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DATE: February 4, 2012    TIME: 4:58 PM

Medications Prescribed

Commonly Used Remedies

Florical
Prednisone
Niacin

Florical

Florical is being prescribed for the treatment of otosclerosis. This treatment is not widely accepted, and has not been proven to be effective. A large uncontrolled study of about 1500 patients by Dr. Shambaugh and associates suggested that it was effective. Although this medication is not a cure, it is thought to have some benefit in slowing the progression of the disease. This supplement is widely used to prevent osteoporosis (the bone softening that occurs with aging). It is the only medical treatment available for otosclerosis.

This medication is available over-the-counter (ie. without a prescription). It comes in a tablet that contains 3.75mg of fluoride and 145 mg of calcium. Take one tablet three times a day with meals.

Side effects of Florical include occasional stomach upset, allergic itching, and increased joint pains. If aggravation of arthritis occurs, Florical should be stopped and the joints usually return to their previous state in a few weeks.

After two years of Florical treatment, the dose is reduced from three times a day to one tablet once a day. We will need to monitor your hearing in the interval.

If you are a woman of childbearing age contemplating pregnancy, do not take this medicine. ( TOP )

Prednisone

One of the medications you have been prescribed is Prednisone, a steroid used for its powerful anti-inflammatory properties. This medication requires a prescription. Typically, a strong dose is used for 10 days, followed by a tapering of the dose. This tapering of the medicine is important for your body to start producing its own steroids again after you discontinue the medicine. Do not discontinue the medication without your doctor's advise.

Side effects include (but are not limited to) gastrointestinal distress such as heartburn or stomach pain, insomnia, mood swings, menstrual irregularities, and increased appetite. Stomach upset may be minimized by taking the medication with meals, particularly bland foods and milk. If you experience significant heartburn or stomach pain, try using an antacid such as ranitidine (Zantac) or famotidine (Pepcid) twice a day. If it persists, discontinue the medicine and contact our office.

Please do not use this medicine longer than prescribed. Inform your physician if you have diabetes, severe high blood pressure, kidney disease, psychiatric illness, tuberculosis or a duodenal ulcer. Blood sugar levels can be significantly affected in diabetic patients with this medicine.

When taken for a short periods of time, side effects are uncommon. Long-term treatment at high doses may result in puffiness of the face, weight gain, increased bone fragility, cataracts, acne, increased facial hair, and rarely a severe hip joint disorder.

The medication is taken as follows unless otherwise notified:

Seventy tablets of 10 mg each are prescribed.

Days 1 through 10: 30 mg (or 3 tablets) in the morning and night
Day 11: 20 mg (or 2 tablets) in the morning and night
Day 12: 10 mg (or 1 tablet) in the morning and night
Day 13: 5 mg (or 1/2 tablet) in the morning and night
Day 14: 5 mg (or 1/2 tablet) in the morning
Day 15: Off medication

If there are any questions about taking this medicine please ask your pharmacist or contact our office. ( TOP )

Niacin

One of the medicines you have been prescribed is niacin, or nicotinic acid. It is a vitamin that has been found to be quite helpful in a number of patients experiencing ear symptoms such as ringing, or tinnitus, fullness, and occasionally vertigo. The mechanism of action is unknown although it is thought to exert its effect by opening the small blood vessels to the inner ear and improving its blood supply. It is commonly used in people with high cholesterol as well.

One of the side effects of this vitamin is that it can cause significant flushing--redness and the sensation of warmth--over the face and body. This usually occurs the first hour after taking the medication but can occur several hours after taking a dose. It usually subsides after several weeks of consistent use. If this appears to be a significant problem for you, the sustained-release formula can be used. It is sometimes also called an "extended-release", "no-flush" or "flush-free" formulation. You can minimize the flushing by avoiding alcohol or hot drinks after taking the tablet. Also, the tablet should be taken with food.

Niacin can be found over-the-counter (without a prescription) in every drugstore, and most grocery stores. You will find that they vary considerably in the number of milligrams (mg) contained in each tablet. The typical dose is between 100 mg and 250 mg twice a day.

Do not take this medicine if you have or have had any significant liver disease. If you have any questions ask your pharmacist or call our office. ( TOP )