Refused pseudoephedrine at hospital

[atpeace]

I have always had to beg for more than 10 tablets but never been refused before at a hospital.  Usually after a few minutes of begging I get 50 pills which will last 1 year.  When my sinuses act up, I need the pills ASAP and I'm fine in 24 hours.  Nothing else works for me and other pills they have tried to tell me work do absolutely nothing.  Has anyone else been refused lately?  Hoping I can go to a different hospital.

[Don Chance]

  Try xylitol.  search the sub.  Ephendrin products don't really work because they always rebound.

[atpeace]

2 minutes ago, Don Chance said:

  Try xylitol.  search the sub.  Ephendrin products don't really work because they always rebound.

Thanks but I've tried so may other alternatives and I just want what I know works.  Maybe I'll go to the hospital now and see if they will give me some  pseudoephedrine.  If they do I will be 100% by tomorrow morning.

[xylophone]

10 minutes ago, Don Chance said:

  Try xylitol.  search the sub.  Ephendrin products don't really work because they always rebound.

Xylitol is a natural sugar alcohol found in plants........how would that help?

[Mike Lister]

Pseudoephedrine is a Category 2 controlled substance here because it is used in the manufacture of methamphetamines'. There was a problem a couple of years ago where several million doses of the drug went missing from local hospitals, believed to have ended up in Myanmar in the hands of drugs factories. 

[KhunLA]

45 minutes ago, atpeace said:

 Hoping I can go to a different hospital.

I think you'll be out of luck, and I wouldn't bother.   Sad they basically banned, the only thing that truly works as a good decongestant, if that's what you need it for.

[LosLobo]

Not only does ephedrine cause rebound as decongestants do, but studies have shown that it is useless for sinus etc.

 

Placebos were found to be just as effective.

 

My doctor does not recommend pseudoephedrine for me as I have controlled high BP and one of its side effects is to increase systolic pressure and to interfere with BP medication.

 

I found antihistamines helpful for sinus except for the side effects.

 

Nasonex seemed to help me the most, but it is a corticosteroid and should only be taken under medical supervision.

 

[connda]

Yeah, they know you're going to take your 10 pills and make methamphetamine out of them just like in Breaking Bad and sell it on the street.  Right?

It is ridiculous.  The government has made pseudoephedrine such an 'evil drug' that it's pretty much unavailable as it's a precursor to meth <cue scary sinister music>
The stupidity behind the rational of what is essentially a ban on pseudoephedrine is that meth on the street costs 10 THB a pill (from what I'm told). By the time you purchase some pseudoephedrine, the reagents and equipment to make meth, and assuming you have the knowledge ala Walter White, your meth would cost multiples of the current street value of the meth made in Myanmar.  So why bother.

The hyperbole surround pseudoephedrine simply leads to more needless suffering, not that either the government or medical 'experts' care as palliative care and pain support are pretty much at the bottom of their priorities.  According to these people, "It's your bad karma that makes you suffer," don't you know?

[TallGuyJohninBKK]

44 minutes ago, xylophone said:

Xylitol is a natural sugar alcohol found in plants........how would that help?

When mixed in with a sterile saline solution, it inhibits bacterial growth.... including bacterial infections in your sinuses....

 

My former sinus doc in the U.S. recommended it when I was having repeat sinus infections that eventually stopped being treated well with antibiotics...

 

And to my surprise, it actually has worked very well... I haven't taken or needed any sinus antibiotics for years.

 

Once or twice a day sinus rinse with the warmed xylitol solution.

 

I use a Nipro 50 ml syringe with a special sinus tip on the end. I use about 2 cups of sterile (boiled and cooled) water warmed in the microwave, combined with about 8 teaspoons of xylitol dissolved and mixed in, along with about a teaspoon of non-iodine salt to provide the saline component.

 

[TallGuyJohninBKK]

8 minutes ago, connda said:

Yeah, they know you're going to take your 10 pills and make methamphetamine out of them just like in Breaking Bad and sell it on the street. 

 

In the U.S. in recent years, after they made pseudoephedrine very hard to get over the counter because of the meth epidemic, things finally eased up some when the drug companies finally came up with a version that supposedly cannot be repurposed into meth.

 

So the last couple times I was in the U.S., it was easy to obtain from the regular drug stores without a prescription just by providing your ID.

 

I wish that same formulation would become available in Thailand, and thus enable the medication to be returned to regular OTC drug store access as it used to be.  But so far, haven't seen any indication of that occurring here.

 

[TallGuyJohninBKK]

43 minutes ago, LosLobo said:

Not only does ephedrine cause rebound as decongestants do, but studies have shown that it is useless for sinus etc.

 

I think... what you're meaning is that recent studies have found that the REPLACEMENT drug that the authorities came up with to replace pseudoephedrine, when it was heavily restricted because of the meth epidemic, is and was never really effective as a sinus medication....

 

Pseudoephed was always very effective for me as a sinus medicine. But its supposed replacement, phenylephrine, was absolutely useless! And now lately the medical authorities have finally admitted just that:

Popular OTC medicines for colds and allergies don’t work, FDA panel says

 Updated 6:37 PM EDT, Thu September 14, 2023

 

"(CNN)  — Phenylephrine, a popular ingredient in many over-the-counter allergy and cold medicines, is ineffective in tablet form, an independent advisory committee to the US Food and Drug Administration agreed Tuesday.

 

Phenylephrine is the main ingredient used in products like Benadryl Allergy Plus Congestion, Sudafed PE and Vicks Sinex.

 

The ingredient is considered safe to use; that was not up for debate. But many doctors have questioned phenylephrine’s effectiveness for years."

 

https://www.cnn.com/2023/09/12/health/phenylephrine-tablets-ineffective-fda-panel-says/index.html

 

16-0 vote by the FDA's advisory committee against phenylephrine...

 

And the sad part is, doctors and drug stores have been telling sinus sufferers for years to use this medication as a primary non-antibiotic medication, when they pretty well knew, because patients were loudly telling them, that it was essentially worthless. To the tune of $1.8 BILLION per year just in the U.S.

 

"These products generated nearly $1.8 billion in sales last year alone, according to data from the FDA that was presented to the Nonprescription Drugs Advisory Committee on Monday during the committee’s two-day meeting."

[KhunLA]

19 minutes ago, TallGuyJohninBKK said:

Popular OTC medicines for colds and allergies don’t work, FDA panel says

They work just as they were designed for ... Profits

[LosLobo]

11 minutes ago, TallGuyJohninBKK said:

 

I think... what you're meaning is that recent studies have found that the REPLACEMENT drug that the authorities came up with the replace pseudoephedrine, when it was heavily restricted because of the meth epidemic, is and was never really effective as a sinus medication....

 

Pseudoephed was always very effective for me as a sinus medicine. But its supposed replacement, phenylephrine, was absolutely useless!

Popular OTC medicines for colds and allergies don’t work, FDA panel says

 Updated 6:37 PM EDT, Thu September 14, 2023

 

"(CNN)  — Phenylephrine, a popular ingredient in many over-the-counter allergy and cold medicines, is ineffective in tablet form, an independent advisory committee to the US Food and Drug Administration agreed Tuesday.

 

Phenylephrine is the main ingredient used in products like Benadryl Allergy Plus Congestion, Sudafed PE and Vicks Sinex.

 

The ingredient is considered safe to use; that was not up for debate. But many doctors have questioned phenylephrine’s effectiveness for years."

 

https://www.cnn.com/2023/09/12/health/phenylephrine-tablets-ineffective-fda-panel-says/index.html

 

16-0 vote by the FDA's advisory committee against phenylephrine...

 

And the sad part is, doctors and drug stores have been telling sinus sufferers for years to use this medication as a primary non-antibiotic medication, when they pretty well knew, because patients were loudly telling them, that it was essentially worthless. To the tune of $1.8 BILLION per year just in the U.S.

 

"These products generated nearly $1.8 billion in sales last year alone, according to data from the FDA that was presented to the Nonprescription Drugs Advisory Committee on Monday during the committee’s two-day meeting."

You are correct, I really meant 'phenylephrine (hydrochloride)'.
 

Thanks!

[connda]

14 minutes ago, TallGuyJohninBKK said:

Popular OTC medicines for colds and allergies don’t work, FDA panel says

 Updated 6:37 PM EDT, Thu September 14, 2023

"Experts say," 'eh?  Just like Covid vaccinations kept everyone from contracting Covid, or so we were informed by the CDC, FDA, and the POTUS?  ????
My personal trust in the FDA is pretty non-existent.  They need to clean up their "regulatory capture" problem. 

[JackGats]

Pseudoephedrine works for people suffering from runny nose syndrome. In some countries it is sold OTC combined with a mild antihistamine. Eg. the brand Rhinopront (pseudoephedrine + Tripolidine).

 

Depriving patients of medicines that work well is one of the many nasty sides of the war on drugs.

[TallGuyJohninBKK]

It wasn't doctors or the drug manufacturers who basically took pseudoephedrine off the market back in the early 2000s... It was governments and law enforcement because they found, correctly, that it was being used as a supply material by meth makers.  That part I can understand....

 

But the bad part is, at least originally, the best they could come up with as a replacement was phenylephrine, which was ALWAYS useless for me and many other sinus sufferers.... Yet for years it has remained the default non-prescription sinus treatment ingredient for OTC medications, providing little to no help for many sinus sufferers but racking up a whole lot of money in sales.

 

Hopefully this will help lead to a return to better access to pseudoephedrine, including to the newer formulations that supposedly cannot be easily used for meth.

 

 

[LosLobo]

43 minutes ago, TallGuyJohninBKK said:

When mixed in with a sterile saline solution, it inhibits bacterial growth.... including bacterial infections in your sinuses....

 

My former sinus doc in the U.S. recommended it when I was having repeat sinus infections that eventually stopped being treated well with antibiotics...

 

And to my surprise, it actually has worked very well... I haven't taken or needed any sinus antibiotics for years.

 

Once or twice a day sinus rinse with the warmed xylitol solution.

 

I use a Nipro 50 ml syringe with a special sinus tip on the end. I use about 2 cups of sterile (boiled and cooled) water warmed in the microwave, combined with about 8 teaspoons of xylitol dissolved and mixed in, along with about a teaspoon of non-iodine salt to provide the saline component.

 

I tried the 50ml syringe route too but not with xylitol, just the saline solution, then transitioned to the Netti Pot.

 

But I found it somewhat cumbersome when on the move and then never got back to it.

 

Mainly, because I read that studies found that continued nasal rinsing would be counter-productive and eventually would wash away all the protective flora.

[Caiman]

I went to an evening ENT clinic here in Hua Hin  to seek assistance for long term Non allergic rhinitis symptoms.

 

The Doctor prescribed medications including Pseudoephedrine tablets.

 

Then referred to the ENT clinic at the Government Hospital where I now receive regular consultation and medications. They always do an address check and occasionally advise me about the Police urine tests!

[TallGuyJohninBKK]

10 minutes ago, LosLobo said:

Mainly, because I read that studies found that continued nasal rinsing would be counter-productive and eventually would wash away all the protective flora.

Sinus rinsing is a pretty commonly recommended and accepted thing among sinus docs... And I've never heard any issue re rinsing of the "protective flora" issue you mention above.

 

The one thing any rinser has to be careful about is NOT to use standard tap water for the rinsing.... Because it can contain some amoebas that have led to fatalities.... But that's avoided if you're using boiled water, or other sterile solutions.

 

A man dies of a brain-eating amoeba, possibly from rinsing his sinuses with tap water

March 3, 2023

 

"The single-celled amoeba lives in warm fresh water and, once ingested through the nose, can cause a rare but almost-always fatal brain infection known as primary amebic meningoencephalitis (PAM).

 

The Centers for Disease Control and Prevention has tallied 157 PAM infections in the U.S. between 1962 and 2022, with only four known survivors (a fifth, a Florida teenager, has been fighting for his life since last summer, according to an online fundraiser by his family)."

 

https://www.npr.org/2023/03/03/1160980794/neti-pot-safety-brain-eating-amoeba

 

Message - NEVER SINUS RINSE WITH PLAIN TAP WATER!

 

"Instead, use distilled or sterile water, which is sold in stores, or tap water that has been boiled for 3-5 minutes and then cooled until lukewarm (it can then be stored in a clean, closed container and used within 24 hours).

 

You could also use a special water filter — labeled "NSF 53" or "NSF 58" — designed to remove those germs."

 

[atpeace]

42 minutes ago, TallGuyJohninBKK said:

When mixed in with a sterile saline solution, it inhibits bacterial growth.... including bacterial infections in your sinuses....

 

My former sinus doc in the U.S. recommended it when I was having repeat sinus infections that eventually stopped being treated well with antibiotics...

 

And to my surprise, it actually has worked very well... I haven't taken or needed any sinus antibiotics for years.

 

Once or twice a day sinus rinse with the warmed xylitol solution.

 

I use a Nipro 50 ml syringe with a special sinus tip on the end. I use about 2 cups of sterile (boiled and cooled) water warmed in the microwave, combined with about 8 teaspoons of xylitol dissolved and mixed in, along with about a teaspoon of non-iodine salt to provide the saline component.

 

OK, think I'll give this a try.  The hospital told me they don't have pseudoephedrine .  Just a few years ago I got it every hospital after the pharmacy ban in 2012.  My sinus infections are nasty and I'll do almost anything.  

 

Where do you acquire  xylitol and I assume you aren't using the 2 cups detailed in your directions above all at once.  One syringe?  I wonder if prolific nasal salt cleansing might help without the xylitol.

 

 

 

 

 

 

[atpeace]

10 minutes ago, Caiman said:

I went to an evening ENT clinic here in Hua Hin  to seek assistance for long term Non allergic rhinitis symptoms.

 

The Doctor prescribed medications including Pseudoephedrine tablets.

 

Then referred to the ENT clinic at the Government Hospital where I now receive regular consultation and medications. They always do an address check and occasionally advise me about the Police urine tests!

The hospital recommended a clinic in town but I assumed they were just trying to get rid of me. Closed now but open tomorrow and usually packed.  Probably have to wait 2 hours with a lot of sick people but there is HOPE!

[TallGuyJohninBKK]

13 minutes ago, Caiman said:

The Doctor prescribed medications including Pseudoephedrine tablets.

I've been able to get pseudo from my doctor at a smaller private hospital here in BKK... Originally, many years back, they were doling them out like no more than 10 at a time... But in later years, that eased up some, and I was able to get 30 or 60 at a time.... But my doctor knew me and was well familiar with my sinus history. But again, that was only via prescription from the hospital's pharmacy...

 

In more recent years, once I went to Xylitol rinsing, I haven't needed sinus antibiotics or pseudo at all... which I count as a good thing!

 

[atpeace]

1 hour ago, KhunLA said:

I think you'll be out of luck, and I wouldn't bother.   Sad they basically banned, the only thing that truly works as a good decongestant, if that's what you need it for.

But the ban in 2012 did not include hospitals and I've always, until 2023, been able to get it at hospitals.

[TallGuyJohninBKK]

32 minutes ago, atpeace said:

Where do you acquire  xylitol and I assume you aren't using the 2 cups detailed in your directions above all at once.  One syringe?  I wonder if prolific nasal salt cleansing might help without the xylitol.

 

Re those various questions...

 

Yes, I am using 2 cups of water per session, typically once a day in the morning when getting ready... so that's maybe 8-10 syringe fulls.... 4 or 5 on each nostril left and right.  I use a standard 2 cup glass Pyrex measuring cup, and make my solution within that. The whole thing takes maybe 5-10 minutes.

 

There are a couple of supply houses in BKK that sell Xylitol in bulk... The one I've been using lately allows you to order via their website and then they deliver by mail to your home. You also can order 1 kg packages for somewhat higher prices via Lazada.

 

https://กรุงเทพเคมี.com/index.php?route=product/product&product_id=506&search=xylitol&description=true

 

Saline only sinus rinsing is a standard thing for sinus sufferers... so there's going to be some benefit there in washing gunk out of your sinuses... But what the Xylitol element adds is the anti-bacterial element.

 

I've seen some sinus docs, including my own, similarly recommend using a saline sinus rinse solution with some portion of mupirocin anti-bacterial ointment dissolved in. But I've never tried that one. And I believe that would be only for short-term use, because it's an antibiotic product.

 

https://www.umc.edu/Healthcare/ENT/Patient-Handouts/Adult/Nose_Sinus/Bactroban_Irrigation.html

 

Or even using the same approach with a Betadine solution, but that is an anti-viral solution instead of an antibiotic one,  so it's aiming at a different target. I tried that a bit long time back, and really didn't like the taste of the solution getting into my throat.

 

https://medhelpclinics.com/resources/advice-from-the-doctor/at-home-treatment-protocol-for-covid-19

 

PS - a side benefit of xylitol is that it's also supposedly good at helping prevent/limit cavities in your teeth.

 

"Xylitol inhibits the growth of the bacteria that cause cavities. It does this because these bacteria (Streptococcus mutans) cannot utilize xylitol to grow. Over time with xylitol use, the quality of the bacteria in the mouth changes and fewer and fewer decay-causing bacteria survive on tooth surfaces."

 

https://www.cda.org/portals/0/pdfs/fact_sheets/xylitol_english.pdf

 

 

 

 

 

[atpeace]

1 minute ago, TallGuyJohninBKK said:

 

Re those various questions...

 

Yes, I am using 2 cups of water per session, typically once a day in the morning when getting ready... so that's maybe 8-10 syringe fulls.... 4 or 5 on each nostril left and right.  I use a standard 2 cup glass Pyrex measuring cup, and make my solution within that. The whole thing takes maybe 5-10 minutes.

 

There are a couple of supply houses in BKK that sell Xylitol in bulk... The one I've been using lately allows you to order via their website and then they deliver by mail to your home. You also can order 1 kg packages for somewhat higher prices via Lazada.

 

https://กรุงเทพเคมี.com/index.php?route=product/product&product_id=506&search=xylitol&description=true

 

Saline only sinus rinsing is a standard thing for sinus sufferers... so there's going to be some benefit there in washing gunk out of your sinuses... But what the Xylitol element adds is the anti-bacterial element.

 

I've seen some sinus docs, including my own, similarly recommend using a saline sinus rinse solution with some portion of mupirocin anti-bacterial ointment dissolved in. But I've never tried that one. And I believe that would be only for short-term use, because it's an antibiotic product.

 

https://www.umc.edu/Healthcare/ENT/Patient-Handouts/Adult/Nose_Sinus/Bactroban_Irrigation.html

 

Or even using the same approach with a Betadine solution, but that is an anti-viral solution instead of an antibiotic one,  so it's aiming at a different target. I tried that a bit long time back, and really didn't like the taste of the solution getting into my throat.

 

https://medhelpclinics.com/resources/advice-from-the-doctor/at-home-treatment-protocol-for-covid-19

 

 

Interesting and thank you for taking the time to help.  I wonder if that is why doctors online recommend mixing baking soda(anti-bacterial) with the salt.  I just finished about 1/2 cup salt solution and it seems to be already working if that is even possible.  I'm desperate:)  Have a marathon in a few weeks and not being able to breath or train is not ideal. 

[TallGuyJohninBKK]

37 minutes ago, atpeace said:

The hospital told me they don't have pseudoephedrine .

I don't know where you are... But at least here in BKK, I think most private hospitals are going to have pseudo in stock in their pharmacies.... But as noted, you can't just walk in and ask for and buy it... It's only going be available via order (prescription) from one of their doctors that you've seen.

 

[atpeace]

3 minutes ago, TallGuyJohninBKK said:

I don't know where you are... But at least here in BKK, I think most private hospitals are going to have pseudo in stock in their pharmacies.... But as noted, you can't just walk in and ask for and buy it... It's only going be available via order (prescription) from one of their doctors that you've seen.

 

That is what I've done 20+ times the last 10 years but the last two refused,  I get the impression they are scared but not sure.  I'm in small town on the Mekhong river but the same happened in Pattaya hospital a few months back.

[TallGuyJohninBKK]

6 minutes ago, atpeace said:

Interesting and thank you for taking the time to help.  I wonder if that is why doctors online recommend mixing baking soda(anti-bacterial) with the salt.  I just finished about 1/2 cup salt solution and it seems to be already working if that is even possible.  I'm desperate:)  Have a marathon in a few weeks and not being able to breath or train is not ideal. 

The baking soda also helps make the solution easier to tolerate on your sinuses...by adjusting the Ph levels, AFAIK.

 

"Nasal saline irrigation is used to improve the health of the sinuses in patients with poor sinus function due to chronic sinus problems or patients recently undergoing surgery.

...

Some people prefer to add 1 level teaspoon of baking soda (pure bicarbonate) to the solution to make it less irritating. This is optional."

 

https://www.umc.edu/Healthcare/ENT/Patient-Handouts/Adult/Nose_Sinus/Nasal_Saline_Irrigation.html

 

 

[atpeace]

Just now, TallGuyJohninBKK said:

The baking soda also helps make the solution easier to tolerate on your sinuses...by adjusting the Ph levels, AFAIK.

 

15 minute now and nasal flood has stopped.  Maybe my sinuses were trying to clear something out and the sinus flushing did just that. To good to be true but maybe...

[Sheryl]

@atpeace

 

What exactly was your interaction at the hospital that led to this refusal?

Did you first consult an ENT?

Walking into a hospital and asking for a specific drug - -especially one that is a controlled substance as this unfortunately is -- will set off all king of alarm bells.

 

Have a consultation with a doctor, explain your history and symptoms and that this drug usually works for you.