Q. I have suffered from COPD (emphysema) since the 1980s. Trials of various medications were not too successful and my physician suggested we try Troleandomycin (Tao) which proved to be the only medication that actually helped. Recently I was informed that Tao was discontinued by the manufacturer. We have tried several medications and nothing seems to help like Tao did. Is there a generic form or a known substitute for Tao?

A. Emphysema (COPD) is a serious and chronic lung disease causing a decrease in normal air flow to and from the lungs. It is estimated to affect 15 million or more Americans and is the 4th leading cause of death in the U.S. Eighty to ninety percent of cases are caused by smoking; genetic factors, pollution, and second-hand smoke may also contribute.

Treatment in addition to quitting smoking includes medications to dilate constricted airways, cortisone compounds to reduce inflammation, and antibiotics to treat or control infection. Troleandomycin is one of a group of antibiotics known as the macrolides, the most common of which is erythromycin. There is some evidence that this drug helps reduce inflammation in addition to its infection-fighting properties. Ask your doctor if other related drugs might help you, or if Troleandomycin can still be obtained from the manufacturer under "compassionate use" laws.

http://www.mayoclinic.com/invoke.cfm?id=DS00296

http://www.drugdigest.org/DD/PrintablePages/Monograph/0,7765,695,00.html

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