People’s Pharmacy: Don’t put hemorrhoid remedy in your nose

Q. I have something like varicose veins in my nose that cause frequent nosebleeds. My nose is often dry regardless of weather conditions.

To counteract this, I have used either Vaseline or Preparation H as the ear, nose and throat specialist suggested. Believe it or not, the Preparation H works great and really keeps the bleeds at bay. If I have a mild bleed, I use Preparation H for at least a week. Otherwise, I use one of these every other day or so.

A. We understand why Preparation H might be helpful against nosebleeds. It contains phenylephrine, a vasoconstrictor. That means it shrinks blood vessels in the nose as well as the rear end.

There is a problem with your strategy, however. Both Vaseline and Preparation H contain petroleum jelly (also known as petrolatum). Physicians have been arguing about the benefits and risks of putting petrolatum in the nose for years.

A report in BMC Ear, Nose, and Throat Disorders (Aug. 19, 2016) asks doctors to warn against “long-term application of petroleum-based oils and ointments to the nose and discourage such use of these products.” The researchers were reporting on a case of lipoid pneumonia in an older woman who regularly used Vicks VapoRub in her nose. It too contains petrolatum, and the packaging warns “Do not use in nostrils.”

If you want the vasoconstrictor action of phenylephrine without the petroleum jelly, you might want to ask your ENT doctor about Neo-Synephrine Nasal Spray. It contains phenylephrine without petrolatum. We don’t know if it will help your nosebleeds as much since it does not contain moisturizer. You could add a saline gel or nasal spray to your regimen.

Q. My doctor prescribed Ozempic last year when he diagnosed me with Type 2 diabetes. Even at a low dose, the nausea and fatigue were daily side effects that were difficult to live with. I also experienced acid reflux and constipation.

I did get all the way up to the full 2 milligram dose before my doctor suggested switching to Mounjaro. Mounjaro is much better for me.

I still deal with fatigue but only for the first few days after the injection. It’s not as severe as with Ozempic and I have little to no nausea. Fiber helps with the constipation.

I’m a slow loser, with a 25-pound loss over eight months, but I’m not complaining. My A1C dropped to 5.6 almost immediately.

A. Thank you for sharing your experience with Ozempic, a drug prescribed to control Type 2 diabetes. We have heard from many readers that the GLP-1 agonists like semaglutide can cause some unpleasant digestive side effects, from nausea and vomiting to severe constipation or diarrhea.

Fatigue has received less attention, but the official prescribing information for Wegovy (semaglutide prescribed for weight loss) lists fatigue as affecting 11% of study subjects.

Mounjaro is tirzepatide, also for Type 2 diabetes. While its prescribing information does not mention fatigue, the side effect list for Zepbound, (tirzepatide for weight loss), indicates that fatigue might affect up to 6% or 7% of study subjects. Both semaglutide and tirzepatide should help people with Type 2 diabetes lower their HbA1c, a measure of blood glucose over several weeks.

You can learn more about these new medicines for diabetes as well as dietary and other nondrug approaches in our “eGuide to Preventing and Treating Diabetes.” This online resource may be found under the Health eGuides tab at www.PeoplesPharmacy.com.

Write to Joe and Teresa Graedon via their website: www.PeoplesPharmacy.com.