BY PAUL G. DONOHUE, M.D. DEAR DR. DONOHUE: My doctor prescribed statin drugs to control my LDL cholesterol. First I took lovastatin (Mevacor) and then simvastatin (Zocor), but I had muscle pain and weakness with them. I am reluctant to start the pravastatin (Pravachol) that he has now prescribed. Are there alternatives? How about Endur-acin? CoQ10 has been suggested. — D.L.

ANSWER: Statins are the most potent cholesterol-lowering drugs, including lowering LDL cholesterol — bad cholesterol, the kind that clings to artery walls. They’ve been around for 20 years, and their safety record has been good. Some people develop muscle pain. Those people can try a different statin. You did. However, you might be reacting a bit too fast in rejecting pravastatin (Pravachol). It is the statin that most infrequently is involved with muscle complaints.

I don’t know any herb on the list of herbs you included (in an edited part of the letter) that compare with medicines for cholesterol control. However, there are things you can do to lower cholesterol, including reducing your saturated fat and cholesterol intake. Saturated fats are the fats found in many meats, whole-fat dairy products and many other commercially prepared foods. You have to look on the label. Omega-3 fatty acids lower cholesterol. They’re found in fish. If you cannot stand fish, take the omega-3s in pill form.

Questran, Colestid, Welchol and Zetia are cholesterol-lowering drugs that are unrelated to statins.

Niacin can increase HDL cholesterol (good cholesterol) and lower triglycerides, fats that also figure into artery clogging. Endur-acin is a slow-release preparation of niacin. Slow-release preparations were introduced to lessen flushing, one of the side effects of niacin.

Coenzyme Q10, or CoQ10, is an antioxidant made by the body and also is available in pill form. Antioxidants counter the damaging byproducts coming from cell chemistry. I don’t see any references mentioning that it lowers cholesterol.

The cholesterol booklet gives an in-depth treatment of cholesterol. Readers can order a copy by writing: Dr. Donohue — No. 201, 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: Please give me some information on the Muse for erectile dysfunction. What are its side effects? — L.G.

ANSWER: The Muse system includes a device that delivers a small pellet of the drug alprostadil into the penis. Alprostadil dilates arteries so that blood floods into the penis to produce an erection in about seven minutes. It’s successful around 65 percent of the time.

Side effects include discomfort or pain from the injection and, rarely, a drop in blood pressure.

Have you tried the oral erectile dysfunction medicines — Viagra, Cialis and Levitra? If they have failed, Muse might work. It employs an entirely different drug.

DEAR DR. DONOHUE: What is your opinion of prolotherapy? I have quite severe osteoarthritis in both thumbs and have been receiving cortisone injections for it. I was told that prolotherapy would be more effective than cortisone and that the relief would be longer-lasting. — B.N.

ANSWER: Prolotherapy involves the injection of various substances around damaged ligaments and tendon attachments. It triggers inflammation. The inflammation, in turn, promotes healing by stimulating collagen formation. Often the material injected is dextrose (sugar) mixed with lidocaine (an anesthetic).

Some reports say that it is quite successful in things like tennis and golf elbow, where the pain comes from ligament tears. Other reports question its efficacy. It won’t hurt you.

I find it hard to believe it is more effective than cortisone for the inflammation of arthritis.

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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