add salt to my food, so am I okay?
The U.S. recommended daily allowance is 1,500 to 2,400 mg of sodium . Which is only 1 tsp of salt a day! Also of interest is that 70% of sodium we eat is from processed and prepared foods like chips, soup (canned soup can have 900mg of sodium in 1/2 cup!) and fast food. So check those labels because it is not just what we put on our food but what is in our food!
I am a 24 year old woman and I have a UTI. What can I use to treat it?
The typical UTI (urinary tract infection) is a bladder infection that needs to be treated with antibiotics so you will need to contact your physician (ask for an effective but inexpensive antibiotic like Bactrim or Cipro generics). It is important that you treat it because it can progress to a more serious and harder to treat infection in the kidney. For the pain associated with UTIs, you can take OTC Azo Standard ( phenazopyridine) 1 to 2 tablets three times daily for 2 days.
My husband ate a whole bloomin’ onion and feels like he is going to throw up. What can I give him?
It sounds like he has a sour stomach. Zantac (ranitidine) or good old Pepto-Bismol should help him feel better! For more info, see Catie’s article, “Nausea and Vomiting, It’s the Pits!”
I’m on Flagyl and my pharmacist said that I will projectile vomit if I drink a beer…is that true?
Yes. Flagyl (metronidazole) can cause disulfiram-like reaction…which means drinking alcohol and taking Flagyl can lead to projectile vomiting. Don’t drink and drive and don’t drink and take Flagyl.
How do I take plan B?
You take 1 tablet now then the second tablet in 12 hours.
The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. Consult your physician or local pharmacist to determine the appropriateness of the information for your own situation. Reading the information on this website does not create a physician-patient relationship.
