Ask the Pharmacist

Over the years I have compiled a list of questions I have received varying from medication to disease states to urban legends. Many times when the conversation starts with “I read on the internet…” I feel compelled to impart real, unbiased medical advice. Here are two recent questions that came my way (and yes I do get the irony that I’m posting this on the internet to read):

I always thought aspirin was the “wonder” drug, now I’m being told not to use it…what’s the deal?

Some experts are backpedaling on aspirin to prevent heart disease. Aspirin is beneficial for SECONDARY prevention…to prevent a second heart attack or stroke in patients who’ve already had one. For these patients, aspirin’s benefit significantly outweighs its major downside…the risk of major bleeding. For primary prevention, aspirin prevents only about one initial serious cardiac event for every 1000 patients/yr…but causes a similar number of major bleeds.

Many men and women are routinely started on aspirin when they reach a certain age. But some experts are skeptical about the benefits of using aspirin for primary prevention…at any age. Many physicians are now recommending aspirin in men at age 45 and women at 55 IF they have additional cardiovascular risk factors such as hypertension, dyslipidemia, etc…and they aren’t at high risk for bleeding. This includes diabetics as well.

As far as the dose, most physicians will recommend 81 mg/day of aspirin for prevention. There’s no proof that higher doses work better…plus they may increase bleeding. I recommend monitoring blood pressure…uncontrolled hypertension increases the risk of hemorrhagic stroke.

Is coconut water really better than plain water?

Coconut water does provide electrolytes that plain water doesn’t…but it’s not the cure-all that some would have you believe. I’ve seen claims that it improves circulation, prevents kidney stones, slows aging, boosts immunity, and reduces the risk of heart attacks, strokes, and cancer. Coconut water is low in fat and calories and contains the electrolytes potassium, magnesium, calcium, phosphate, and sodium. However there’s no solid proof it does anything more than provide good hydration.

It’s a very good post-workout drink…think “natural Gatorade”. It does contain a good dose of potassium…1 cup being approximately equivalent to a banana or cup of orange juice…making it a good supplement for those in need.

Hydration? Yes. Cure-all? Not the magic bullet so many crave.

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