Q: What is the best vaccine strategy for maximum protection during the flu season? Is the flu worse early in the season or later? How quickly does the shot become effective? How long does it last?
My pharmacy is urging customers to get their flu shot right now! I worry that the benefits might fade before the peak flu season is over in January or February.
A: Influenza is highly variable. There is no way to predict when it will hit, how long it will last or when it will be most virulent. Last year’s flu season persisted for over five months. The nasty H3N2 virus struck late in the season — from mid-February through mid-May. The vaccine did not work well against this strain of influenza.
As for timing, the Centers for Disease Control and Prevention states that: “Vaccinating early — for example, in July or August — may lead to reduced protection against influenza later in the season, particularly among older adults.”
The CDC recommends that most people get vaccinated by the end of October. It takes about two weeks for your body to make antibodies against influenza viruses.
You may find our Guide to Colds, Coughs & the Flu of interest. In it, we discuss vaccines as well as nondrug cold strategies with vitamins C and D, astragalus, ginger and thyme. It is available in the Health eGuide section of peoplespharmacy.com.
Q: As a podiatrist, I have noticed that a six-month course of the oral antifungal drug itraconazole (Sporanox) is not only good against nail fungus. It also can help clear up eczema, acne and sometimes even psoriasis. I know the drug can cause liver problems, but you can test for that.
A: The Food and Drug Administration originally approved oral itraconazole in 1992 for serious systemic fungal infections. The agency added toenail fungus as an “indication” in 1995. It is NOT approved for acne, eczema or any other skin condition.
There is a black-box warning that cautions physicians not to prescribe this oral antifungal drug to people with heart failure. Itraconazole can interact dangerously with dozens of other medications. Liver damage, although rare, can come on suddenly and can be life-threatening. Nerve damage and hearing loss are other serious complications of this medication.
Q: Two years ago I read an article you wrote about the lack of lot numbers on prescription-drug labels. As of today, the problem still exists in that lot numbers do not appear on individual prescription bottles.
What suggestions do you have to pressure pharmaceutical companies to include the lot number on bottle labels? I take the blood-pressure medicine valsartan. I know that many manufacturers have had to recall this medicine because of contamination. My pharmacist told me he doesn’t have any knowledge or access to lot-number information. Just sign me — Frustrated!
A: We share your frustration, but it is a bit more complicated than you think. Pharmaceutical companies must print the lot numbers on ALL brand name and generic medications they ship to drugstores.
The problem occurs when pharmacists take pills out of big bottles and put them into small amber bottles and print a label with your name on it. During this repackaging process, the lot number is lost. As a result, it is nearly impossible for you or your pharmacist to tell whether your pills have been recalled.
It is past time for Congress to require every pill bottle dispensed in the U.S. to carry a lot number, a true expiration date and the NDC (national drug code).