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Getting omega-3 fatty acids

Q. Fish oil makes me vomit. I am aware of the benefits of omega-3 fatty acids, but I am at a total loss for a source that my body tolerates. I have tried many oral forms, and all have the same effect.

Is there a suppository or other route of administration? I can't even take multivitamins that contain fish oil.

A. As far as we can tell, no one sells a fish oil suppository. You'd have to be rather desperate to take it by that route.

You might find that eating fish is a perfectly reasonable alternative to get your beneficial omega-3 fats. A couple of servings a week should be enough.

Other sources of omega-3 fatty acids include walnuts, flaxseed and dark-green leafy vegetables like spinach or chard. Getting adequate omega-3 fats from plant sources is difficult, however, because our bodies do not use those fatty acids as efficiently as fish oil.

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Q. My mother has type 2 diabetes and high blood pressure. Each drug she takes seems to cause side effects that lead to the prescription of more pills to cure the side effects of each new drug. She is on doxazosin, furosemide, carvedilol, repaglinide, digoxin, warfarin, metformin, a beta blocker, a statin and allopurinol.

I am wondering if drug companies have a vested interest in overmedicating the old, since all this started the moment she became eligible for Medicare. She is never taken off a pill, just given a new one. This is very worrisome, since she used to be in good health and now seems continually bothered by multiple blood tests and new side effects.

A. We share your concern about this long list of drugs, since there are a number of potential interactions. The combination of the diuretic furosemide with the heart medicine digoxin calls for extremely close monitoring of potassium and magnesium levels. Furosemide also may increase the blood levels of the diabetes drug metformin, leading to more side effects, while the heart drug carvedilol can increase furosemide levels.

There are far too many tricky issues here to discuss all of them. Your mother's doctor should review this list to see if any could be discontinued safely.

To help you with that conversation, we are sending you our Guide to Drugs and Older People and our Drug Safety Questionnaire. Anyone who would like a copy, send $3 in check or money order with a long (No. 10), stamped (61 cents), self-addressed envelope to: Graedons' People's Pharmacy, No. OQH-883, P.O. Box 52027, Durham, NC 27717-2027. They also can be downloaded from our website: www.peoplespharmacy.com.

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Q. My doctor prescribed Zegerid for acid reflux. It contains omeprazole plus sodium bicarbonate.

My pharmacist says I can take OTC omeprazole plus baking soda and get the same results for less money. A 30-day supply of the prescription is $129.

A. The pharmacist gave you money-saving advice. Make sure she tells you how to substitute the dose of house-brand omeprazole and the baking soda so they parallel the doctor's prescription. Be careful not to overuse baking soda, since this could provide too much sodium.

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