Q: My daughter, 33, who lives in Los Angeles, has epilepsy. She has stayed seizure-free with Keppra. However, her health insurance will no longer pay for it, and it costs nearly $2,000 a month.

She has read on message boards that epileptics who take the generic may experience breakthrough seizures. Unless she can find a way to get Keppra affordably, she will have no choice but to take the generic. What advice can you give her so that she can attempt to obtain the highest quality generic possible?

A: We searched for an authorized generic version of Keppra (levetiracetam). That would mean a formulation identical to the brand name. Sadly, none appears to be available, so this is not an option.

A different approach might be to purchase brand-name Keppra from a reputable online Canadian pharmacy. If your daughter were taking the maximum daily dose of 3,000 mg, the cost would be around $300 for a month’s supply.

You can find cost comparisons at www.PharmacyChecker.com. We offer more information on evaluating online Canadian pharmacies and authorized generic drugs in our eGuide to Saving Money on Medicines. You will find it in the Health eGuides section at www.PeoplesPharmacy.com.

Q: I’ve had eczema on my fingertips for about 15 years. It’s worse in the winter.

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I’ve tried over-the-counter cortisone creams and prescriptions from my dermatologist. With these, the cuts on my fingertips would eventually heal, but I felt as though I was fighting a losing battle. As soon as one finger would start to heal, another would develop a painful slit.

About two months ago, I asked a local pharmacist for anything that could help this condition. She recommended O’Keeffe’s Working Hands. I bought some and used it every single time after washing my hands. Within a week, the slits on all my fingers were completely healed.

Now I use it a couple times a day, and my fingers remain completely healed and pain free. If my fingertips start to feel a little rough, I increase my usage until they are soft again.

A: We have heard from other readers that O’Keeffe’s Working Hands can help heal cracked fingertips. Among many other ingredients, it does contain urea, which can improve the barrier function of the skin.

Some people have reported great success sealing fingertip cracks with household instant glue or New-Skin liquid bandage. Sealing also allows fingertips to heal more quickly.

Q: I never realized that medicine could deteriorate during transportation. I use a mail-order service because I have to. Before, I let pills sit in the mailbox no matter what the temperature. After reading your column, that will not happen again.

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A: Many medicines should be kept at room temperature (68 to 77 degrees F). The Food and Drug Administration does allow temporary temperature excursions during shipping and storage from 59 to 86 F.

When the FDA recently requested the recall of all ranitidine (Zantac) products, it noted that the nitrosamine impurity (NDMA) in these products “increases over time and when stored at higher than room temperatures…” NDMA is a probable carcinogen.

Leaving drugs in a mailbox during a hot summer or cold winter day would likely exceed the FDA’s storage guidance. Liquid drugs like insulin or epinephrine may degrade faster if exposed to extreme temperatures. Then they may not work as expected. We don’t know if other drugs, like ranitidine, would degrade and develop impurities if stored improperly.