Is methenamine (Hiprex) available in Thailand

[simon43]

I decided to have another go at 'shifting' the chronic, asymptomatic UTI that I have had for the past ... er ... 2 years or so! This UTI refused to be eliminated from my bladder when I had prostate cancer tests a year ago in the UK - they postponed my biopsy for a total of 6 weeks as they tried different antibiotics to clear the infection, (because having a prostate biopsy does have an increased infection risk if one already has a UTI).  In the end, the doctor gave up on treating the UTI and did the biopsy anyway (which was negative for cancer cells).

 

He prescribed further antibiotics after the biopsy to have another go at killing the UTI, but it stubbornly refused to go!

 

Since that time, the UTI has remained with me, but I read that long-term usage of methenamine (Hiprex) has proven relatively successful in medical tests.

 

My simple question is:  Is methenamine available in Thailand from a pharmacy?  I have not located this medicine here in north Laos, but if it's available in Thailand then I'm sure a shipping service can buy a year's supply of it and send it to me here in the back of beyond!

 

BTW, I also drink cranberry juice and take Vitamin C tablets daily, which both might also help to eliminate the UTI 🙂

Edited February 21 by simon43

[BritManToo]

I swear by norfloxacin 400, 1/2 tab morning and evening for the first 10 days of every month until it's fixed.

 

Obviously there's the risk of ligament damage for those susceptible.

Edited February 21 by BritManToo

[Sheryl]

There us no brand of it registered in Thailand.

 

And to my reading not advised for treatment of prostatitis. Main indication is prevention of recurrent bladder infection.

 

How do you know you still have the infection?

[simon43]

1 hour ago, Sheryl said:

There us no brand of it registered in Thailand.

 

And to my reading not advised for treatment of prostatitis. Main indication is prevention of recurrent bladder infection.

 

How do you know you still have the infection?

Mainly due to the smell of my urine (foul-smelling, fishy smell)

[Sheryl]

39 minutes ago, simon43 said:

Mainly due to the smell of my urine (foul-smelling, fishy smell)

Might be worth trying anorher culture & sensitivity then

[arick]

Go to any  hospital and the pharmacy will check in their computer. I stead of getting mislead down a windy path in here.

[arick]

Everything is available order online 

[simon43]

On 2/21/2024 at 11:01 PM, Sheryl said:

Might be worth trying anorher culture & sensitivity then

Yes a good idea, but it requires me to fly to Thailand to do this (no decent hospitals here in Laos).  Sheryl, can you suggest a Bangkok hospital/doctor that can carry out these tests on request, rather than a hospital that will simply perform a UTI check?  Thanks.

[Stevemercer]

You might have something similar to me - bladder diverticulus (sort of like a little pouch off the bladder). It's assymptomatic, but bacteria can get stuck in the little pouch causing recurring infections. It's diagnosed through an abdominal CT. Having said that, I don't think there is anything that can be done.

[Sheryl]

10 hours ago, simon43 said:

Yes a good idea, but it requires me to fly to Thailand to do this (no decent hospitals here in Laos).  Sheryl, can you suggest a Bangkok hospital/doctor that can carry out these tests on request, rather than a hospital that will simply perform a UTI check?  Thanks.

I don't really understand what you mean by "just perform a UTI check" ?

 

Any hospital can do a culture and sensitivity if a doctor on staff there orders it. Many stand alone labs can also do this. Including this one in Vientiane:

 

https://ncle.gov.la/en/contact

 

 

 

[Serenity_Now]

uti and prostratitis

standard would be 4-6 weeks of cipro
its classed as the gold standard of prostatitis

in extreme cases 12 month course but very very rare

but t carries a black box warning in usa

just yesterday there was a big story about severe side effects

https://www.theatlantic.com/politics/archive/2021/02/side-effects-drug-labels-levaquin-cipro/617992/

so check if you have ever had flouroquines before to see susceptibility

[Mark Nothing]

I conducted experiments in my toilet bowl by not flushing and the unpleasant aroma  gets worse and worse each day.  Could the foul smelling fishy odor you experience simply be a reaction to the water in the toilet bowl from metal pipes sediment and chemicals added to water by water company?  

 

If you are asymptomatic other then that you may be concerned over nothing.

[simon43]

A quick update:  I went over the notes from my doctor in the UK last year when they were doing prostate cancer checks - the biopsy kept getting delayed because of my asymptomatic UTI.  Hidden in the notes is a comment that my UTI is E.Coli (common enough), but also with ESBL, which my good friend Dr Google informs me can nullify the effects of common antibiotics.

 

With this new information at hand, what antibiotics are suggested that are not nullified by the presence of ESBL?

 

Following BritManToo's advice, I have been following a course of Norfloxacin which seems to have cleared up the fishy smell...

[Lorry]

On 3/6/2024 at 10:12 PM, simon43 said:

what antibiotics are suggested that are not nullified by the presence of ESBL?

There is no general answer to this question. You have to do sensitivity testing, available in all hospitals.

( if they wrote ESBL that means they did sensitivity testing, so you should find the results in your records, but I would do a new one)

Ask to include testing for sitafloxacin and fosfomycin, sometimes effective against ESBL E coli and easily available in well-stocked pharmacies.

Norfloxacin is usually not effective. So, if norfloxacin was effective you probably didn't have ESBL.

[xylophone]

Augmentin is Amoxicillin + Clavulanic Acid which is an antibiotic which can address ESBL problems and as mentioned Fosfomycin (Monurol) can also work well and only one dose needs to be taken in water, perhaps followed by another on 3 days later if necessary.

 

Overuse of Fluoroquinolones has resulted in many bacteria being resistant to them, so is no longer recommended as a first-line option for a UTI and beside which the potential tendon/muscle problems with this particular antibiotic can be quite damaging, especially to older folk.

 

As for Hiprex, I searched Thailand and cannot find it here so I order through Chemist Warehouse in Australia, and IMO it is brilliant.