Ask the Pharmacist
By Ron and Marla Chapleau
Health & Fitness
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Q: I heard medications that I stopped taking years ago, could affect my upcoming cataract surgery. Is this true?
A: Unfortunately, this is indeed correct. While generally drugs that you have stopped taking will no longer impact your life shortly thereafter, sometimes there can be lingering issues even decades later.
This is one reason why we believe patients should keep records not only of what medicines they are currently taking, but also of drugs they have taken in the past and what the impact was on their health (another reason is the almost daily occurrence where patients are prescribed drugs they believe are new to them only to be informed that they took the same medicine years ago and are uncertain as to why the treatment had been stopped in the first place).
In this case, the family of drugs called the alpha-blockers has the potential to increase the risk of complications during cataract surgery even if the drug was stopped years ago.
The alpha- blockers are medicines designed to help manage the symptoms of an enlarged prostate, such as urinary frequency and urgency. The drugs include tamsulosin (Flomax), alfuzosin (Xatral), doxazosin, terazosin and prazosin.
They can cause a complication called "floppy-iris syndrome" which can lead to more post-operative pain for the patient, a longer recovery time and less improvement in vision than would normally be expected.
This complication occurs nearly all the time in patients who have taken tamsulosin and almost 70 per cent of the time with the other alpha-blockers (the risk in the general population is close to three per cent).
Other drugs have also been implicated in increasing this risk, including mirtazepine (Remeron), carvedilol (Coreg), labetalol (Trandate), risperidone, chlorpromazine and the tri-cyclic antidepressants (amitriptyline, nortriptyline, etc.).
Ideally, if you’re a candidate for cataract surgery, hold off on starting any of these drugs until after the surgery (this may not be a good decision for those prescribed the cardiovascular drugs labetolol or carvedilol).
For those who have already taken these drugs, the good news is that ophthalmologists can take special precautions during the cataract surgery to decrease the risk that this complication might occur. The key is to have the information available so that you can warn the surgeon beforehand.
For more information about this or any other health-related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination
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Monday, May 14, 2012