Q: Recently, my left big toe swelled up, formed something like small blisters and itched and burned.
The physician assistant diagnosed the problem as "herpetic whitlow." She prescribed acyclovir to speed recovery. I couldn't afford it, and when I learned it wouldn't cure the problem, I went without. I took diphenhydramine to help me sleep through the itch. It seemed to reduce the swelling a bit as well.
I've never heard of herpetic whitlow before. What can you tell me about it?
A: Most people have seen cold sores and fever blisters on or near the mouth, caused by herpes simplex virus. The herpes virus also can get into small cuts or abrasions on the fingers or toes and cause painful swelling, blisters and itching. The medical term for this type of sore is "herpetic whitlow."
Acyclovir or other anti-herpes drugs such as valacyclovir or famciclovir can help ease symptoms of whitlow, but they should go away on their own.
Here is a link to a picture and more complete discussion of this skin condition: tinyurl.com/3leuyu3
Q: I have read that many people don't take their prescribed medications because of concern about costs. Please tell your readers that anyone who can't afford the prescription should talk to the pharmacist about an alternative.
I have heard of people saving money through generics, an older drug to treat the same problem or medicine from a compounding pharmacy. The best solution is financial aid from the pharmaceutical company that makes the drug.
A: You have summarized these options well. While generic drugs can save lots of money, some people find they do not always work the same as their brand-name counterparts.
Q: Seven months ago, my doctor put me on Trilipix to lower my cholesterol. By the fourth or fifth month, my blood-sugar level went from normal to diabetic high. My blood pressure also rose, to 220/120. I also got hundreds of floaters and flashes in my eyes.
The doctor crammed more and more blood pressure drugs in me, but we got no results. Then someone said Trilipix might be at fault. I stopped the drug two months ago, and finally my blood sugar, eyesight and blood pressure all went back to normal.
I've talked to several pharmacists about this problem, and none of them knew anything about it. Neither did my doctor. Has anyone else reported these side effects?
A: Trilipix (fenofibric acid) is often used in conjunction with a statin to help get cholesterol down. High blood pressure has indeed been reported as a side effect of the drug, but we could find no mention of Trilipix raising blood sugar or triggering retinal detachment. We hope you saw your eye doctor when you noticed an increase in floaters and flashes.
Joe and Teresa Graedon answer letters from readers. Write to them c/o King Features Syndicate, 300 W. 57th St., 15th floor, New York, NY 10019, or via their website: www.peoplespharmacy.org
