Is This Side Effect Possible?

Q. My neurologist has me on 4ap. I have diarrhea and stomach distress, which they claim it is not the medication causing it. What can I do?

A. Any drug can cause practically any side effect. It is entirely possible for 4ap to cause stomach distress. The only way to know for sure is to test it.

Stop using the 4ap for a day and see if your stomach problems improve. The benefits from 4ap are short-lived and are only felt when the drug is taken regularly. Missing a day or two won't do any long-term harm. You can start up again the day after your test if you determine that the 4ap is NOT a problem.

If you DON'T feel better in a day or so, the 4ap dose is not the cause.

If you do feel better when not using the dose of 4ap, then the 4ap prescription is probably responsible. It might be the 4ap itself or it might be the filler used by the pharmacist. Ask your compounder what filler is in the capsule

NOTE: There is always filler. If you have a 5mg 4ap dose, for example, there is approximately 225mg of filler in each capsule. If the filler is lactose and you're lactose intolerant*, you could experience stomach distress. Consider that if you take four capsules a day you would also be ingesting almost 900mg of lactose. We stopped using lactose in all of our compounds because it seemed that more and more people suffer from lactose intolerance - usually stomach distress and diarrhea.

You can ask your compounding pharmacist to use a different filler. There are many available. With just a little effort, you will find a preparation that works and doesn't cause distress.

It is important to keep in mind that it is possible that anything we ingest can cause difficulties for us. Some foods don't sit well with some people. Drugs are likely to cause problems and we often see people using one drug to counteract the bad effects from another one they're using. The potential for a serious drug reaction increases with the number of different drugs a person is using. People who take five or more different drugs in a day have approximately 100% probability of experiencing at least one side effect.

Most of us ignore this serious potential and take whatever the doctor prescribes - along with the myriad bottles of drugs and supplements we use without a prescription. Please take the time to ask your doctor and pharmacist about the possible negative effects possible from the drugs you are prescribed - and how they may interact with other drugs you are using. Be alert to changes whenever you start a new drug. At the first sign of difficulty, contact your pharmacist and doctor for advice. Sometimes the dose can be adjusted - or even the schedule you follow. Sometimes one or another prescribed drug can be discontinued (ONLY with the doctor's permission).

The potential for reactions - serious ones too - is present in everything we ingest, especially drugs. Be alert and report your concerns as soon as possible. Your doctor and pharmacist want to help.

* LACTOSE INTOLERANCE is the inability to metabolize lactose, a sugar found in milk and other dairy products, because the required enzyme lactase is absent or its availability is lowered in pasteurized dairy products. It is estimated that 70% of adult humans are lactose intolerant