Individuals’s Pharmacy: Generic Prozac failure led to canine bites

Q. You’ve written about issues with generic medicine, and I wished to share that pets can be adversely affected by modifications in generic medicines. Our canine was prescribed generic Prozac 9 years in the past for extreme canine aggression. She was given the identical generic (similar producer), which labored fantastically for eight years. No canine aggression.

A few 12 months in the past, the pharmacy modified its fluoxetine provider to a special generic. I didn’t assume a lot about it: similar drug, similar dose, proper? Flawed! We had two vital episodes of unprovoked canine aggression, each requiring vet care, inside 4 weeks.

At that time, it dawned on me that the one change we had made was the generic fluoxetine. We requested the pharmacy to modify her again to her previous generic. That was 18 months in the past. She has not had a single incidence of aggression since.

A. Many readers have reported issues with their very own generic medicine over the previous twenty years. Yours is the primary to explain an issue with generic drugs in an animal.

Not all generic medicine are completely interchangeable, even when they’ve the identical lively ingredient. Completely different formulations and excipients (inactive components), in addition to high quality management on the producer, might end in variations in effectiveness. Thanks for alerting us that generic drug issues may additionally influence our pets.

Individuals who wish to know extra about utilizing generic medicine correctly could also be inquisitive about our eGuide to Saving Cash on Medicines. This on-line useful resource is discovered below the Well being eGuides tab at peoplespharmacy.com.

Q. I complained to my ENT about itchy ears and likewise confessed to utilizing cotton swabs to dry my ears after showering. As well as, that’s how I apply a dab of child oil for the itching. He mentioned the swabs irritate my ears, which makes them itch.

I doubted this, since I’m very mild. I have to say, nonetheless, that since I reluctantly stopped utilizing the swabs, the itching has not solely drastically subsided, it’s virtually nonexistent.

A. Thanks for sharing your story. Ear, nostril and throat docs discourage the usage of cotton swabs as a result of they’ll trigger ear accidents (JAMA Otolaryngology Head & Neck Surgical procedure, Feb. 1, 2018). They advocate a moist washcloth as a substitute.

Q. My physician is recommending Reclast to deal with osteoporosis. I simply heard from a buddy, nonetheless, that when she acquired injections of this drug, she developed horrible issues along with her tooth.

I’ve not been capable of finding out whether or not this treatment causes dental issues. Might you please present some perception into its advantages and dangers?

A. Zoledronic acid (Reclast) is taken into account efficient for stopping fractures as a result of osteoporosis. A examine within the New England Journal of Drugs (Dec. 20, 2018) discovered that: “The variety of girls that may have to be handled to forestall the incidence of a fracture in 1 lady was 15.”

There’s a identify for the complication your buddy might have skilled: Medicine-related osteonecrosis of the jaw, or MRONJ. On this situation, the jawbone fails to heal after dental surgical procedure, akin to an extraction. This will go away the bone uncovered, and is troublesome to deal with.

This complication is uncommon with oral osteoporosis medicine akin to alendronate (Fosamax), ibandronate (Boniva) or risedronate (Actonel). You would possibly ask your physician if one in all these is perhaps applicable for treating your bone loss.

Negative effects of Reclast might embrace muscle and bone ache, arthritis, complications, digestive upset, dizziness, hypertension and kidney issues. For a couple of days after the infusion, sufferers might complain of fever, flulike signs and irritation of the iris of the attention.

Of their column, Joe and Teresa Graedon reply letters from readers. Write to them in care of King Options, 628 Virginia Drive, Orlando, FL 32803, or electronic mail them by way of their web site peoplespharmacy.com. They’re the authors of “Prime Screwups Medical doctors Make and Keep away from Them.”