Jingthing Posted May 30, 2022 Share Posted May 30, 2022 (edited) I've been told by multiple credible pharmacists that Lispril / Zestril / Lisinopril is now completely unavailable in Thailand! Except if a random pharmacy has some stock left which is unlikely the pharmacies can't order new stock.. I was told an estimated date that they might have it again. July. Beginning or end of July? No guarantees. So obviously each individual has their own medical details but after doing some research I learned that the most common substitute is Losartan generic brand Loranta. Rather than another ace inhibitor Equivalent doses Lisinopril 10 mg Losartan 50 mg This is NOT to be taken as medical advice! Do what you feel you need to do as far as starting a substitute. See a doc / do your own research / consult a trusted pharmacist etc. Anyway this topic is here for discussion for people impacted by this supply chain problem. Edited May 30, 2022 by Jingthing 1 Link to comment Share on other sites More sharing options...
buick Posted May 30, 2022 Share Posted May 30, 2022 interesting news. my usual pharmacy guy in bkk appeared to imply the same about a month ago. i tried getting the 10mg lispril (he's had it before) but he only had 20mg (i bought those) and he mumbled something but i wasn't sure what he was saying - i wondered, did he just say he isn't getting any more of this stuff. i went in again to get some other meds and noticed the shelf still had only 20mg. probably gone soon. 1 Link to comment Share on other sites More sharing options...
Jingthing Posted May 30, 2022 Author Share Posted May 30, 2022 (edited) 22 minutes ago, buick said: interesting news. my usual pharmacy guy in bkk appeared to imply the same about a month ago. i tried getting the 10mg lispril (he's had it before) but he only had 20mg (i bought those) and he mumbled something but i wasn't sure what he was saying - i wondered, did he just say he isn't getting any more of this stuff. i went in again to get some other meds and noticed the shelf still had only 20mg. probably gone soon. Yes that is correct. Pharmacies here can't order it now. When did you see it? If its still there grab it. Its interesting that they can't get new supply of either the original or the generic. I wouldn't count on that July estimate either. Edited May 30, 2022 by Jingthing Link to comment Share on other sites More sharing options...
Sheryl Posted May 31, 2022 Share Posted May 31, 2022 There are several generic brands of Losartan, including Losaratn GPO as well as Loranta. These and other ____sartans are ARBs not ACE inhibitors. So not the closest substitution. The closest substitutions for lisinopril, would be ramipril or enalapril. Enalapril is much cheaper but also more likely to cause side effects such as cough. Ramipril is generally better tolerated, and slightly more effective, than enalapril but also costs more and has fewer local brands https://link.springer.com/article/10.1007/BF03258424 That said, most people taking it just for hypertension will do fine on enalapril It should be noted that people who have heart failure or history of a heart attack need to consult their cardiologist before changing BP meds, as meds that are essentially equievalent as antihypertensive can differ in their effect in heart function in such patients. 1 Link to comment Share on other sites More sharing options...
Jingthing Posted May 31, 2022 Author Share Posted May 31, 2022 (edited) 2 hours ago, Sheryl said: There are several generic brands of Losartan, including Losaratn GPO as well as Loranta. These and other ____sartans are ARBs not ACE inhibitors. So not the closest substitution. The closest substitutions for lisinopril, would be ramipril or enalapril. Enalapril is much cheaper but also more likely to cause side effects such as cough. Ramipril is generally better tolerated, and slightly more effective, than enalapril but also costs more and has fewer local brands https://link.springer.com/article/10.1007/BF03258424 That said, most people taking it just for hypertension will do fine on enalapril It should be noted that people who have heart failure or history of a heart attack need to consult their cardiologist before changing BP meds, as meds that are essentially equievalent as antihypertensive can differ in their effect in heart function in such patients. I already noted that Losartan is not an ace inhibitor but surprisingly I am seeing it mentioned as the closest sub for Lisinopril in multiple sources! Also no dry cough issues with Losartan. A patient may be fine with Lisinopril but have the cough with another ace inhibitor. Keep this in mind. This is about a STOPGAP fix for a presumed temporary supply chain issue. For perhaps a month or two. I presume the vast majority will switch back to Lisinopril when the supply returns. https://www.goodrx.com/conditions/hypertension/lisinopril-vs-losartan-how-are-they-different It may come as no surprise, but many patients have asked me about how lisinopril and losartan differ. You see, the two drugs are pretty similar and healthcare providers use them interchangeably at times, especially for patients with heart problems. In fact, both drugs are recommended as first-line treatments for hypertension. Nonetheless, there are some differences I can highlight to help you better understand these two drugs. https://walrus.com/questions/what-can-be-substituted-for-lisinopril-hctz Summary There are several alternatives for Lisinopril-HCTZ including the individual components. The closest alternative to lisinopril and other ACE inhibitors would be ARBs like losartan Edited May 31, 2022 by Jingthing Link to comment Share on other sites More sharing options...
Sheryl Posted May 31, 2022 Share Posted May 31, 2022 2 hours ago, Jingthing said: The closest alternative to lisinopril and other ACE inhibitors would be ARBs like losartan "and other ACE inhibitors" i.e. they are talking about alternatives to ACE inhibitors altogether. The closest alternative to lisinoipril alone would be other ACE inhibitors. As afar as I know the supply issue is only for lisinopril. Link to comment Share on other sites More sharing options...
Jingthing Posted May 31, 2022 Author Share Posted May 31, 2022 9 minutes ago, Sheryl said: "and other ACE inhibitors" i.e. they are talking about alternatives to ACE inhibitors altogether. The closest alternative to lisinoipril alone would be other ACE inhibitors. As afar as I know the supply issue is only for lisinopril. You're right as usual but still the Losartan doesn't risk coughing and it seems OK to me as a stopgap. It addresses BP just in a different way. Fascino told me they only have Enalapril and Perindopril Ace inhibitors at my nearest branch. They mentioned the extra side effects risk with Enalapril. Do you have any comments about Perindopril? Link to comment Share on other sites More sharing options...
Sheryl Posted May 31, 2022 Share Posted May 31, 2022 7 minutes ago, Jingthing said: You're right as usual but still the Losartan doesn't risk coughing and it seems OK to me as a stopgap. It addresses BP just in a different way. Fascino told me they only have Enalapril and Perindopril Ace inhibitors at my nearest branch. They mentioned the extra side effects risk with Enalapril. Do you have any comments about Perindopril? All ACE inhibitors have similar side effect profile (cough, GI upset etc). The incidence is slightly higher with enalapril but difference is no huge and most people tolerate enalapril just fine. It will likely cost much less than perindopril. Since you have already been on an ACE without apparent problems I would not be unduly worried about taking either one. 1 Link to comment Share on other sites More sharing options...
Suradit69 Posted June 20, 2022 Share Posted June 20, 2022 On 5/31/2022 at 6:12 PM, Jingthing said: You're right as usual but still the Losartan doesn't risk coughing and it seems OK to me as a stopgap. It addresses BP just in a different way. Fascino told me they only have Enalapril and Perindopril Ace inhibitors at my nearest branch. They mentioned the extra side effects risk with Enalapril. Do you have any comments about Perindopril? I found this article specifically comparing and contrasting the two drugs … I don’t think it’s been referenced above. Quote Lisinopril vs. Losartan: What’s the Difference? - https://www.goodrx.com/conditions/hypertension/lisinopril-vs-losartan-how-are-they-different i read, or think I did somewhere, that AstraZeneca was aiming to stop production of Zestril and transition to permitting generics to replace it, which seemed to be what some Fascino pharmacists told me. Link to comment Share on other sites More sharing options...
BonMot Posted June 20, 2022 Share Posted June 20, 2022 (edited) On 5/31/2022 at 12:54 PM, Sheryl said: Enalapril I've taken this for over 15 years. No side effects. Dirt cheap. It's absolutely everywhere. Edited June 20, 2022 by BonMot Link to comment Share on other sites More sharing options...
willyumcr Posted June 22, 2022 Share Posted June 22, 2022 On 5/31/2022 at 6:23 PM, Sheryl said: All ACE inhibitors have similar side effect profile (cough, GI upset etc). The incidence is slightly higher with enalapril but difference is no huge and most people tolerate enalapril just fine. It will likely cost much less than perindopril. Since you have already been on an ACE without apparent problems I would not be unduly worried about taking either one. Hello Sheryl. As I am taking 40mg Lisinopril daily, what would be the equivalent mg in Enalapril? Link to comment Share on other sites More sharing options...
Sheryl Posted June 22, 2022 Share Posted June 22, 2022 34 minutes ago, willyumcr said: Hello Sheryl. As I am taking 40mg Lisinopril daily, what would be the equivalent mg in Enalapril? 20mg https://wikem.org/wiki/ACE_inhibitor 1 Link to comment Share on other sites More sharing options...
Mentors65 Posted June 29, 2022 Share Posted June 29, 2022 I could not find Lispril in Pattaya-Jomtien today. Two pharmacies awaiting a delivery next month. So i bought Enalapril, better than nothing... i think... 1 Link to comment Share on other sites More sharing options...
willyumcr Posted June 29, 2022 Share Posted June 29, 2022 41 minutes ago, Mentors65 said: I could not find Lispril in Pattaya-Jomtien today. Two pharmacies awaiting a delivery next month. So i bought Enalapril, better than nothing... i think... I did the same thing 1 Link to comment Share on other sites More sharing options...
Jingthing Posted June 29, 2022 Author Share Posted June 29, 2022 3 hours ago, Mentors65 said: I could not find Lispril in Pattaya-Jomtien today. Two pharmacies awaiting a delivery next month. So i bought Enalapril, better than nothing... i think... Yeah me too. Did they say about what day in July? Link to comment Share on other sites More sharing options...
Jingthing Posted June 29, 2022 Author Share Posted June 29, 2022 On 6/22/2022 at 6:11 PM, Sheryl said: 20mg https://wikem.org/wiki/ACE_inhibitor This suggests 10 mg. Lisinopril.equals 10.mg. Enalapril . mmc1.pdf Link to comment Share on other sites More sharing options...
Sheryl Posted June 29, 2022 Share Posted June 29, 2022 1 hour ago, Jingthing said: This suggests 10 mg. Lisinopril.equals 10.mg. Enalapril . mmc1.pdf 100.84 kB · 1 download No, it does not. It shows 10mg lisinopril as equivalent to 5 mg enalapril you will also see that on this site https://globalrph.com/medcalcs/drug-comparisons-ace-inhibitors-medication-equivalents/ Whatever site you choose, lisinopril dosage is double that of enalapril for equivalence 1 Link to comment Share on other sites More sharing options...
Jingthing Posted June 29, 2022 Author Share Posted June 29, 2022 (edited) 1 hour ago, Sheryl said: No, it does not. It shows 10mg lisinopril as equivalent to 5 mg enalapril you will also see that on this site https://globalrph.com/medcalcs/drug-comparisons-ace-inhibitors-medication-equivalents/ Whatever site you choose, lisinopril dosage is double that of enalapril for equivalence Thanks. But I'm still confused. The source I showed does appear to show 10 mg equals 10 mg. It doesn't say that? So assuming it does show that, you're ssying it's wrong, yes? Edited June 29, 2022 by Jingthing Link to comment Share on other sites More sharing options...
Mentors65 Posted June 30, 2022 Share Posted June 30, 2022 16 hours ago, Jingthing said: Yeah me too. Did they say about what day in July? No, i guess everyone is just hoping... Link to comment Share on other sites More sharing options...
Jingthing Posted June 30, 2022 Author Share Posted June 30, 2022 14 minutes ago, Mentors65 said: No, i guess everyone is just hoping... Well if they were able to place orders that's good news. Before pharmacists were telling me that the suppliers weren't even accepting orders. Link to comment Share on other sites More sharing options...
Sheryl Posted June 30, 2022 Share Posted June 30, 2022 14 hours ago, Jingthing said: Thanks. But I'm still confused. The source I showed does appear to show 10 mg equals 10 mg. It doesn't say that? So assuming it does show that, you're ssying it's wrong, yes? Yes, it is wrong (as regards enalapril). The equivalence shown for rampiril is correct. 1 Link to comment Share on other sites More sharing options...
Jingthing Posted July 6, 2022 Author Share Posted July 6, 2022 I was told today by a Boot's pharmacist that Zestril (Lisonopril) will not be available until DECEMBER at the earliest. Link to comment Share on other sites More sharing options...
kensisaket Posted July 7, 2022 Share Posted July 7, 2022 When someone is finally able to purchase this medicine please add an update to this post. Thanks. Link to comment Share on other sites More sharing options...
Thailand Posted July 26, 2022 Share Posted July 26, 2022 Lispril 5. Not available today. May have to try Enalapril (5?) when my supply runs out in a month. Link to comment Share on other sites More sharing options...
Jingthing Posted July 26, 2022 Author Share Posted July 26, 2022 24 minutes ago, Thailand said: Lispril 5. Not available today. May have to try Enalapril (5?) when my supply runs out in a month. You should probably cut the Enalapril 5 in half then. Link to comment Share on other sites More sharing options...
Mentors65 Posted September 16, 2022 Share Posted September 16, 2022 Update: LISPRIL is available again! Bought it today 1 Link to comment Share on other sites More sharing options...
Jingthing Posted September 16, 2022 Author Share Posted September 16, 2022 8 minutes ago, Mentors65 said: Update: LISPRIL is available again! Bought it today Where? Did they have a variety of doses? Link to comment Share on other sites More sharing options...
Mentors65 Posted September 16, 2022 Share Posted September 16, 2022 Just now, Jingthing said: Where? Did they have a variety of doses? i bought it in a pharmacy in Pattaya-Jomtien. They have Lispril 20 in store Link to comment Share on other sites More sharing options...
Jingthing Posted September 16, 2022 Author Share Posted September 16, 2022 Just now, Mentors65 said: i bought it in a pharmacy in Pattaya-Jomtien. They have Lispril 20 in store Thanks. Which pharmacy? 1 Link to comment Share on other sites More sharing options...
Mentors65 Posted September 16, 2022 Share Posted September 16, 2022 (edited) 11 minutes ago, Jingthing said: Thanks. Which pharmacy? Just in a small pharmacy in Jomtien. I think others have them too. (Manufactured end of June) Edited September 16, 2022 by Mentors65 Link to comment Share on other sites More sharing options...
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