Q: Last week I came down with a horrible cough, followed within a few hours by fever and exhaustion. By the next morning, I had muscle aches and figured I had caught the flu.
The weather was dreadful, and I didn’t have the energy to drag myself to the doctor. So, when I saw that the practice had an e-visit option, I used it. I was very disappointed. A doctor I’ve never met responded that I didn’t meet the criteria for treatment because I don’t have chronic heart or lung disease and because I’m not being treated for cancer. Instead, he told me to take Tylenol and ibuprofen, stay hydrated and wash my hands frequently. He assured me that my symptoms would probably improve within 10 days.
Needless to say, that wasn’t very helpful. I didn’t want to spend 10 days in bed if I didn’t have to. So I called my regular doctor, who said I should come in to be tested. I’m glad I braved the bad weather. The test showed I had type A flu and she prescribed oseltamivir (Tamiflu). I started taking it and felt noticeably better by the next day. My cough has almost disappeared, and my temperature is back to normal.
I understand that doctors want to make sure you really have flu before they write a prescription. I don’t understand why they would have an e-visit protocol that essentially says “just suffer.”
A: We don’t understand that, either. The Centers for Disease Control and Prevention acknowledges that antiviral medications can be helpful. The agency lists four drugs that may be prescribed to treat outpatients with acute uncomplicated influenza. Two are pills: oseltamivir (Tamiflu) and baloxavir (Xofluza). Zanamivir (Relenza) is inhaled and peramivir (Rapivab) is given by IV injection.
Q: You have written about “authorized generic” drugs. I can’t find a pharmacy that will fill my prescription with an authorized generic. Can you steer me in the right direction?
A: The makers of authorized generic drugs have negotiated agreements with the brand-name manufacturers so that they can use the exact same “recipe.” Sometimes authorized generic drugs are even made on the same production line.
Finding a list of authorized generic drugs can be a challenge, and we don’t know of any list that is complete. However, you will find the best list we could assemble on our website, www.PeoplesPharmacy.com, and in our eGuide to Saving Money on Medicines. Look for it in the Health eGuides section of the website.
Not all medications have an authorized generic available. If you find the drug you are looking for, you will need to ask the pharmacist to order from that manufacturer specifically. Independent pharmacies may be more willing to do this than chains.
Q: When I’ve asked health professionals to wash their hands before touching me, most of the time they say they have used the hand sanitizer outside the door, then opened the door. It is sad there are no longer sinks with soap dispensers and water in the exam rooms to save costs and time while putting us patients at risk.
A: We agree that soap and water might be better than hand sanitizer, especially if someone has to touch the (potentially contaminated) doorknob after using the sanitizer. Alcohol-based sanitizers seem to work against many bacteria but are less effective against viruses (Journal of Food Protection, June 2016).
Recent research on the drug-resistant fungus Candida auris suggests that first washing with soap and water, drying the hands, then applying alcohol-based gel works to remove the microbe (Journal of Infection and Public Health, Jan. 28, 2020).