Q: Does taking a medication such as Flonase, with immune-suppressing activity, increase the chance of contracting COVID-19 or other illnesses? Allergy season is almost here. I would like to use Flonase but am hesitant.
A: Flonase (fluticasone) is a strong corticosteroid nasal spray. Fluticasone is used in both asthma and COPD inhalers.
A study conducted at the Cleveland Clinic found that COPD patients relying on inhaled corticosteroids were no more likely to need hospitalization or intensive care due to COVID-19 (PLoS One, June 3, 2021). The scientists did not find higher rates of coronavirus infection among people using such medications.
Q: I once took a medication (metronidazole) that would make you sick if you drank alcohol with it. While I was on it, I went camping. While fueling the alcohol stove with denatured 100% ethanol, I spilled a lot of it on my hands. I did not drink any alcohol.
Later that night, I was violently ill with vomiting and diarrhea. My doctor was quite surprised when I told him about this reaction.
A: Metronidazole (Flagyl) is frequently prescribed for vaginal infections, amebic dysentery and several bacterial infections. The symptoms you experienced are typical of an interaction between metronidazole and alcohol. Headaches and flushing are sometimes part of that reaction. People on metronidazole must avoid consuming alcohol until at least three days after they stop the medication. Most doctors would probably be as surprised as yours was to learn that you might absorb enough alcohol through your skin to trigger symptoms.
Q: Is treating high blood pressure a science, or is it more like throwing darts blindfolded? I have moderately high blood pressure. My doctor tried lisinopril, but I developed an uncontrollable cough. Next we went to amlodipine, and my ankles swelled. I’ve never had a problem with edema before. Then he prescribed a beta blocker; it made me tired and interfered with my sex life. The other choice is water pills, but my doctor hates using diuretics.
It’s frustrating, because my blood pressure when we started all this was 145/91. That’s obviously not good, but the goal of getting patients to 120/80 as they get older seems unrealistic. I’m in my 50s. My father-in-law is on three blood pressure drugs and I’d rather not do that. Wouldn’t I be better off losing 20 pounds and checking back in six months?
A: Losing weight can certainly lower blood pressure, so your idea is based on solid science. A study from the United Kingdom targeted weight loss for diabetes control (Diabetologia, May 31, 2021). Many of the volunteers also had high blood pressure. The researchers had them stop their blood pressure pills when they started the low-calorie diet formula. Within about two months, their blood pressure had dropped substantially. Scottish researchers report that blood pressure drops about one point for every two pounds lost.
You can learn about foods, beverages, supplements and other nondrug approaches to blood pressure control in our eGuide to Blood Pressure Solutions. This online resource may be found under the Health eGuides tab at www.PeoplesPharmacy.com.
One example of such an approach involves nitrate-rich vegetables (Journal of Nutrition, June 3, 2021). Beets and leafy greens such as kale, spinach and chard are rich in natural nitrates.