Parkinsons Treatment - Information about medications

[Speedo1968]

Someone I know who lives in England and, is married to a Thai lady for about 20 years, developed a rare form of Parkinson’s around 8 years ago.

Their intention is to travel to Thailand later this month before his condition possibly makes travelling not possible.     They may consider that staying here is an option.

One of the purposes is to meet with me as I formally suffered from Parkinson’s ( not Parkinsonism ) for many years whilst living here.   He wishes to discuss alternative approaches that helped me, as he does not wish to go down the slippery slope of multiple medications.   I no longer take any medication.     These approaches may be lifestyle changes that can help, not just with the physical but also the emotional side.

He was initially prescribed 6 medications but so far has only been treated with 4 of them.

I am fully aware that one must have a letter from the UK hospital / GP stating details of his medications, preferably both.

My questions are as follows regarding the list of medications shown below:-

#1 – Are any of the following banned in Thailand, as he will need to bring a supply of his current medications with him when he visits ?

#2 – Is there a limit to the number of tablets he can bring in for any of the medications ?

#3 – Are any of the medications only available here from a hospital ?

#4 – Are any of those medications in the list not available as per the specific trade name ?

#5 – If yes does anyone know of a replacement medication ?    I understand that some people, like myself, are allergic to one brand but not another, for me Aspirin was one.

#6 – Has anyone been in / are in the position of having to use any of those medications in the list ?  If yes could they give some details about the side effects, if any, that they have experienced ?         I appreciate people may not wish to discuss this online, but I would be most grateful if they could give details by messaging me.      Please note that I did not use any of the medications in the list, perhaps they are more suitable for the rare form that he has, ( unfortunately I do not know what specific form he has, only that it is very rare form ).

#7 – Does anyone have any idea about the prices for the same or replacement medication ?

#8 – Can anyone recommend a hospital / doctor in Khon Kaen regarding Parkinson’s treatment ?   I myself was under a very good doctor in Bangkok whilst suffering from Parkinson’s but, have been living about 50km from Khon Kaen for the past few years.    

Medication List

#1 – Co-careldopa 50mg/200mg – Not issued as yet

#2 – Laxido Orange 50mg/100mg

#3 – Ramipril 10mg

#4 – Sinemet Plus 25mg/100mg

#5 – Zapain 30mg/500mg

#6 – Zolmitriptan 2.5mg – Not issued as yet

Any help or advice you can give would be greatly appreciated.

 

[Aussieroaming]

Another drug available here from most pharmacy's if you order it is SIFROL (Pramipexole) at about 1300 baht per box of 30.

[Sheryl]

Co-careldopa is a term for the group of medications that Sinemet belongs to. Your friend would not be on both Sinemet Plus and another co-careldopa drug.

Brands equivalent to Sinemet Plus here are Levomet and Sinemet 25/100. They do not require a prescription.

Laxido is a laxative for constipation. It is not available here but many types of laxative are.

Ramipril is for hypertension or heart failure. It is available both in that brand (expensive) and locally made equivalents. No prescription required.

Zapain is paracetemol + codeine. Codeine is a class 2 narcotic and brining it in requires a permit from the Thai FDA narcotics bureau. If you google you'll find the site and instructions. They are pretty good about responding quickly and I recommend going to the trouble of bringing it in because, although it is available here, it can only be gotten at a hospital and Thai doctors are often reluctant to prescribe it, especially for chronic pain.

Zolmitriptan is for migraine headaches. It is not available in Thailand. Older drugs in the same class i.e. sumatatriptan are available but expensive.

The rule on medications brought in for personal use is 30 day supply. They are not strict on that (i.e. don't actually count the number of tablets) except possibly for controlled substance such as the paracetemol + codeine.

Your friend seems to have quite a lot of medical problems and should think twice about moving here unless he is wealthy IMO. The problem is not the medications he is currently on, it is the cost of medical care especially major hospitalizations. He will not be able to get health insurance with all these pre-existing problems. A heart attack, stroke, major accident etc can easily cost 1 million baht in a govt hospitsl and 3-5 times that in a private one. A number of TV members luving here have exhausted their savings due to medical expenses and had to go home.

The best medical care in your region is at Srinagarind Hospital (Khon Kaen Univ Hosp). I can't give you a specific name but go to the after hours clinic and ask for a neurology acharn.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[Speedo1968]

4 hours ago, Sheryl said:

Co-careldopa is a term for the group of medications that Sinemet belongs to. Your friend would not be on both Sinemet Plus and another co-careldopa drug.

Brands equivalent to Sinemet Plus here are Levomet and Sinemet 25/100. They do not require a prescription.

Laxido is a laxative for constipation. It is not available here but many types of laxative are.

Ramipril is for hypertension or heart failure. It is available both in that brand (expensive) and locally made equivalents. No prescription required.

Zapain is paracetemol + codeine. Codeine is a class 2 narcotic and brining it in requires a permit from the Thai FDA narcotics bureau. If you google you'll find the site and instructions. They are pretty good about responding quickly and I recommend going to the trouble of bringing it in because, although it is available here, it can only be gotten at a hospital and Thai doctors are often reluctant to prescribe it, especially for chronic pain.

Zolmitriptan is for migraine headaches. It is not available in Thailand. Older drugs in the same class i.e. sumatatriptan are available but expensive.

The rule on medications brought in for personal use is 30 day supply. They are not strict on that (i.e. don't actually count the number of tablets) except possibly for controlled substance such as the paracetemol + codeine.

Your friend seems to have quite a lot of medical problems and should think twice about moving here unless he is wealthy IMO. The problem is not the medications he is currently on, it is the cost of medical care especially major hospitalizations. He will not be able to get health insurance with all these pre-existing problems. A heart attack, stroke, major accident etc can easily cost 1 million baht in a govt hospitsl and 3-5 times that in a private one. A number of TV members luving here have exhausted their savings due to medical expenses and had to go home.

The best medical care in your region is at Srinagarind Hospital (Khon Kaen Univ Hosp). I can't give you a specific name but go to the after hours clinic and ask for a neurology acharn.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app
 

Thank you so much Sheryl for your very quick and extensive reply.

It answers many of the questions I raised and I am sure my friend with take note of your advice.

 

Having suffered from Parkinsons myself for many years from 2002 I know how difficult it can be for all concerned.

I found I was medicating to counteract the side effects of other medications and I can vouch for the high cost.

Trying to maintain a position as a freelance consultant with a Thai company was difficult, fortunately the position which involved most of the time away from the office visiting farms gave me a little hiding space but, walking around farms posses its own problems.

In early 2009 I got fed up with the problems. and expense, that medication was causing me and started to cutback medication very slowly ( even a quarter of a tablet at a time ).   I kept extensive notes.   It took me 30 months but finally I was free of all Parkinson meds.    I made life style changes, not that there were many; ( I have been a vegan for 40 years and do not drink or smoke anyway and do not have diabetes ), which also helped.

 

For the HBP I take only one med and have changed my lifestyle again following a big stroke last year.    Once I was able to walk again ( following another 3 months off my legs with severe leg infection from a dog scratch I am now walking 3km twice a day and do yoga floor exercises 1 - 2 hours per day ).

 

Although I would not recommend the same to others regarding the medications they may be taking I most certainly recommend that they make as many useful lifestyle changes as they can, not all at once of course.

[Speedo1968]

21 hours ago, Aussieroaming said:

Another drug available here from most pharmacy's if you order it is SIFROL (Pramipexole) at about 1300 baht per box of 30.

Thank you, yes Sifrol is available here.   Its a medication I was on when I had Parkinsons.

Two of the higher priced drugs I was on cost 3,000 baht per box.   Another reason to quit if possible.