DEAR DR. DONOHUE: I have a medication question. I often have bladder infections, and the medications I use are Cipro (an antibiotic) and Pyridium (for bladder pain). When I take the generic form of Cipro, it does not work as well as the brand-name drug. And the new Pyridium (a long pill) I take cannot be the same as the old one (a round one).

I asked the doctor about the difference and was told that all meds are the same. Am I the only one who does not agree with this theory? – L.C.

Is the new Pyridium manufactured by the same company (Parke-Davis) as the old one, or is it Pyridium Plus, a drug manufactured by a different company? Check with the pharmacist.

As for generics, it must have the same active ingredient as the brand name and in the same strength. Furthermore, it has to be absorbed equally well as the brand name, and it has to be produced in a way that has been approved by the Food and Drug Administration. Today, generic drugs constitute more than 60 percent of all drug prescriptions written in the United States.

A generic drug differs in color, size, shape and flavor from the brand-name drug. Its inactive ingredients are also different. Inactive ingredients are components of the pill that keep it from dissolving and that permit it to be shaped into a specific form.

Most people respond to a generic drug exactly as they would to the brand-name drug. If you aren’t getting the same results as you did with the brand-name medicine, ask your doctor to write on the prescription that only the brand-name drug is to be dispensed to you. See if there is a difference.

The selling point of generics is their cost savings. If your medicines are covered by insurance, make sure that the insurance company will go along with dispensing the brand-name drug.

DEAR DR. DONOHUE: Please explain claudication and how it’s treated. Is it life-threatening? – D.T.

The Roman emperor Claudius walked with a limp. That’s where “claudication” comes from. In medicine, it means leg pain, most often felt in the calves, that comes when walking and stops when a person rests. The culprit is a leg artery obstructed with plaque – the buildup of fat and cholesterol on the artery wall. Plaque prevents increased blood flow to exercising muscles, and they respond with pain. It’s more often called PAD – peripheral artery disease. I know you’ve heard of that. It’s featured in TV commercials. PAD doesn’t shorten life, but it can indicate that heart arteries are similarly affected. That does shorten life.

PAD can be treated with medicines, surgery or angioplasty – the squashing of the plaque buildup with a balloon-tipped catheter (a thin, flexible tube introduced into a surface blood vessel).

The booklet on PAD explains this common condition and its treatments. Readers can obtain a copy by writing: Dr. Donohue – No. 109, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Will not replacing an old pacemaker battery with a new one guarantee that a person will have a stroke? – J.K.

The heart’s natural pacemaker generates a tiny electrical blip a little more often than once a second to stimulate a heartbeat. An artificial pacemaker takes over the job when the natural pacemaker falters. Without that electrical signal, the heart doesn’t pump blood. If the natural pacemaker fails to generate the electric signal and there is no artificial pacemaker, the person will pass out from lack of blood flow to the brain. If the natural pacemaker never recovers, the person dies. Life or death depends on how bad off the natural pacemaker is. Not replacing a battery or a worn-out pacemaker doesn’t guarantee death, but the probability of death can be high.

DEAR DR. DONOHUE: During my menstrual period I bleed more than a cup of blood. For all the years I have been menstruating, that comes to 100 quarts. I have been to many doctors but have never learned what constitutes normal menstrual bleeding. Apparently the subject is taboo in our culture. I am worried that this will eventually affect my health. What is the normal amount of menstrual blood? – J.H.

Menstruation is a normal, female body function and should not be a taboo subject. The average length of a menstrual period is 4.7 days, with a range of three to seven days. The average volume of menstrual flow is 35 ml, slightly more than an ounce. Only half the flow is blood. The other parts include cells shed from the uterus. Bleeding in excess of 80 ml – a little less than 3 ounces – leads to anemia.

One cup is 235 ml, almost 8 ounces. That’s excessive, and your body cannot produce enough blood cells to replenish such a loss. If you really do lose that much, you’re likely to be anemic. Check with your doctor.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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