Diabetic neuropethy

[Carlosm]

I have a severe case of diabetic neuropathy. If i sit or lay down my feet feel like they are on fire, its agony. Tried ever painkiller up to morphine, did very little. Eventually i was prescribed gabapentin, worked well, reduced the pain by half.

Unfortunately it is very expensive. Around 4,200bt a month from the hospital, even more expensive from a pharmacy and i cannot afford it. Unfortunately i am low on cash, built a snooker hall just before covid and its been closed ever since.

So, does anyone with diabetic neuropathy have another medication that is cheaper but still helps relieve the pain ? if so i would be very grateful.

[metisdead]

Moving to the Health and Medicine forum. 

[Sheryl]

What brand did you get at pharmacy? And what pharmacy fid you ho yo?

 

There are locally made generic equolivalents (e.g. Gabapentin GPO) which cost much less.

 

You need a real  Thai pharmacy  that carries generics (i.e. not a Boots or Watsons etc). Where in Thailand are you?

[Carlosm]

6 minutes ago, Sheryl said:

What brand did you get at pharmacy? And what pharmacy fid you ho yo?

 

There are locally made generic equolivalents (e.g. Gabapentin GPO) which cost much less.

 

You need a real  Thai pharmacy  that carries generics (i.e. not a Boots or Watsons etc). Where in Thailand are you?

I'm in the district of Phetchabun. Get my gabapentin from the local hospital, it is the GPO version. Have been looking at similar pain relievers such as Lyrica but the cost is just the same.

[Sheryl]

48 minutes ago, Carlosm said:

I'm in the district of Phetchabun. Get my gabapentin from the local hospital, it is the GPO version. Have been looking at similar pain relievers such as Lyrica but the cost is just the same.

What dosage are you on?

[CanNot]

I'm sorry about your condition. You can try amitryptylin it is cheap as generics are available and you can take it for chronic nerve pain. 

Also Thiogamma 600, it might be expensive in Thailand but I want to have it mentioned as its especially used for diabetic neuropathy. I think it's more a supliment then a medicine. 

 

When you try new medication please consult a doctor for proper dosage. 

 

Edited November 27, 2022 by CanNot

[Carlosm]

34 minutes ago, Sheryl said:

What dosage are you on?

3600mg (max) still in pain but manageable.

[Sheryl]

5 hours ago, Carlosm said:

3600mg (max) still in pain but manageable.

A very high dose indeed (more on that later).

 

As you are taking Gabapentin GPO which comes in no more than 300 mg strength, you are taking 12  tablets a day. So a little more than 3 1/2 boxes (box of 100) per month.

 

I got  boxes of 100 tabs of Gapentin GPO 300 mg  last April for 450 baht per box at a large pharmacy in Bangkok. If coming to Bangkok is possible for you I will share location details.

 

The online pharmacy site Medtide has it for 640 baht a box and will deliver to you. While much more than discount pharmacy in Bangkok this would still be a lot less than you currently pay.  https://medtide.com/product/gabapentin-gpo-300-mg-100-capsules-box/

Note that you will need to register for an account (which is free) before you can get it to show specific medication prices.

 

I suggest you also ask the online pharmacy Medisafe. You have to do so through Facebook messenger, search function on their website does not work.   https://www.facebook.com/Medisafe.Pharmacy.Rama4/

 

Both Medtide and Medisafe are completely reliable services.

 

Ask Medisafe for quotes for both Gabapentin 300mg and Gabapentin 600 mg as there are several locally made brands that come in 600 mg strength, which would be more convenient for you and possibly also cheaper.

 

Aside from this I think you need a second opinion on management of your neuropathy. Addition of a second drug, such as venlafaxine or a tricylcic antidepressent, might help. See https://www.researchgate.net/publication/23659514_Gabapentin_and_Venlafaxine_for_the_Treatment_of_Painful_Diabetic_Neuropathy

Other things that might help are:

• acupuncture
• use of TENS machine
• local application of capsacin ointment

From Pechabun, the best place to go is Khn Kaen University Hospital (Srinagarind). They have a pain clinic.

 

 

 

 

 

[Carlosm]

On 11/27/2022 at 11:47 AM, Sheryl said:

A very high dose indeed (more on that later).

 

As you are taking Gabapentin GPO which comes in no more than 300 mg strength, you are taking 12  tablets a day. So a little more than 3 1/2 boxes (box of 100) per month.

 

I got  boxes of 100 tabs of Gapentin GPO 300 mg  last April for 450 baht per box at a large pharmacy in Bangkok. If coming to Bangkok is possible for you I will share location details.

 

The online pharmacy site Medtide has it for 640 baht a box and will deliver to you. While much more than discount pharmacy in Bangkok this would still be a lot less than you currently pay.  https://medtide.com/product/gabapentin-gpo-300-mg-100-capsules-box/

Note that you will need to register for an account (which is free) before you can get it to show specific medication prices.

 

I suggest you also ask the online pharmacy Medisafe. You have to do so through Facebook messenger, search function on their website does not work.   https://www.facebook.com/Medisafe.Pharmacy.Rama4/

 

Both Medtide and Medisafe are completely reliable services.

 

Ask Medisafe for quotes for both Gabapentin 300mg and Gabapentin 600 mg as there are several locally made brands that come in 600 mg strength, which would be more convenient for you and possibly also cheaper.

 

Aside from this I think you need a second opinion on management of your neuropathy. Addition of a second drug, such as venlafaxine or a tricylcic antidepressent, might help. See https://www.researchgate.net/publication/23659514_Gabapentin_and_Venlafaxine_for_the_Treatment_of_Painful_Diabetic_Neuropathy

Other things that might help are:

• acupuncture
• use of TENS machine
• local application of capsacin ointment

From Pechabun, the best place to go is Khn Kaen University Hospital (Srinagarind). They have a pain clinic.

Thanks a lot for that... very helpful ????. I will be looking into that, way cheaper !

Edited November 29, 2022 by blackcab
Fixed quote

[Carlosm]

Medtide is 'out of stock' on gabapentin ????

Interesting read about venlafaxine, but way too expensive https://medtide.com/product/venlafaxine-efexor-xr-150-mg-28-capsules-box/

[Sheryl]

3 hours ago, Carlosm said:

Medtide is 'out of stock' on gabapentin ????

Interesting read about venlafaxine, but way too expensive https://medtide.com/product/venlafaxine-efexor-xr-150-mg-28-capsules-box/

Efexor is imported brand. There is a less expensive local brand (Valosine). And tricyclics are very chesp. But do not add a medication without checking with dictor (preferrably pain 

 

Suggest you ask Medisafe re Gabapentin. Ask price for both 300 and 600 mg.

[Carlosm]

Medisafe Pharmacy are very well priced. Gabapentin 600mg is 950bt/box of 100. Thats around 1,750bt a month... wow, big saving from my local suppliers. The pharmacy near me charges 950bt/box for the 300mg capsules !

Again, i'd like to thank Sheryl for the very helpful and informative post ! ????

[Sheryl]

2 hours ago, Carlosm said:

Medisafe Pharmacy are very well priced. Gabapentin 600mg is 950bt/box of 100. Thats around 1,750bt a month... wow, big saving from my local suppliers. The pharmacy near me charges 950bt/box for the 300mg capsules !

Again, i'd like to thank Sheryl for the very helpful and informative post ! ????

Glad it helped.

 

Do see a pain specialist at  Khom Kaen univ hospital when you have a chance as addition of a tricylcic or other med may help.

[Encid]

On 11/27/2022 at 12:54 PM, CanNot said:

Also Thiogamma 600, it might be expensive in Thailand but I want to have it mentioned as its especially used for diabetic neuropathy. I think it's more a supliment then a medicine. 

You can buy it on Lazada... search for "ALA".

 

[Ainsley]

So sorry about your pain! I don't experience the same, however, I thought I might be useful for you. My uncle is a prediabetic. He takes ozempic weekly injections but his insurance doesn't cover the medications. The expenses are huge, that you can understand, so he buys meds overseas. There are often ozempic coupon offers, so he can sometimes save a little. Maybe this info will help you somehow. Have a good luck!

 

 

[Carlosm]

Medisafe a refusing to serve me any meds due to the fact i ordered glipized and they wanted to charge me 990bt per box when my local pharmacy only charges 340bt. I told them this (politely) and they spat their dummy out and said 'well go buy all your drugs there' and now will not even communicate with me. I tried apologizing but they are in full sulk mode, wouldn't even talk to me on the phone ... crazy !

[BigStar]

6 hours ago, Carlosm said:

Medisafe a refusing to serve me any meds due to the fact i ordered glipized and they wanted to charge me 990bt per box when my local pharmacy only charges 340bt. I told them this (politely) and they spat their dummy out and said 'well go buy all your drugs there' and now will not even communicate with me. I tried apologizing but they are in full sulk mode, wouldn't even talk to me on the phone ... crazy !

Funny. Here I can agree with our Thainess experts.

[Sheryl]

7 hours ago, Carlosm said:

Medisafe a refusing to serve me any meds due to the fact i ordered glipized and they wanted to charge me 990bt per box when my local pharmacy only charges 340bt. I told them this (politely) and they spat their dummy out and said 'well go buy all your drugs there' and now will not even communicate with me. I tried apologizing but they are in full sulk mode, wouldn't even talk to me on the phone ... crazy !

They are indeed touchy, I have had issues with them like this as well. Best to never question a price. Just thank them for info and place order if desired.  Though it may be worth verifying brand name and quantity first.  As glipized is a misspelling I suspect they misunderstood and thought you mean Glimepiride.  Which comes in boxes of 100 and indeed costs over 900 baht.

 

Give Medisafe  a few days rest and try again but without any discussion, just request to order the Gabapentin. Worst case, have someone else do it for you via a different facebook account. But I think if you let a few dfays pass and then just message a request to order the gabapentin it will go through OK.

 

You can get glipizide 5 mg 30 tabs in a box for B 190 a box here   https://medtide.com/product-tag/glipizide/

 

 

[Carlosm]

4 hours ago, Sheryl said:

They are indeed touchy, I have had issues with them like this as well. Best to never question a price. Just thank them for info and place order if desired.  Though it may be worth verifying brand name and quantity first.  As glipized is a misspelling I suspect they misunderstood and thought you mean Glimepiride.  Which comes in boxes of 100 and indeed costs over 900 baht.

 

Give Medisafe  a few days rest and try again but without any discussion, just request to order the Gabapentin. Worst case, have someone else do it for you via a different facebook account. But I think if you let a few dfays pass and then just message a request to order the gabapentin it will go through OK.

 

You can get glipizide 5 mg 30 tabs in a box for B 190 a box here   https://medtide.com/product-tag/glipizide/

 

 

Funny you pointed that out, already ordered from them and its on the way with a couple of boxes of gabapentin. They only sell 2 boxes at a time, strange.

Also, thought the same, will give it a month then make up another FB account and try again.

[Carlosm]

Here's their quote :-

 

glipizide 5mg - 990( 100 tabs)/ Metformin HCI 500mg -450 ( 500 tabs).simvatatin 20 280 ( 100 tabs)

 

Here's what i said :-

 

Have you the right price for glipizide ? this site is 340bt/100 ... https://medtide.com/product/glipizide-gipzide-5-mg-10-tablets-strip/

 

Here's their reply :-

 

We do not have this brand

And we do not sell expired meds

This website is not legal

No issues you can choose this website

No problem. We cancel whole so you can save more we always want our customer get best price

Edited December 1, 2022 by Carlosm

[Sheryl]

2 hours ago, Carlosm said:

Here's their quote :-

 

glipizide 5mg - 990( 100 tabs)/ Metformin HCI 500mg -450 ( 500 tabs).simvatatin 20 280 ( 100 tabs)

 

Here's what i said :-

 

Have you the right price for glipizide ? this site is 340bt/100 ... https://medtide.com/product/glipizide-gipzide-5-mg-10-tablets-strip/

 

Here's their reply :-

 

We do not have this brand

And we do not sell expired meds

This website is not legal

No issues you can choose this website

No problem. We cancel whole so you can save more we always want our customer get best price

 

Is that reply from Medsafe or Meditide? You should certainly not send Medsafe messages about their competitor. They are touchy enough as  it is.

 

Nothing at all wrong with Medtide or their products, go ahead and order from them.

 

Did Medsafe they tell you what brand this was at 100 tabs of 990 baht? And what brand do you get locally? Price differences this wide must reflect different brands

 

Re the selling only 2 boxes, I had issues with them in the past ordering large quantities as they accused me, in effect, of being a reseller (which I most definitely am not!) With some persistance I was finally able to get the large order through (a year's supply of several meds). Of course in your case with the Gabapentin, you are on a larger dose than most people so they might think 2 boxes was already a many months supply. If you have a copy of doctor's note saying dose of 3,600 mg it may help.

 

[Neeranam]

On 11/27/2022 at 6:47 PM, Sheryl said:

I got  boxes of 100 tabs of Gapentin GPO 300 mg  last April for 450 baht per box at a large pharmacy in Bangkok. If coming to Bangkok is possible for you I will share location details.

I found coming off Gabapentin had withdrawals, and I was only on 1x300 mg per day. Beware. 

[Sheryl]

1 minute ago, Neeranam said:

I found coming off Gabapentin had withdrawals, and I was only on 1x300 mg per day. Beware. 

OP is unlikely to come off it. Diabetic neuropathy is a long tetm condition

 

Ditto the lady with post polio syndrome that I bought it for. 

[Carlosm]

21 hours ago, Sheryl said:

 

Is that reply from Medsafe or Meditide? You should certainly not send Medsafe messages about their competitor. They are touchy enough as  it is.

 

Nothing at all wrong with Medtide or their products, go ahead and order from them.

 

Did Medsafe they tell you what brand this was at 100 tabs of 990 baht? And what brand do you get locally? Price differences this wide must reflect different brands

 

Re the selling only 2 boxes, I had issues with them in the past ordering large quantities as they accused me, in effect, of being a reseller (which I most definitely am not!) With some persistance I was finally able to get the large order through (a year's supply of several meds). Of course in your case with the Gabapentin, you are on a larger dose than most people so they might think 2 boxes was already a many months supply. If you have a copy of doctor's note saying dose of 3,600 mg it may help.

 

I get Namedia brand glipizide.

Medisafe never mentioned the brand of Glipize.

Medtide are very fast delivering. Ordered and paid for on Wednesday and already have it with me now. Will use them again.

[Carlosm]

On 11/27/2022 at 6:47 PM, Sheryl said:

A very high dose indeed (more on that later).

 

As you are taking Gabapentin GPO which comes in no more than 300 mg strength, you are taking 12  tablets a day. So a little more than 3 1/2 boxes (box of 100) per month.

 

I got  boxes of 100 tabs of Gapentin GPO 300 mg  last April for 450 baht per box at a large pharmacy in Bangkok. If coming to Bangkok is possible for you I will share location details.

 

The online pharmacy site Medtide has it for 640 baht a box and will deliver to you. While much more than discount pharmacy in Bangkok this would still be a lot less than you currently pay.  https://medtide.com/product/gabapentin-gpo-300-mg-100-capsules-box/

Note that you will need to register for an account (which is free) before you can get it to show specific medication prices.

 

I suggest you also ask the online pharmacy Medisafe. You have to do so through Facebook messenger, search function on their website does not work.   https://www.facebook.com/Medisafe.Pharmacy.Rama4/

 

Both Medtide and Medisafe are completely reliable services.

 

Ask Medisafe for quotes for both Gabapentin 300mg and Gabapentin 600 mg as there are several locally made brands that come in 600 mg strength, which would be more convenient for you and possibly also cheaper.

 

Aside from this I think you need a second opinion on management of your neuropathy. Addition of a second drug, such as venlafaxine or a tricylcic antidepressent, might help. See https://www.researchgate.net/publication/23659514_Gabapentin_and_Venlafaxine_for_the_Treatment_of_Painful_Diabetic_Neuropathy

Other things that might help are:

• acupuncture
• use of TENS machine
• local application of capsacin ointment

From Pechabun, the best place to go is Khn Kaen University Hospital (Srinagarind). They have a pain clinic.

 

 

 

 

 

#Sheryl, in this post you mentioned 'more on that later' regarding my high dose of gabapentin, Just wondering what more you were thinking, thanks.

 

[Sheryl]

33 minutes ago, Carlosm said:

#Sheryl, in this post you mentioned 'more on that later' regarding my high dose of gabapentin, Just wondering what more you were thinking, thanks.

 

Use of addtionsl  drugs, such as tricylics or venlafaxine might allow a lower dose of gabapentin with same of better results.

 

And/or pregbalin might give more 

Relief. Some stidies have shown itis more effective than gabapentin in conyrolling pain of fiabetic neuropathy.

 

There are down sides to taking gabapentin especially in such large dose. Inclufind tremor, increased bone loss with risk of fracture, visual problems and psychiatric conditions.

 

Obviously when in severe pain, pain control comes first but if it were possible to get equivslalent psin control on lower dose of gaba or on another drug  it would be better.

 

I continue to suggest you see psin management specialist at KKU.

[Carlosm]

4 hours ago, Sheryl said:

Use of addtionsl  drugs, such as tricylics or venlafaxine might allow a lower dose of gabapentin with same of better results.

 

And/or pregbalin might give more 

Relief. Some stidies have shown itis more effective than gabapentin in conyrolling pain of fiabetic neuropathy.

 

There are down sides to taking gabapentin especially in such large dose. Inclufind tremor, increased bone loss with risk of fracture, visual problems and psychiatric conditions.

 

Obviously when in severe pain, pain control comes first but if it were possible to get equivslalent psin control on lower dose of gaba or on another drug  it would be better.

 

I continue to suggest you see psin management specialist at KKU.

Wow, those drugs you mentioned are really expensive :-

 

https://medtide.com/product-tag/venlafaxine/

https://medtide.com/product-tag/pregabalin/

 

Thanks though, it will be next year when i can go to see the pain specialist, i will let you know how it works out.

[Sheryl]

57 minutes ago, Carlosm said:

Wow, those drugs you mentioned are really expensive :-

 

https://medtide.com/product-tag/venlafaxine/

https://medtide.com/product-tag/pregabalin/

 

Thanks though, it will be next year when i can go to see the pain specialist, i will let you know how it works out.

That site lists only imported brands.

 

There are locally made brands that cost substantially less. I doubt local brands would be more than your gabapentin.

 

KKU would have them and so might Medisafe.