Rumor vs. Truth – 4 things you may not know

Rumor: Nicotine replacement products don't work.

Some people have heard that using nicotine replacement products (patches, gum, etc) to stop smoking don't really work. This stems from hyped up news reports of a study showing they aren't effective for the majority of patients using them.

It's true that many patients fail to stop smoking even when using nicotine replacement products. But more often than not, it's due to inappropriate use...NOT because nicotine replacement is ineffective. Patients buying these products OTC (over-the-counter) often don't use them consistently and don't get needed counseling from a health professional.

There's plenty of evidence that patients who use nicotine replacement products correctly, successfully quit smoking about a quarter of the time.

It’s very important to talk with your physician or pharmacist to understand how to use these products safely and successfully.



Rumor: Natural vitamin E is more effective than synthetic vitamin E.


Lots of people are hearing that "natural" vitamin E is better than "synthetic" vitamin E.  This all

started after media reports suggested that the natural version is more effective.

Vitamin E is sometimes called "natural" vitamin E because it occurs naturally in foods.  
It's true that natural vitamin E is the most active form of alpha-tocopherol. It has the highest affinity for the transport protein that carries vitamin E from the liver to the plasma. But there's no proof that natural vitamin E has any clinically significant advantage over synthetic vitamin E.

When it comes to getting the recommended dietary intake, most people get enough vitamin E from their diet.  If you are using a vitamin E supplement, you can use either natural or synthetic vitamin E.   But you will need a slightly higher dose if they use the synthetic form.


Rumor: There's a 20% difference in active ingredients between generic and brand drugs.


Some people still think generics aren't as effective...because they're hearing that generics and brands don't contain the same amount of active drug.                             

It's not true. Generics get approved by the FDA if the average rate and extent of absorption is within 80% to 125% of the brand product...but the actual difference between most brands and generics is only 3.5%. This means that a 100 mg brand tablet is bioequivalent with a generic tablet containing 96.5 mg or 103.5 mg of active drug.

The generic equivalent will produce the same therapeutic results.  In fact, nearly 80% of generics are made by brand name manufacturing companies. Patients should use generics when there's one available due to cost savings, unless specified otherwise by their doctor.





Rumor: It's okay to take drugs that interact with grapefruit, as long as they are separated by two hours.


Patients often ask how long to avoid grapefruit juice if they take certain drugs. Some are being told to avoid grapefruit altogether...others are told to separate grapefruit from their drugs by a few hours.

Grapefruit can increase the levels of many drugs...lovastatin, simvastatin, diazepam, some calcium channel blockers, protease inhibitors, etc.

Certain substances in grapefruit inactivate CYP3A4 in the gut. Now there's evidence it can take THREE DAYS or LONGER for enzyme activity to recover.

New evidence is also surfacing that suggests other fruits can have effects similar to grapefruit...tangelos...limes...and Seville oranges.  But there's no interaction with most other citrus fruits...sweet oranges...lemons...tangerines...and citrons.  In addition to grapefruit juice, keep in mind that the fruit itself can be a problem.  Most of the studies indicate that 8 ounces of grapefruit juice is enough to cause the interaction.

Just one small glass of grapefruit juice occasionally is not likely to be a problem.  But to be safe, avoid grapefruit entirely if you are taking medications that interact.   It is also important to note that separating grapefruit from medications by a few hours won't decrease the possibility of an interaction.