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From the pharmacy.

Quinine Available, More Expensive: People have been taking quinine pills for decades to treat nighttime leg cramps--even though the FDA has long warned that the drug's risks outweigh the benefits when used for this purpose. Generic quinine pills pre-date the enactment of current laws regarding safety and efficacy tests. However, now that the FDA has approved a quinine product named Qualaquin, untested versions of the drug must be removed from the market. Qualaquin is prescribed to treat malaria, and its label specifically warns against its use for leg cramps. While doctors may prescribe Qualaquin for patients with leg cramps, each pill costs about $5. Stretching before bedtime, keeping well hydrated, and applying a heating pad to the area may help ease nighttime leg cramps. If not, your doctor may suggest other medications.

Drug Therapy for Alzheimer's Disease: To M.C. from Dearborn, Michigan: While Alzheimer's disease is not yet fully understood, low levels of at least two chemicals in the brain--glutamate and acetylcholine--appear to play a role in its development. Namenda is designed to help restore adequate glutamate levels in the brain. Drugs to slow the breakdown of acetylcholine (called acetylcholinesterase inhibitors) include Aricept, Exelon, Razadyne, and Cognex. These medicines help delay the progression of Alzheimer's disease. Current research literature suggests that prescribing both types of drugs (to address both chemicals) is more effective than single drug therapy in some cases. Unfortunately, the cure remains elusive.

More on Storing Lantus: To E.S. from Napa, California: In your letter, you ask about storing the diabetic drug Lantus when prescribed for veterinary use. The manufacturer recommends that the vial of Lantus be discarded after 28 days even when it is kept in the refrigerator. If using a small drug amount, you might consider the Lantus Opticlik. This pen device contains 300 units in each pen-fill, as opposed to 1,000 units in each vial. Lantus Opticlik is sold in boxes of five cartridges. The Opticlik injection device must be obtained through the prescribing physician.

OTC Help for Eye Allergies: Zaditor (Novartis Pharmaceuticals) and Alaway (Alimera Sciences) are now available without a prescription to treat itchy eyes due to allergies. Both products contain the same ingredient, in original prescription strength, for immediate and up to 12 hours of relief. Many OTC allergy drops contain a decongestant and, with regular use, patients risk "rebound" redness in the eyes. Zaditor and Alaway do not contain a decongestant and can be safely used long term. Suggested retail price of each product is about $15. Insurance companies may opt to stop paying for prescription eye drops such as Patanol, Optivar, and Elestat since they are very similar to the new OTC options.

Editor's Note: Pharmacists are an integral, and sometimes untapped, part of the healthcare maintenance team. If you have a question about medications, write to: Cara Acklin, Pharm.D.; From the Pharmacy; 1100 Waterway Blvd.; Indianapolis, IN 46202.
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Title Annotation:storing Lantus; drug therapy for Alzheimer's disease; Qualaquin approved
Author:Acklin, Cara
Publication:Saturday Evening Post
Geographic Code:1USA
Date:Mar 1, 2007
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