Drugs and Supplements

When should I go back on a bisphosphonate drug?

DEAR DOCTOR K: I am currently on a bisphosphonate "drug holiday." How will I know if, or when, I should go back on the drug?

DEAR READER: After menopause, loss of bone (osteoporosis) can lead to crippling bone fractures. Drugs called bisphosphonates slow bone loss. Below, I've put a table with detailed information about these drugs. But bisphosphonates can cause troubling side effects. The pills can cause burning in the esophagus. And a small number of users have developed bone loss in the jaw and in the large bone in the upper legs (the femur), causing the femur to break.

What are the differences in erectile dysfunction drugs?

DEAR DOCTOR K: Is there a difference between the drugs that are available for erectile dysfunction?

DEAR READER: Erectile dysfunction (ED) is a problem faced, to one degree or another, by many middle-aged and older men. Since sildenafil (Viagra) was launched in 1998, men have been turning to medication to help address this problem. There are currently four ED drugs on the market: sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) and avanafil (Stendra).

What does antibiotic resistance mean for the future?

DEAR DOCTOR K: I've been hearing a lot about "antibiotic resistance." What does it mean?

DEAR READER: When penicillin was discovered, many people (including doctors) thought bacterial infections would become a thing of the past. Unfortunately, penicillin and other early antibiotics didn't successfully treat all kinds of bacteria that make us sick.

Do I really need to be on statins?

DEAR DOCTOR K: I had bypass surgery last year, and I've been on two different statins. But I had severe muscle and joint pain. Do I really need to be on a statin? The side effects are awful for me.

DEAR READER: Statins are the most widely prescribed cholesterol-lowering drugs. They significantly lower levels of harmful LDL cholesterol in the body. And they've been shown to reduce death, heart attack and stroke risk by up to 30 percent in people at high risk.

How can I cut down on my type 2 diabetes medications?

DEAR DOCTOR K: I have Type 2 diabetes. Is there anything I can do to cut down on my medications?

DEAR READER: Yes. In fact, some of my patients have entirely eliminated their need for medication with aggressive lifestyle changes. And many more have reduced the number or the dose of the medications they are taking with the same lifestyle changes.

Does testosterone therapy really work?

DEAR DOCTOR K: I've seen a lot of commercials advertising testosterone therapy for "low T." Does it live up to its promise? Should I be on it?

DEAR READER: I've seen the commercials, too. They promise that testosterone therapy for low blood levels of testosterone, or "low T," will make you feel more alert, energetic, mentally sharp and sexually functional. Testosterone therapy is a good option for some men, but there are also risks.

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.