ArcaMax

DEAR DR. ROACH: My husband and I have started taking Zepbound for various medical reasons. The medication has significantly and positively impacted the conditions that we hoped it would, but we have seen other results we are curious about.

First, within a month, my husband stopped snoring completely and doesn't seem to stop breathing during the night. Second, both my knees (bruised with slight tears and arthritis) lost all their inflammation and feel great. Finally, for whatever reason, we both feel more optimistic about almost everything.

We would like to hear what you think about our experience and about the possibility of long-term use. Is Zepbound a "miracle drug"? -- S.R.

ANSWER: Tirzepatide (Zepbound), like semaglutide, is a prescription medication originally used for diabetes but now approved for weight loss. In my opinion, these drugs should only be used in people with metabolic disease associated with obesity.

Two conditions that are associated with obesity are obstructive sleep apnea and arthritis. It is possible to have these conditions and be of a normal weight. But obesity is a risk factor for both, and losing weight can improve the symptoms associated with the conditions.

In obstructive sleep apnea (OSA), a person is unable to breathe properly when asleep, and snoring is often a precursor to OSA. Weight loss can sometimes stop OSA completely. I'm guessing your husband was at the point where the weight loss during the first month of treatment effectively treated what certainly sounds like OSA.

The main form of arthritis, osteoarthritis, doesn't just suddenly disappear, but losing weight can reduce symptoms. It's also possible that as you've lost weight and started to feel better, you've gotten more physically active, which is probably the most important treatment of osteoarthritis. It sounds as though you are in a "virtuous cycle" where one thing goes right, leading to more and more things going right. Feeling better physically leads to feeling better mentally as well.

As far as long-term use, these medicines do need to be used long-term to get long-term benefit. Most people started regaining weight as soon as they stopped the medicine. I tell my patients they should expect to be on the medication long-term, just as they would for treatment of high blood pressure.

These are not miracle drugs. By the time this is published, there may be some new side effect discovered (although the odds of this happening are getting smaller as more people use them longer). Still, they are very effective, but their limitations need to be kept in mind.

DEAR DR. ROACH: I normally take two extended-release Tylenol Arthritis pills in the morning. By mistake, I took two more an hour or so after the first two. Do I need to worry? -- A.F.

ANSWER: Each Tylenol Arthritis tablet is 650 mg of acetaminophen, so you took 2.6 grams in a short period of time. Since I am not an expert in toxicology, I called Poison Control at 1-800-222-1222. Anyone can call this number for a question about a possible overdose.

Fortunately, you took less than a normal day's worth of acetaminophen (4 grams), so you are not at risk for liver disease, although you may have stomach upset. Very large doses of acetaminophen, taken by mistake or on purpose, need to be evaluated in the emergency room in order to check blood levels.

A dose greater than 7.5 grams or more in a healthy adult (less in someone with existing liver disease) is potentially toxic and should absolutely be evaluated immediately.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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