Drugs and Supplements

Are there any safety precautions for taking acetaminophen?

DEAR DOCTOR K: As I've entered my 50s, I find myself reaching for Tylenol more often for my aches and pains. Should I be aware of any safety precautions?

DEAR READER: Acetaminophen is the active ingredient in Tylenol and several other over-the-counter medications. As with all medications, you should use it cautiously. But if you stick to the guidelines, there's little need to worry.

What are the different pills for Type 2 diabetes?

DEAR DOCTOR K: I have Type 2 diabetes and my doctor wants to prescribe medication. Fortunately, he says I don't need shots, just pills. What are the different pills for Type 2 diabetes?

DEAR READER: No one likes needles, but the needles used to give yourself insulin are very small, and the shots are very easy to administer. But for Type 2 diabetes, it is true that pills are often all that are needed. In Type 2 diabetes, like the less common Type 1, blood glucose (sugar) levels are too high.

Are there risks of taking a daily aspirin to reduce the risk of a heart attack or stroke?

DEAR DOCTOR K: What are the risks of taking a daily aspirin to reduce the risk of a heart attack or stroke?

DEAR READER: I didn't have to do much homework on this one, because I take a daily aspirin and already know the answer. It was front-page news in 1988 when colleagues of mine at Harvard Medical School reported the results of a randomized trial that found that a daily aspirin protected against heart disease. A simple, cheap, over-the-counter pill could protect against the No. 1 cause of premature death: heart disease (specifically, atherosclerosis of the arteries of the heart)? It seemed too good to be true.

What medications can affect balance?

DEAR DOCTOR K: You've mentioned that some medications affect balance. Which ones? If a drug I'm taking is affecting my balance, what can I do about it?

DEAR READER: There are enough of them that I don't have space to mention them all. Medicines that affect balance in some people may not do so in you. In fact, most people can take medicines that can cause balance problems, without having the medicines affect their balance.

Should I be managing my several medications?

DEAR DOCTOR K: I'm in my 70s. Like many women my age, I'm on several medications. Should I be actively managing them? Or can I leave that to my doctor?

DEAR READER: Many older adults are on a number of medications, prescribed to treat different health conditions. Yet each medication you take has the potential to interact -- sometimes dangerously -- with another. And if you see specialists for various health conditions, your medications may be prescribed by several different doctors.

I’ve read about hypothyroid supplements that could help my symptoms — Should I take them along with my thyroid medicine?

DEAR DOCTOR K: I have hypothyroidism. According to the Internet, there are several supplements that could help my symptoms. Should I be taking a supplement along with my thyroid medicine?

DEAR READER: Hypothyroidism is a condition in which the thyroid gland (located in the front of the neck) doesn't produce enough thyroid hormones. Every cell in the body needs thyroid hormone for normal function. When there is not enough hormone circulating in the blood, symptoms develop.

Can aspirin cause macular degeneration?

DEAR DOCTOR K: I take a daily aspirin to prevent a heart attack. I just read that aspirin can cause macular degeneration. Should I stop taking it?

DEAR READER: No, you shouldn't stop taking aspirin. Medicine — and life — is full of trading off one risk for another. Doctors and medical scientists aren't (yet) smart enough to discover or invent treatments that have absolutely no risks, only benefits. So you have to compare the risk of a treatment against your risks if you don't take it.

Should I take tamoxifen longer than five years?

DEAR DOCTOR K: I was diagnosed with ER-positive breast cancer a few years ago. My doctor told me to take tamoxifen for five years to prevent my cancer from coming back. I recently read that taking tamoxifen longer further decreases the risk of a cancer recurrence. What should I do?

DEAR READER: The simple answer is: Ask your primary care doctor if you should talk to a breast cancer specialist, because it may well be a good idea to continue on the tamoxifen. But I know you won't be satisfied with a simple answer, so here's a more elaborate one.

How does Pradaxa compare with warfarin?

DEAR DOCTOR K: My wife has atrial fibrillation. Her medication was recently changed from warfarin to Pradaxa. Her doctor says the new medicine does not require regular INR tests and is just as effective. Is that so?

DEAR READER: Yes, it is. Before I explain why, let me provide some background. In people with atrial fibrillation, the upper chambers of the heart (the atria) lose that strong beating action that keeps the blood moving efficiently. As a result, blood tends to pool in the atria. When it does, clots are more likely to form.