DEAR DR. DONOHUE: I was treated for a sinus infection, and after 10 days, I felt much better. Then I suddenly got worse. I had severe shortness of breath, rapid heartbeat and debilitating fatigue. My doctor ordered pulmonary function tests, EKG, chest X-ray, exercise stress test with thallium and an echocardiogram. All were normal. I was referred to a cardiologist, who performed cardiac catheterization. Normal. All I could do was lie on the couch all day. So what was wrong? I had a reaction to taking generic lisinopril. My employer required that we order our meds from a pharmacy of its choosing. I started taking the generic drug when I was recovering from the sinus infection. I diagnosed myself. When I stopped the generic, I got much better. So far, my insurance has been billed $23,500. Any comments on generic medicines? — D.A.

ANSWER: Generic medicines are less-costly equivalents of an original drug that had been previously protected by a patent. When the patent expires, other manufacturers can produce the original drug in competition. The price of the drug falls. A generic drug must have the same active ingredient as the original drug and contain the same amount of that ingredient. Its bioavailability cannot vary from the original by more than 20 percent. Bioavailability is the amount of drug absorbed by the body in a certain time period.

Generics can and do have different preservatives and different fillers, materials that hold the drug together. In a few individuals, the preservatives and fillers might cause trouble.

Your story is a turn-off for generic medicines. I’m sorry about your experience. I am still a user and supporter of these drugs. They hold down the cost of medicines. Your story is unique. Most people tolerate generics without a hitch. People who do notice symptoms upon switching to a generic can learn from your experience. Thanks for telling it.

Doctors went somewhat overboard on your tests.

TO READERS: People are confused by electrolytes, sodium, potassium chloride and bicarbonate, and their roles in the body. The booklet on electrolytes explains them. To order a copy, write: Dr. Donohue — No. 202, 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 you address hepatitis C? My roommate has it. It bothers me that she cooked for me when I didn’t know she had it. She coughs without covering her mouth. She has fevers when she takes her medicine. I feel sick when she has fevers. Please explain this illness to me. — K.H.

ANSWER: Let me assure you that you are in no danger of catching hepatitis C. It’s mostly spread when a hepatitis C-contaminated syringe needle punctures the skin. Drug users are at risk of catching it. At one time, blood transfusions were the greatest source of transmission. Now that there is a test for detecting it, transfusions almost never pass the virus. It is not spread through casual contact. Coughing does not spread it. If your roommate’s medicines give her a fever, that does not affect passage of hepatitis C to others. It possibly might be transmitted by sexual relations, but not in the numbers that hepatitis B is. You will not catch it from food she prepares. I have to save the general topic of hepatitis C for another time.

DEAR DR. DONOHUE: I was diagnosed with macular degeneration three years ago. Since then, I have been on a vitamin and mineral combination. It is vitamin A-free. It is my understanding that if you are not and never have been a smoker, you shouldn’t take vitamin A or beta carotene. I have never smoked. Should a nonsmoker never take beta carotene? — S.M.

ANSWER: Someone gave you the wrong information. High doses of vitamin A or beta carotene (a substance that’s converted into vitamin A when ingested) can increase a smoker’s risk of developing lung cancer. This warning doesn’t apply to you. You can take the vitamin or its precursor, beta carotene.

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 www.rbmamall.com.

Copy the Story Link