Q. My family doctor has prescribed tamsulosin for frequent urination at night. I am a 75-year-old woman, and after reading about the side effects of this drug, I am concerned. I can live with the frequent nightly nuisance, but it would be nice not to get up quite so often. What is your opinion on this?
A. Our first reaction was that tamsulosin (Flomax) is approved only for men with enlarged prostate glands and not for women. Upon searching, however, we found that tamsulosin has been studied and found helpful for reducing excessive nighttime urination in women (Urology Journal, May-June 2014).
The side effects of this medication vary in severity. Some, such as fatigue or drowsiness, might not be a problem since you are taking it at night. You will have to determine whether others, such as dizziness, sore throat, back pain and runny nose, pose a problem for you.
If you already have had cataract operations, one serious side effect won’t be relevant. But if you may need to have cataracts removed in the future, you might want to forgo the drug. It makes the iris floppy, complicating cataract procedures. This reaction appears to be irreversible.
Testing of generics?
Q. I recently filled a zolpidem prescription and was given a generic from an unfamiliar company. When I took it, I was unable to sleep. I felt agitated, and my restless legs syndrome was almost unbearable. I don’t take zolpidem frequently, but I have used it occasionally over a number of years. This experience was jolting. I would like to send these pills out for testing. Is there a lab that could analyze them?
A. Sadly, the cost of having your generic zolpidem pills analyzed would probably be exorbitant. The Food and Drug Administration rarely runs tests itself on generic drugs. Usually it relies on the manufacturer to submit such data.
We have heard from dozens of other readers who also have had trouble with some generic versions of zolpidem. This is just one example of similar complaints found on our website:
“I have been taking name-brand Ambien for 10 years. When I began, my copay was $50. Now it is $110, and my physician has to get prior approval for me to have the name brand.
“I have twice been given a generic by mistake and had a horrible experience. I could not sleep and had hallucinations and anxiety.
“Both times I called the pharmacy and found the prescription had been filled with generic even though I was charged for the name brand. I would NEVER knowingly take a generic again.”
Q. You’ve written about ketamine for hard-to-treat depression. Can ketamine be used for a few weeks while another, more standard, antidepressant is added? This would seem to offer the benefit of a quick-acting drug to prevent suicide until the other drug kicks in.
A. You offer an intriguing idea. Animal research suggests this may be a viable option, though it is not yet being offered in clinics (Translational Psychiatry, May 2015).
Joe and Teresa Graedon: www.peoplespharmacy.com