Luscious, long lashes? (Alex Quesada for The New York Times)

A friend of mine with early glaucoma uses daily drops to prevent vision loss in one eye. The result: one eye has changed color and developed long thick lashes.

But it never occurred to me that people with healthy eyes might consider using these drugs to get a similar side effect. In “Love the Long Eyelashes. Who’s Your Doctor?” my colleague Natasha Singer today writes that Allergan, the company that brought us Botox, has repackaged a glaucoma treatment as the first federally approved prescription drug for growing longer, lusher lashes.

The product has the same formula as Allergan’s eye drops for glaucoma, called Lumigan. It is one of several drugs in a category known as prostaglandin analogs, which are meant to reduce dangerous pressure in the eyeball. But as a side effect, the treatment tends to make the eyelashes of many patients longer and fuller.

Unlike the version for glaucoma, Latisse isn’t used as a drop, but instead is applied once daily to the base of the upper eyelashes with a disposable applicator. One worry is that cosmetic users may experience some other side effects, including red, itchy eyes and changes in eyelid pigmentation. And longer lashes don’t come cheap. Latisse is expected to cost about $120 a month.

I regularly use mascara to lengthen my lashes, but I can’t imagine going to the trouble of daily eyedrops. But Cindy Ross, vice president for sales at Young Pharmaceuticals in Wethersfield, Conn., who participated in the Latisse clinical trial, loves the result so much that she had a doctor prescribe the glaucoma drug to use on her lashes until Latisse becomes commercially available.

“People would say to me ‘Are you wearing false eyelashes?’ — even my own mother asked,” Ms. Ross said. “I wouldn’t stop. I found a way to get it.”

What do you think? Are long lashes important to you? Would you take a daily drug to get them?

Pass the pills, please. (Monica Almeida/The New York Times)

Borrowing and sharing of prescription drugs among friends and family is common, particularly among younger women, a new report shows.

Researchers from the Centers for Disease Control and Prevention surveyed more than 25,000 adults and found that sharing of prescription drugs is common, with 29 percent of women and 27 percent of men engaging in the practice.

But drug-sharing rates were highest among younger women ages 18 to 44, raising special concerns about side effects and health risks of unchecked prescription drug use among women who might become pregnant. Among the 7,500 women of reproductive age in the survey, more than one in three shared prescription drugs with friends or used medication offered by friends, according to the report, published in The Journal of Women’s Health. Among women of reproductive age, about 37 percent shared drugs, compared to 20 percent of women in other age groups.

Allergy medicines and pain pills were the types of drugs most commonly borrowed or shared by women. Read more…

(Naum Kazhdan/The New York Times)

Patients often are warned against taking certain pills with grapefruit juice, which can turn normal doses of a drug into a toxic overdose. Now, researchers have raised a new concern: grapefruit, orange and apple juices may also block the effects of some drugs, wiping out any potential benefit to patients, according to a new study.

Healthy volunteers took a dose of the allergy drug fexofenadine, downing it with water or juice. When the drug was taken with grapefruit juice, for instance, only half of the dose was absorbed into the bloodstream, compared to taking it with water. The findings were presented this week at the national meeting of the American Chemical Society by researchers at the University of Western Ontario in London, Ontario.

So far, the investigators have found that grapefruit, orange and apple juices reduce absorption of the anticancer drug etoposide; certain beta blockers used to treat high blood pressure; cyclosporine, used to prevent rejection of transplanted organs; and certain antibiotics. Additional drugs are likely to be added to the list, said David G. Bailey, a professor of clinical pharmacology at the University of Western Ontario.

“This is just the tip of the iceberg,” Dr. Bailey said in a press release. “I’m sure we’ll find more and more drugs that are affected this way.”

It was Dr. Bailey who originally identified the potential harm in consuming medications with grapefruit juice, showing that it can interact with drugs in a way that raises blood concentration of the medication to dangerous levels. It’s known to affect about 50 drugs, ranging from cholesterol-lowering statins to Viagra. Some drugs now carry labels warning consumers against taking them with grapefruit juice or fresh grapefruit.

Dr. Bailey said patients should consult with their doctors or pharmacists before taking any medications with grapefruit or other juices. The best advice, however, is to take most medications only with water.

For lists of drugs affected by grapefruit, click here, or check out the Grapefruit-Drug Interactions Web site.

Viagra doesn’t work as a treatment for women, most studies show. But new research suggests that among women who suffer sexual side effects as a result of antidepressants, the little blue pill may help.

Sexual side effects due to antidepressant treatment are common, affecting from 30 percent to 70 percent of men and women who use the drugs. In the first month of treatment, about two out of three patients will stop using antidepressants, often citing sexual side effects as a reason.

In a new study, researchers studied the effects of Viagra and a placebo in 98 women, average age of 37, who were using antidepressants for major depression. All the women also reported sexual side effects like lack of arousal or difficulty achieving orgasm. For eight weeks, the women took either Viagra or a placebo pill one to two hours before having sex. Read more…

Transverse fracture. (New York-Presbyterian Hospital)

This ugly image is a transverse fracture of the femur — you can see how the bone broke straight across. It’s a rare type of fracture — accounting for only about 5 percent of all fractures to the hip area, and it often happens as a result of severe trauma.

But a handful of case reports of low-trauma fractures have detected the odd pattern in long-term users of bone drugs called bisphosphonates. It’s a rare side effect, but notable given that bone drugs are supposed to strengthen bones, not weaken them.

The cases of bone drug users with these unusual fractures are the topic of my Well column in this week’s Science Times. One of the case studies involves a Tucson physician, Dr. Jennifer Schneider, who was traveling in New York when her subway car lurched. The jolt caused Dr. Schneider to shift her weight, and her thigh bone, which had been aching for weeks, suddenly snapped. After two surgeries and a lengthy recovery, Dr. Schneider began researching the issue and learned of the association between the unusual break and long-term use of bone-building drugs caused bisphosphonates, which are used to treat patients with osteoporosis. She wrote up her own story in the medical journal Geriatrics and has given talks on her experience.

“What I want is research to find out who are the people at risk,” Dr. Schneider said. “If we can find it out before they have a fracture, maybe we can prevent it.”

Early data are mixed. The Journal of Orthopedic Trauma recently reported on a study from researchers at New York-Presbyterian Hospital/Weill Cornell Medical Center. Among 20 cases of the unusual fracture, 19 were on the bone drug Fosamax. However, Mayo Clinic researchers in Rochester have studied about 1,700 fracture cases, and preliminary findings have not turned up any increase in the unusual fracture. And the researchers who have identified the trend all emphasize that for people at high risk of osteoporotic fractures, the benefits of bone drugs clearly outweigh the risks.

To read more about the issue, read my full Well column here.

And to find out your risk for bone fracture, check out this calculator created by the World Health Organization. There are four different tools for the United States, including one each for Caucasians, Blacks, Hispanics and Asians.

Cholesterol-lowering statin drugs, the most prescribed pills in the world, have become a family affair.

(Kim Scafuro)

Middle-aged men, many women and the elderly are routinely put on the powerful drugs to lower high cholesterol. Now the nation’s leading pediatric group says that certain high-risk children as young as 8 may also be put on statin therapy, just like Mom, Dad and Grandpa.

The new guidelines from the American Academy of Pediatrics have been sharply criticized by many pediatricians and parents. They worry about the long-term health consequences of the drugs and have raised questions about financial ties between the academy and drug companies. There is also concern that the guidelines could lead to more widespread use of the drugs among children. An estimated 13 percent of children have total cholesterol above 200 milligrams per deciliter, the threshold used in adults to determine high cholesterol.

But the doctors who wrote the guidelines say they have been largely misunderstood. They say that far from leading to widespread use of statin drugs by children, the guidelines target the small percentage of children with genetic cholesterol problems or those with several worrisome risk factors, like obesity, high blood pressure and diabetes.

“I don’t see this as a major groundswell for the indiscriminate use of lipid-lowering drugs,” said Dr. Stephen Daniels, a member of the A.A.P.’s nutrition committee and chairman of the department of pediatrics at the University of Colorado Denver School of Medicine. “That’s exactly why we need these guidelines, to say where the limits of that usage should be.” Read more…

Earlier this week, the nation’s leading pediatric group issued guidelines suggesting that some high-risk children be given cholesterol-lowering statin drugs that are typically prescribed for middle-aged men. The news shocked many pediatricians, who predicted a backlash from the public and doctors.

I spoke with Dr. Darshak Sanghavi, a pediatric cardiologist at the University of Massachusetts School of Medicine, about the move to put children on adult drugs.

“Children’s bodies are very different in how they metabolize or handle drugs,” he said. “Their livers are different, their kidneys are different. In many cases it’s about the same if they’re taking Tylenol or asthma medication. But for other drugs like statins that might have some impact on their endocrine system, we just really don’t know. I, for one, feel unsafe simply saying children are little adults in this case.”

To read the original story about the new guidelines, click here. Dr. Sanghavi also answered readers’ questions about the issue here.

And to listen to the rest of my conversation with Dr. Sanghavi about kids, drugs and cholesterol, listen to the podcast below.

Listen to the Podcast (mp3)

Researchers at the University of North Carolina have published a lengthy list of prescription drugs that increase the risk of falling among older patients.

Falls are the leading cause of both fatal and nonfatal injuries in adults 65 and older. An estimated 300,000 hip fractures occur each year, often as a result of falling. Head injury is also a problem among adults who fall.

Adults who take four or more medications at a time are at highest risk for falling. But certain types of drugs can also make someone more prone to falling, said Susan Blalock, an associate professor at the U.N.C. Eshelman School of Pharmacy.

The medications on the list cover a wide range of common prescription seizure medications and painkillers, among others. Also on the list are popular antidepressants like Celexa, Effexor, Wellbutrin, Prozac and others. Read more…

Among the many unanswered questions about hormones prescribed for menopause is whether a woman’s health risks change after she stops taking the pills. A new study shows that virtually all the benefits disappear but that a slightly higher risk for breast and other cancers persists for at least three years after stopping the drugs.

The data come from a major study by the Women’s Health Initiative that looked at more than 16,000 women who used the estrogen and progestin combination drug Prempro, made by Wyeth. Reporting in The Journal of the American Medical Association, the study’s investigators urge caution in interpreting the results, noting that a woman’s individual risk remains small. The excess cancer risk among former hormone users translates to an added annual risk of 0.3 percent for an individual woman, or three additional cases of breast or other cancers a year among 1,000 women.

The findings don’t change current recommendations for hormone use, which advise that women consider using hormones only if they have moderate to severe hot flashes and other symptoms, and only at the lowest dose and for the shortest possible time.

“What we found in the study is quite consistent with the current guidelines,” said Gerardo Heiss, the report’s lead author and a professor of epidemiology from the University of North Carolina, Chapel Hill. “There is no reason for alarm. The absolute risk is of small magnitude.” Read more…

At a time when the drug industry is facing increasing scrutiny from Congress and the public, the cast of “Saturday Night Live” has weighed in with a hilarious spoof of television drug ads.

The “commercial,” modeled after the real advertising campaign for the birth control pill Seasonale, touts a fake pill, Annuale. The spoof uses similar pill packaging, actors and even the same pink chairs, sneakers and yoga mats depicted in the real ad. Watch the video, posted below, for the over-the-top punchline. One of the funniest lines is in the list of “side effects” that rolls across the screen at the end of the ad.

“Do not take Annuale if you plan to ever become pregnant, as it may turn your baby into a firemonster,” the ad says. “In the days around your period, you may develop a leathery tail.”

The send-up comes at a time of increasing scrutiny of the estimated $5 billion that pharmaceutical giants spend on drug ads aimed at consumers. A Congressional committee is investigating ads for Lipitor, the best-selling drug in the country. An article in The Times earlier this month reported on the appearance of artificial heart pioneer Dr. Robert Jarvik in ads for Lipitor, including the use of a stunt double in scenes that appeared to show Dr. Jarvik sculling. Pfizer has announced it will drop the campaign. The cholesterol-lowering drug Vytorin also has been heavily advertised on television, but earlier this year the results of a clinical trial showed it didn’t work any better than a cheaper generic.

Here’s the video:

Cholesterol-lowering statin drugs have had a rough time of it lately.

There was the headline-making trial of the statin-combination drug Vytorin, which rattled conventional wisdom about the value of lowering cholesterol. Business Week weighed in with a report that asked: “Do Cholesterol Drugs Do Any Good?” And my Well column in Science Times last month pointed out that there’s no data to show that statins prolong the lives of many people who use them.

Now, The Wall Street Journal has joined the fray. Health Journal columnist Melinda Beck revisited questions about whether statin drugs have cognitive side effects that leave users, particularly women, with muddled thinking and forgetfulness. “This drug makes women stupid,” Dr. Orli Etingin, vice chairman of medicine at New York-Presbyterian Hospital, declared at a recent luncheon, according to the Journal. Read more…

A new study of cholesterol drugs has confused patients. (JB Reed/Bloomberg)

This weekend, New York City cardiologist Dr. Nieca Goldberg and her nurse spent their Saturday fielding phone calls from patients. The issue was a recent study of the cholesterol drug Vytorin.

Dr. Goldberg says she enjoys educating patients about their health, but has been frustrated lately by how much time she has spent trying to undo confusion about the latest cholesterol drug study. The report showed that Vytorin, an expensive branded drug, didn’t do any better job of protecting arteries than a cheaper generic drug. It didn’t do any worse either, but the findings, which surprised the scientific community, have alarmed many patients. Dr. Goldberg says one of her patients thought the drug was being pulled off the market, and others thought the study showed the drug might be risky. Neither is true.

“We had so many phone calls,” said Dr. Goldberg, medical director of the women’s heart program at New York University. “My patients were concerned.”

The reasons behind the confusion are outlined in my Well column in Tuesday’s Science Times. Do you use a cholesterol drug? What do you think about the latest study? Read the column here, and post your comments below. I look forward to hearing from you.

Arthritis sufferers are routinely targeted by the $20 billion supplement industry, which has introduced more than 800 purported remedies for arthritis in recent years.

With so many different products promising relief, it’s tough to know which are worth trying. This month, American Family Physician, a medical journal, offers some guidance. A new review article sifts through the research to determine which supplements really work.

The review article’s top pick — glucosamine sulfate — is typically derived from crustacean shells. Unlike many products sold by the supplement industry, this one has been widely studied. According to the authors, researchers at Creighton University in Omaha, glucosamine has been the subject of more than 20 randomized controlled trials involving over 2,500 patients. Read more…

Manufacturers withdrew several infant cough medicines from store shelves today amid safety concerns. (David Paul Morris/Getty Images)

Makers of cough and cold medicines for very young children announced they are pulling the products from retail shelves, The New York Times is reporting. The news is certain to startle parents who have long used the drugs to quiet the coughs of young children.

It’s no great loss. There’s no real evidence that these cough medicines work, and it is clear that in kids the drugs can cause unpleasant side effects such as agitation and sleep problems. If you’ve just given your infant a dose of Pediacare or Triaminic, however, there’s no need to panic. The health concerns appear to arise from parents accidentally giving their kids the wrong doses, or from using different medicines containing the same active ingredients. Read more…

Can grief be medicated away? Should it be?

Those are the intriguing questions emerging from a recent study of the prescribing habits of doctors. Researchers at Columbia University had been talking to physicians about prescribing anti-anxiety drugs to the elderly. But during the survey, the scientists stumbled across a surprising trend. More than half of the 33 Philadelphia-area doctors interviewed said that they had prescribed Xanax and other potentially addictive drugs specifically for bereavement. Read more…