Copyright People’s Pharmacy

Q: You’ve written about Voltaren gel for arthritis pain.  I cannot use this drug, as it causes me severe stomach pain and acid reflux.  I wish I could use it for my sore joints.  My aunt died from using an NSAID.  It gave her an ulcer that led to infection and death.  I can’t believe we can buy NSAIDs without a prescription in this country.  They can kill you and are known to cause ulcers even when people are unaware of the damage until it is too late.

A: You are correct that non-steroidal and anti-inflammatory drugs (NSAIDs) such as diclofenac, ibuprofen (Advil, Motrin IB), meloxicam and naproxen (Aleve) can cause stomach ulcers (Expert Review of Gastroenterology & Hepatology, June 2016).  Such complications can indeed be deadly.  For most people, occasional use of ibuprofen or naproxen is not highly dangerous.  Many people take these medicines daily, however, to ease the pain of arthritis. We discuss safer options to manage arthritis pain in our eGuide to Alternatives for Arthritis, available at peoplespharmacy.com.

Q: I’ve been on medications (Plaquenil, methotrexate, Medrol and folic acid) since around 2000 to treat rheumatoid arthritis.  My former rheumatologist kept me on these old medications since he was conservative in what he prescribed.  A new rheumatologist has recommended going on biologics.  My questions is: Since I was on the old standard medications, my hair has curled and I love  it.  If I go on a biologic and stop taking my old meds, will my hair revert to its former straight look?

A: There is nothing in the medical literature about your medications making hair curl.  Hydroxychloroquine (Plaquenil) can cause hair changes, and some others have reported curling.  Hair loss appears more common than curling, though, even with the new biologics for RA.  It is hard to predict how your hair would react to drugs like adalimumab (Humira) or etanercept (Enbrel).