THE PEOPLE'S PHARMACY
Marijuana Question Is Raised

Q: I have heard that marijuana can greatly reduce intraocular pressure, but
I have also heard that it can have side effects. Could you please tell me
what to expect? How would one obtain marijuana legally? Can you get a
prescription? I am a law-abiding citizen, but I need to control my glaucoma
better.

A: There is preliminary research suggesting that ingredients in marijuana
can lower intraocular pressure in about two-thirds of patients.

The problem is that marijuana is not legal, and there are side effects
associated with smoking this herb. It can lower blood pressure, increase
heart rate and cause drowsiness or dizziness. Coordination and judgment can
be impaired, so driving is dangerous. The euphoria or "high" can be
disturbing for some people.

Your doctor could prescribe an oral formulation called Marinol, which has
been approved for nausea and vomiting associated with cancer chemotherapy
and loss of appetite due to AIDS. Whether it would work for glaucoma is not
clear.

There are many effective prescription glaucoma drugs available. Please
discuss your treatment with an ophthalmologist.

Q: I took Premarin for 10 years after menopause and Prempro for four years
after that. I was told these hormones would prevent osteoporosis and heart
disease, which runs in my family.

Last fall my doctor detected a lump in my right breast. It turned out to be
an early stage of cancer, which was treated with lumpectomy and radiation.

My oncologist prescribed tamoxifen to prevent a recurrence and said
estrogen could be dangerous. After a few months I noticed that my vision
was deteriorating. My eyesight is critical for my work, so I asked my
doctor about stopping tamoxifen. He said it would be all right for a while,
but now I wonder what else I should be doing to protect myself. I just read
that another drug might reduce the risk of breast cancer and that diet
doesn't help. I would be grateful for any information you can send me.

A: The drug you are wondering about is Evista (raloxifene). It is
prescribed for osteoporosis but has recently been shown to reduce the risk
of breast cancer dramatically. Like tamoxifen, it counteracts estrogen in
the breast, which may account for its value against this kind of cancer.

Ask your doctor whether Evista would be appropriate for you. Visual side
effects have not been reported with this medication as they have with
tamoxifen.

We are sending you "Evista, Osteoporosis and Estrogen: Benefits, Risks &
Interactions" for a discussion of some popular herbs that you may want to
avoid because of their estrogenlike effects. .

Q: Can you explain why Sudafed is still being advertised and sold? I
thought it had been taken off the market.

A: The decongestant recently removed from the market was
phenylpropanolamine, or PPA. It was an ingredient in over-the-counter cold
or flu remedies as well as diet aids. Researchers found that young women
taking PPA were more susceptible to stroke.

Sudafed contains pseudoephedrine, a different decongestant. The Food and
Drug Administration has not asked manufacturers to pull pseudoephedrine
from the market.

Pharmacologist Joe Graedon and nutrition expert Teresa Graedon answer
letters from readers. E-mail them at askpeoplespharmacy@HealthCentral.com
or visit www.peoplespharmacy.com (on the HealthCentral.com network). Or
write The People's Pharmacy, P.O. Box 52027, Durham, NC 27717.