Q: Years ago, my doctor prescribed 800 milligrams of ibuprofen three times a day. I was waiting for spinal laminectomy surgery due to a herniated disk.
My stomach began to ache, and I was worried about developing an ulcer. This may sound crazy, but I noticed the GI irritation was always less when I took ibuprofen with hot coffee.
Is it possible that taking pills with a hot drink reduces damage to the GI tract and assists with dissolving and absorption? If I think of simple things such as washing dishes, it is harder and takes longer if the water is cold.
A: You raise a fascinating question that has not been well studied. Does beverage temperature impact drug absorption?
A small study of acetaminophen (Tylenol) demonstrated that a hot drink resulted in faster and greater drug absorption (Pharmaceutical Research, August 2014). Lab tests showed tablets disintegrated almost three times faster in warm liquids than in cool ones (European Journal of Pharmaceutical Sciences, Aug. 1, 2020).
The caffeine in your coffee also might have an effect. Caffeine can increase pain relief from NSAIDs such as ibuprofen (Pharmaceuticals, May 11, 2023). An objective review from the Cochrane Collaboration concluded that “taking a single 200-milligram ibuprofen tablet with a cup of modestly strong coffee or caffeine tablets …” could provide good pain relief at lower doses of ibuprofen (Cochrane Database of Systematic Reviews, July 14, 2015).
Q: I have never dyed my hair. That’s why I’m puzzled that it has not turned gray, even though I’m in my 80s. I have been prediabetic for 12 years. I wonder if any of the medicines I take could keep hair from turning gray. Here’s the list: multivitamin, calcium with vitamin D3, clopidogrel (Plavix), sertraline (Zoloft), L-thyroxine (generic for Synthroid), and rosuvastatin (generic for Crestor).
A: We could find no research to answer this fascinating question. Other readers have reported, however, that taking a statin turned graying hair dark again.
Q: I am a woman who had a heart attack at age 54. My only risk factor was that some people in my father’s family had early heart attacks.
I started taking a statin and baby aspirin. Ten years later, my cardiologist tested my Lp(a), and it was 123. That’s very high, and he’s convinced that it is the culprit for my heart attack.
He prescribed Repatha injections to get my LDL below 70. My Lp(a) has fluctuated between 123 and 145 since starting the Repatha, and I’m still taking a statin.
My two daughters are in their early 30s, and one of them inherited high Lp(a). I do hope they come out with a drug to treat this soon. I feel like a ticking time bomb, despite my healthy diet and lifestyle.
A: As you have learned, lipoprotein (a) is an important risk factor for heart disease. In fact, some researchers believe it may be even more harmful than “bad” LDL cholesterol.
Drug companies are developing new medications to lower Lp(a) levels (Current Vascular Pharmacology, Dec. 20, 2023). A meta-analysis published in the European Heart Journal (June 21, 2020) concluded that statin-type cholesterol-lowering drugs actually raise Lp(a).
You can learn more about Lp(a) and what to do about it in our “eGuide to Cholesterol Control and Heart Health.” This online resource may be found under the Health eGuides tab at PeoplesPharmacy.com.