The portal to do it is MedWatch: www.accessdata.fda.gov/scripts/medw... You will need the manufacturer's name (it's on the pharmacy bottle). The options you want are Consumer/Patient (FDA Form 3500B), "Had problems after switching from one product maker to another maker".

...grace jones??

This may need to be a t-shirt for our times.

Title text: "Reductio ad absurdum fails when reality is absurd."

Alt text: https://explainxkcd.com/3087#Transcript

The priest didn't stop for the accident victim because he was gonna be late to say Mass. The deacon didn't stop because maybe the guy was an addict and faking being hurt. The communist atheist lesbian saw him and took him to the hospital in her Subaru. Which of these was neighbor to him?

I mean, that makes sense - Jesus was rebuking the Pharisees as one insider to another, not as someone rejecting interlopers, and, well, the insiders now are the clergy, among whom are many good and holy men, and also the other ones.

It was a banger, though. My dad is a conservative deacon, and I'm a conservative-turned-liberal who attends Mass weekly, so you might say I have a vested interest; it galls me to no end how often you can read the Gospel and substitute "priest" for Pharisee" and it still makes perfect sense.

CORRECT

I think levocetirizine is available otc now as Xyzal—I used to have an rx until it got approved for otc use

Another example is cetirizine: it's not only generic but it's available OTC, but levocetirizine is just the (R)-(-)-cetirizine half and it's rX-only. It's also safer to use in people with cardiac QT-prolongation because it doesn't affect the QT interval as much.

There is a complex pharmaceutical explanation here but basically, use levalbuterol instead, that drug is only the right-handed molecule and that one is *not* the MC destabilizer.

Use clonidine (if you're using it for blood pressure) or ivabradine (for arrhythmias) instead. The other "most likely to be accidentally prescribed" vindicated my entire childhood: albuterol is a mast cell destabilizer, it will make breathing-related MCAS problems WORSE.

--and we'd have added ketotifen by now if you didn't have to have it compounded in the US (it's approved but nobody makes it commercially). Also, there is a list of drugs to avoid! Beta blockers (propranolol et al) are most likely to be accidentally prescribed to LC patients.

My MCAS collection is up to 10mg cetirizine BID, 10mg loratidine BID, 20mg famotidine BID, 10mg montelukast daily (or twice daily in a flare), 50mg diphenhydramine PRN for rescue meds, 25mg promethazine PRN for rescue, 5mg diazepam PRN for rescue and a lot of other shit, and .2mg clonidine TID--

rX only: Canada also has ketotifen, which is an excellent MC stabilizer, plus there's cromolyn, quercetin, montelukast or any of the leukotriene receptor antagonists, benzodiazepines help in a lot of people, and then there's a lot of other shit that's never been studied well --

--then treating it like MCAS will probably make it improve. If you can find a better doctor, there's all kinds of prescription mast cell stabilizers that may help.