Pharmaceutical Terrorism

Two random warnings on the Internet from reputable pharmacologists 

(1) “Ranolazine (Ranexa) is an anti-anginal medication prescribed to treat chronic angina.

What are side effects of Ranolizine?…they include dizziness,  spinning sensation, nausea, vomiting, stomach pain, constipation, headache, dry mouth, ringing in the ears, swelling in hands, ankles, feet, slow/fast/irregular heartbeats.” 

(2) “In summary…common side effect of Entresto include Hyperkalemia, Hypotension, and increased creatinine.”

I know they mean well, but…

Two hospital doctors have advised me that I should take Ranolazine (500 mg.) twice a day. Given the medicine’s potential side effects, I prefer avoiding Ranolazine altogether, rather than risk dealing with a side effect that may be worse for me than Ranolazine itself.  I’m not a gambler.

I don’t speak for others when I say that apart from that risk, I cannot swallow that pill even if it were absolutely without side effects and as sweet as candy. The reason for that is that the medical instructions for Ranolazine firmly forbid a patient to “crush, chew, or split tablets.”  

For me, that warning obviates any possibility to ingest the pill. I have a single phobia, i.e., swallowing any pill whole larger than an aspirin. I will not do that under any circumstances, including the possibility of death if I don’t ingest that pill as directed.  

I have not had Entresto prescribed for me. But at a glance, I’ve read its potential side effects. They are at least as frightening to me as those for Ranolazine. The side effects of Entresto’s combined ingredients, sacubitril and valsartan, and all other side effects I’ve read about potential side effects I’ve researched, read like biological minefields. 

Following, is a list of Entresto’s potential side effects: “fatigue, bone pain, headaches, nausea, vomiting, constipation, forgetfulness, lethargy, depression, irritability, muscle aches, weakness, cramping and/or twitches.”  Perhaps worst of all those side effects is “frequent urination and thirst” — a human dilemma similar to that of Tantalus who was punished by a Greek god who placed him in a pool of water and a fruit tree, each  of which alternately withdrew from his endless and fruitless grasp. Whereas Tantalus was tantalized but denied food and water, a patient must accept a pill that is anathema to him. Forced feeding? —I think not!

Now, perhaps I’m a bit too squeamish, but I find it somewhat difficult to choose which of those side effects above I would choose except that of throwing-up, which is totally out of the question. I’m ninety-four years old and have thrown-up only once, when I was a child. After that unspeakable event I promised I would never throw-up again. So far, I have kept my promise and my stomach has cooperated.  (Note that I’ve written the V-word when quoting the list of side effects above because I’m hopelessly committed to cite quotations precisely even when they are lurid, as is the V-word on that list. As spine-chilling as the expression “throw-up” may be, it is less decimating than the V-word.)

I surmise that side effect warnings are derived from patients who have experienced them. A warning is probably required even if only one death is purported to have been the result of a deadly side effect. The fatal warning usually appears at the end of a list of side effects, e.g., “…death is rare,” or “…may even cause death.”  That last item on the list is a gross understatement. Although death is almost always traumatic, I hardly regard death as a ‘side effect.’ 


The opinions and/or facts herein, wherein, and within, have not been, may or may not be, either implicitly or explicitly, limited to this document, which has not been reviewed and/or approved by the Food and Drug Administration and/or any Center for Disease Control or prominent physician.

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