The People's Pharmacy

Q: I have fibromyalgia, and it disturbs my sleep. I take Lunesta every night. What is your opinion of the new medication Rozerem?

A: Lunesta (eszopiclone), hailed as the first sleeping pill OK'd for long-term use, is being widely advertised. Side effects may include headache, dry mouth, drowsiness, indigestion and a bad taste in the mouth.

Rozerem (ramelteon) is new and should start showing up in pharmacies soon. It's the first sleeping pill to act on melatonin receptors. While more effective than the natural sleep hormone melatonin for helping people get to sleep, it doesn't seem to help them sleep longer. Side effects may include headache, daytime sleepiness, nausea, dizziness, fatigue, worsening insomnia and colds.

Q: Since my husband's open-heart surgery last spring, even putting his clothes on makes him so breathless he can barely speak. He is weak and exhausted all the time.

His doctor pooh-poohs the idea that this might be caused by any of the drugs he's taking. I found online that metoprolol has a warning to contact the doctor immediately if you have wheezing, shortness of breath or swelling of hands and feet. He has all those.

A: Metoprolol is a beta blocker that helps prevent the heart from overworking. It also can lower blood pressure.

Some people are sensitive to such medications and develop wheezing or difficulty breathing. This is a serious reaction that deserves immediate medical attention. Your husband should consult a lung expert (pulmonologist) as soon as possible. The swelling of hands and feet merits a prompt evaluation by a cardiologist.

Q: What is the interaction between statin drugs and grapefruit? Are statin users not supposed to eat any grapefruit at all? Or can you eat grapefruit in the morning and take your medication in the evening?

A: Grapefruit slows elimination of some statin drugs (Mevacor, Lipitor and Zocor). That means that if you eat grapefruit or drink grapefruit juice, it is likely blood levels of your cholesterol drug will be higher than normal. This may increase the risk of side effects. The grapefruit effect is long-lasting. Reported effects may linger for up to 48 hours, so eating your grapefruit in the morning will not protect you from an effect in the evening.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them c/o King Features Syndicate, 888 Seventh Ave., New York, NY 10019, or e-mail them at pharmacy@mindspring.com or via their Web site: www.peoplespharmacy.org