How Long You’re Contagious With Covid, Flu, R.S.V. and More

Dear Doctor: Why Didn't Anyone Warn Me About The Painful Side Effects From Taking Levofloxacin?

DEAR DR ROACH: I'm writing in to warn readers of a possible side effect of an antibiotic known as levofloxacin. I was recently treated with this medication for a sinus infection that would not clear up with amoxicillin. After five days of taking the medication, my joints became very inflamed, especially my ankles, and it was painful. I discontinued the medication, but almost three weeks later, I still have pain in my joints.

My doctor never told me of this horrible possible side effect. Levofloxacin is the generic form of Levaquin, which was removed from the market years ago due to these issues. Why wasn't the generic form taken off the market as well? Articles state that the symptoms can be permanent. I'm hoping they eventually lessen because it's miserable. -- K.S.

ANSWER: Levofloxacin is a powerful medication that should not be used lightly. Janssen Pharmaceuticals did indeed stop making brand-name Levoquin in 2017; although the company did not specify why, a spokesperson said "[t]he decision to discontinue Levaquin was made due to the wide availability of alternative treatment options and our focus on developing innovative medicines designed to address unmet medical patient needs."

Levofloxacin, like all drugs in the fluoroquinolone class, has the potential for serious harm. I believe you have tendinopathy (inflammation in the tendons), which is among the more serious side effects, partly because it can lead to rupture of the tendon. Although this is reported to be rare (3 per 100,000 cases), I have personally seen more cases than I would expect to with those numbers. Most people recover in two months, but some cases were reported to last between one to two years.

The Food and Drug Administration put a "black box" warning (the highest possible warning) on levofloxacin to remind physicians of the danger of this side effect and the danger of another symptom called neurological toxicity, which can cause delirium and memory impairment. There are more side effects that occur less commonly.

I hardly ever prescribe this medicine, but I don't think it should be banned entirely. There are a few times when this class of medications alone can be lifesaving. But physicians shouldn't be prescribing it lightly. I'm afraid too many physicians prescribe antibiotics for viral diseases too often.

Patients want them and sometimes demand them, but we still shouldn't prescribe them when we know they won't help. Doctors who refuse antibiotics are at risk for bad reviews from patients, and these can have a significant impact on a physician's practice. All antibiotics have the potential for adverse effects, and overuse contributes to resistance. But fluoroquinolones, in particular, should be used extremely sparingly.

DEAR DR. ROACH: I have tinnitus, which is very loud and makes it difficult to hear people, especially a group of them in a room. Is there anything that can be done for tinnitus? Do hearing aids help? I mind it the most when I'm trying to get to sleep, but I'm not sure if I could wear hearing aids to bed anyway. -- M.B.

ANSWER: Tinnitus almost always happens with hearing loss, but it's important to test this. For people with hearing loss confirmed by an audiologist, a hearing aid can help with understanding speech, and it can also mask tinnitus, which improves symptoms.

For people who have bothersome symptoms at night, increasing ambient noise can be helpful. My patients have recommended using fans, tuning the radio in between stations to provide static at a low volume, and buying specialized sound machines. These can be helpful for many people, but unfortunately, they are not effective for everyone. They occasionally make things worse. The American Tinnitus Association (ATA.Org) has many suggestions and references.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.Cornell.Edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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Vyvamind Vs Adderall: - Finding The Right Solution For You

We'll explore their key features, benefits, and potential drawbacks while introducing you to two compelling natural supplements.

The demand for enhanced cognitive performance has never been higher in today's fast-paced world. This comprehensive guide will dive deep into the intricacies of Vyvamind and Adderall, two titans in cognitive enhancement.

We'll explore their key features, benefits, and potential drawbacks while introducing you to two compelling natural supplements. By the end, you'll know to decide on the best cognitive enhancement solution for your needs.

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Buy Brain Pill at the Cheapest price from its Official Website Final ThoughtsVyvamind vs Adderall: Which Will You Choose? The choice between Vyvamind and Adderall ultimately comes down to your individual preferences and goals. Vyvamind offers a natural, non-prescription approach to cognitive enhancement, while Noocube and Brain Pill provide even safer, gentler solutions. Carefully consider the pros and cons of each option to determine the best fit for your unique needs. By making an informed choice, you can unlock your full mental potential and achieve your cognitive enhancement goals. Frequently Asked Questions What is better, Adderall or Vyvanse?Vyvanse is generally considered more effective than Adderall for treating ADHD symptoms. What is better than Adderall?Vyvamind, a natural nootropic supplement, can be a better alternative to Adderall as it provides cognitive enhancement without the potential side effects of prescription stimulants. What is the closest drug to Vyvanse?Lisdexamfetamine is the closest drug to Vyvanse in terms of its active ingredient and mechanism of action. Which ADHD medication is best for motivation?Natural OTC supplements like Brain Pill are considered one of the best ADHD medications for improving motivation and focus. Why do people prefer Vyvanse over Adderall?People often prefer Vyvanse over Adderall due to its smoother, longer-lasting effects and lower abuse potential. Why choose Vyvanse over Adderall?Vyvanse may be preferred over Adderall for its more stable, consistent therapeutic effects and lower risk of side effects or crashes. What type of ADHD is Vyvanse best for?Vyvanse is particularly effective for treating the inattentive type of ADHD, as well as for adults with ADHD. Is Adderall the most effective ADHD med?Yes, Adderall is considered one of the most effective ADHD medications for improving focus, concentration, and cognitive function. Why is Adderall cheaper than Vyvanse?Adderall is generally cheaper than Vyvanse due to its longer history of use and the availability of generic formulations. What is the most effective ADHD medication for adults?Noocube is often considered one of the most effective over-the-counter ADHD medications for adults, as it provides sustained cognitive benefits with zero side effects.   Disclaimer: The views and opinions expressed in this sponsored article are those of the sponsor/author/agency and do not represent the stance or views of Mid-Day. Mid-Day holds no responsibility or liability for any direct, indirect, implied, punitive, special, incidental or consequential damages resulting directly or indirectly from the use of this content. Any purchases made from the branded segment are at your own discretion and risk. It is advisable to seek guidance from an expert advisor or health professional before making any such purchase.

How To Get The Most From Your ADHD Meds

When it comes to ADHD medication, let's just say, it's complicated. And maybe not for the reason you think.

Simulants are a first-line treatment for ADHD—but they're in short supply.

The Food and Drug Administration announced a nationwide shortage of Adderall in October 2022, and there's been a shortfall of other ADHD medications since then.

Like any health condition, if someone has a proper ADHD diagnosis and would benefit from medicine, they should be able to get it.

Source: Altin Ferreira/Unsplash

But now tons of people with ADHD are burdened by the twisted reality of feeling like a drug-seeking criminal as they forage and ration their prescriptions each month.

And that's only one part of the love-hate relationship ADHDers tend to have with ADHD medications. With side effects and stigma and thrice daily doses, it's easy to understand why most people who take them don't stick with them.

In one recent study from nine countries, more than half of teens and adults stopped taking their ADHD medication within the first year of starting.

While there's no shortage of reasons to quit ADHD meds, I commonly hear vague comments, like "I don't like them" or "They don't work."

Let's dig into that.

Sometimes, a certain medicine is just not the right fit for a person—even if it's great for someone else. It's also possible to "grow out" of the need for medication, especially in milder cases.

That said, ADHD medications can be finicky. They're not exactly easy to please, and getting them to work well usually takes some finesse. And time.

Finding harmony between optimal medicine type and dose can take months, or longer. That's some serious patience.

But there's more to it than that. Other significant—and perhaps surprising—things can make ADHD medications work better, or worse.

So, before you break up with ADHD meds—or to make the most out of your limited supply—consider the following tips. Of course, always talk with your doctor before making any changes to your medications. This is not medical advice.

To Eat or Not to Eat? That's a Good Question

ADHD medications may or may not be as effective when taken with a meal.

For example, it's not uncommon to get better results taking instant-release medicines on more of an empty stomach—about an hour before, or two hours after, eating. Likewise, some find it best to eat a couple of hours before taking extended-release ones. It's different for everyone.

Tune in to what works best for you, and experiment with the timing.

Don't let yourself get too hungry, though. Going a long time without food can lead to feeling physically and emotionally unwell—and worse ADHD symptoms.

Eating is important, but when you eat relative to your meds matters, too.

Source: Christina Victoria Craft/Unsplash

Hold the Juice

On a similar note, ADHD medications don't always play nice with other stuff we put in our body.

For example, caffeine adds extra stimulant to the situation. So enjoying that coffee or soda can give you an anxious, jittery, or all-around unpleasant feeling.

And if you like to take your medicine with a glass of OJ, think again.

Believe it or not, citric and ascorbic acid can affect how your body absorbs and gets rid of ADHD medication. That doesn't mean fruit juice is off the table for good. You just might want to avoid citrus, carbonated drinks, and high Vitamin C items for an hour before and after taking your ADHD medicine.

And not to be a buzz-kill, but alcohol can make it seem like stimulants aren't working, and vice versa—raising the chances of having too much of either. At best, you can end up feeling intensely amped—like a nightclub is thumping inside of you—or have trouble sleeping. At worst, the combo of ADHD meds and alcohol can be dangerous.

Get Good Sleep

Easier said than done, especially with ADHD. But doing your best to sleep well is essential for a good ADHD life.

Being sleep-deprived can exacerbate ADHD symptoms and make it that much harder to get the most from your medication—or to accurately assess if it's helping.

Do what you can to get a sufficient amount of sleep. That's also different for everyone, but most adults need 7 to 9 hours per night.

Focus on your quality of sleep, too. There are loads of sleep hygiene strategies and healthy habits are personal, but aim to go to bed and wake up around the same time every day, keep a consistent wind-down routine, and try to make a comfy and non-distracting sleep space.

ADHD meds can get in the way of good sleep, so consider cutting your evening dose. That won't always be realistic, especially if you work or study at night, but take your last dose as early as possible before bed.

Source: Hiki App/Unsplash

Timing is Everything

ADHD medications vary in terms of how fast they kick in, and how long they last. Pay attention to how your mind and body feel in the hours after you take it.

If you notice peak effects after one hour, and you need to be at optimum functioning at 9 am, be sure to take your medicine around 8 am. Track the number of hours it takes to wear off, and talk with your doctor about when to take additional doses.

The ideal timing might be inconvenient, so a little planning can help.

Pro tips: Set daily alarms for each dose, schedule meals, and have your medication on you when you need it.

If you're sluggish in the morning, keep the medicine next to your bed, so you can roll over and take it right when you wake up.

Play around with the timing until you find your groove.

Sometimes, Less is More

Remember, more milligrams don't necessarily mean more benefits. Taking more medication than your brain needs can even make ADHD symptoms worse.

So, as you work with your doctor to find the right dose, test different options—go up as needed, but also back down.

You might be surprised that a lower dose feels good and works, too.

Follow Your Lead

Be curious and pay close attention as you make these delicate maneuvers. With each adjustment, take notes about how you feel and function. You'll thank yourself later.

ADHD medications can be very helpful, and the right one could still be out there for you.

At the same time, medication isn't right for everyone. Be honest with yourself about what you want. If you prefer a non-medicated approach, that's OK too!

The key is that you hope and believe in your treatment plan—whether you stick with ADHD meds or not.

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