Q. You have written that Tamiflu can help people recover more quickly from influenza. I don’t think it works.
I came down with the flu and called my doctor’s office. It took a week for them to fit me into the schedule. The doctor did a test and confirmed I had influenza. He gave me a prescription for Tamiflu, but it didn’t do anything for me. It took another week before I felt better. Why all the hype for a drug that doesn’t work?
A. Oseltamivir (Tamiflu) is an oral antiviral medication for influenza. It works by blocking an enzyme the virus uses to spread throughout the body.
To be maximally effective, Tamiflu should be taken within 48 hours of the first symptoms. It still may be somewhat helpful taken up to four days after flu symptoms begin. In your case, though, too much time had passed for Tamiflu to provide any benefit.
Even under the best of circumstances, clinical trials show that Tamiflu shortens flu symptoms by a day or two. The drug may, however, reduce the chance of complications (Medical Letter, Jan. 1, 2018).
Q. My endocrinologist has prescribed the diabetes drug metformin to control thyroid nodules and prevent thyroid cancer. I am not diabetic, so my other doctors wonder why I would be taking metformin. Is there any evidence that metformin has anti-cancer benefits?
A. Your endocrinologist is keeping up with medical research. A review in the journal Frontiers in Endocrinology (online, Nov. 14, 2017) discusses the anti-cancer activity of metformin.
There also is evidence that this drug can reduce thyroid nodules and may both prevent and help treat thyroid cancer. A systematic review concluded that metformin might be helpful in treating colorectal and prostate cancer as well (Annals of Oncology, December 2016).
Q. I don’t mind taking generic drugs, because I can’t afford brand-name medicines. The effectiveness of generics varies so widely, though, that I get frustrated.
My doctor prescribed sertraline for depression and anxiety. The first version I took made me dizzy and gave me tremors. It also didn’t do much for my depression. I switched to Greenstone sertraline, and that worked much better.
I have learned that Greenstone stopped making sertraline. What will I do?
A. Sertraline is the generic name for the antidepressant Zoloft. Until recently, Greenstone offered an “authorized generic,” identical to the brand-name drug.
If you wanted to buy the brand name, it could cost over $300 for a month’s supply. In contrast, the generic is under $15 a month at most pharmacies, but as you’ve pointed out, you won’t know how you will do on a particular generic until you try it.
Many people have reported problems with some generic forms of this drug. One visitor to our website wrote: “When the pharmacy changed manufacturers for my sertraline, I started on a downward spiral. I feel depressed, agitated, anxious, crabby, fatigued and unmotivated.”
It is possible to purchase brand-name Zoloft from a reputable Canadian online pharmacy. The cost for a month’s supply is between $40 and $80. Be careful, though. Rogue online pharmacies sell counterfeit medications. To learn more about authorized generics and reputable online pharmacies, you will want to read our online resource “Saving Money on Medicines,” available at www.PeoplesPharmacy.com.
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 at Questions@PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”