Anyone tried Thai Sumigran sumatriptan/Imigran/Imitrex? 1/10 the price...hmm

[lsemprini]

Has anyone ACTUALLY tried the new Thai Sumigran sumatriptan migrane abortive for a reasonable period of time and what can you report?  Does it work? 

 

Does anyone know anything about the Thai maker, Rx Chumchon aka "Community Pharmacy Public Company Limited" ?

 

I have been purchasing GlaxoSmithKline's pricey Imigran/Imitrex sumatriptan migraine abortive for decades and very interested to see there is now a Thai version.

 

The price is insanely lower, 10x.  One headache (50mg pill) of Imigran/Imitrex is approximately 150B whereas 1 headache (50mg film-coated tablet) of Sumigran is approximately 15B.  Both are supposed to be 50mg sumatriptan succinate with no other ingredients.

 

The price difference could be due to the insane markups of Big Pharma, or it could be due to corner-cutting and fakery.  Glaxo's patent on sumatriptan expired way back in 2009, so either industry collusion kept the price high until now, or there's something dodgy about the local brand.

 

 

[Lorry]

I used to buy their generic moxifloxacin.

I went back to buy Avelox from Bayer.

[lsemprini]

3 hours ago, Lorry said:

I used to buy their generic moxifloxacin.

I went back to buy Avelox from Bayer.

What went wrong?

[Lorry]

22 minutes ago, lsemprini said:

What went wrong?

Nothing went wrong.

It seemed to me that it wasn't as effective as the Bayer stuff, but that was a very subjecive impression. I felt uncomfortable enough to spend several thousand baht more on Avelox.

It didn't help that I didn't know the company, and few pharmacies carried their product. 

[orang37]

I’ve been using the Thai Sumigran for a few months now, and it’s been pretty effective for my migraines—kind of like the Imigran/Imitrex I used to buy. The big price difference is a huge plus, and so far, I haven’t had any issues with it. I looked into Rx Chumchon, the maker, and they seem to be a reputable company. Still, if you have any doubts, it’s always a good idea to chat with your doctor.

 

[lsemprini]

18 minutes ago, orang37 said:

I’ve been using the Thai Sumigran for a few months now, and it’s been pretty effective for my migraines—kind of like the Imigran/Imitrex I used to buy. The big price difference is a huge plus, and so far, I haven’t had any issues with it. I looked into Rx Chumchon, the maker, and they seem to be a reputable company. Still, if you have any doubts, it’s always a good idea to chat with your doctor.

 

Thanks! 

 

My doc is in the US, so I'm on my own for evaluating Rx Chumchon.  So far I've just learned it's a Thai pharma factory put together by a bunch of independent Thai pharmacies.  

 

One Thai pharmacist who used to work for Pfizer says he's not surprised about the price difference given Big Pharma gouging, but then again he sold Sumigran.

 

[Lorry]

I checked prices in India. You can get it for this price from Apollo (reputable chain), made by Sun (a big, renowned manufacturer of generics). So the price is not out of this world.

 

[newbee2022]

18 hours ago, lsemprini said:

Has anyone ACTUALLY tried the new Thai Sumigran sumatriptan migrane abortive for a reasonable period of time and what can you report?  Does it work? 

 

Does anyone know anything about the Thai maker, Rx Chumchon aka "Community Pharmacy Public Company Limited" ?

 

I have been purchasing GlaxoSmithKline's pricey Imigran/Imitrex sumatriptan migraine abortive for decades and very interested to see there is now a Thai version.

 

The price is insanely lower, 10x.  One headache (50mg pill) of Imigran/Imitrex is approximately 150B whereas 1 headache (50mg film-coated tablet) of Sumigran is approximately 15B.  Both are supposed to be 50mg sumatriptan succinate with no other ingredients.

 

The price difference could be due to the insane markups of Big Pharma, or it could be due to corner-cutting and fakery.  Glaxo's patent on sumatriptan expired way back in 2009, so either industry collusion kept the price high until now, or there's something dodgy about the local brand.

 

 

Try it. What are your concerns?

[jcmj]

9 hours ago, Lorry said:

I checked prices in India. You can get it for this price from Apollo (reputable chain), made by Sun (a big, renowned manufacturer of generics). So the price is not out of this world.

 

But can they be delivered to Thailand now with all of the rules on importing meds?

[lsemprini]

2 hours ago, newbee2022 said:

Try it. What are your concerns?

 

Mostly safety concerns (contaminated meds for example) since I don't know the producer and want to hear from others before swallowing their product.

 

Apparently different types of med have very differing difficulty to produce and different ease of accidentally introducing contaminants or producing the wrong molecule, so even if a producer "gets it right" for some meds, it doesn't necessarily translate to their ability to produce sumatriptan.  I have no idea where sumatriptan falls in that spectrum.

 

Second concern would be fake pills that don't have any active ingredient.  The price made me suspect that, but sounds like 15B/50mg might be the actual market price (finally seen, 13 years after patent expires).

 

[lsemprini]

54 minutes ago, jcmj said:

But can they be delivered to Thailand now with all of the rules on importing meds?

 

No need to import; Lorry was just being helpful by seeing if sumatriptan is available from reputable producers in other countries at that price.  Sounds like 15B is actually the market price, not the 150B we've all been paying GlaxoSmithKline even 13 years after their patent expired.

[newbee2022]

16 minutes ago, lsemprini said:

 

Mostly safety concerns (contaminated meds for example) since I don't know the producer and want to hear from others before swallowing their product.

 

Apparently different types of med have very differing difficulty to produce and different ease of accidentally introducing contaminants or producing the wrong molecule, so even if a producer "gets it right" for some meds, it doesn't necessarily translate to their ability to produce sumatriptan.  I have no idea where sumatriptan falls in that spectrum.

 

Second concern would be fake pills that don't have any active ingredient.  The price made me suspect that, but sounds like 15B/50mg might be the actual market price (finally seen, 13 years after patent expires).

 

If you want to go sure you have to buy in EU, particular in Germany. They introduced good regime to control quality.

Drugs manufactured in Thailand have to follow Thai FED. I so far trust them. What else can you do? The price could differ.

[John49]

I tried to buy the cheaper Thai Sumigran  at the 3 pharmacies in the basement of Central Festival Pattaya, yesterday.

Not available – only the expensive imported Imigran/Imitrex on offer.

 

I will try some of the smaller drugs stores down the street, maybe better luck.

[Lorry]

4 hours ago, John49 said:

I tried to buy the cheaper Thai Sumigran  at the 3 pharmacies in the basement of Central Festival Pattaya, yesterday.

Not available – only the expensive imported Imigran/Imitrex on offer.

 

I will try some of the smaller drugs stores down the street, maybe better luck.

That was my experience with moxifloxacin from this company - hard to find.

Only the biggest and most well-stocked pharmacies had it, not my neighborhood pharmacies (of which there are 11)

[John49]

I have now bought a box of 4 tablets, each containing Sumatriptan Succinate equivalent to Sumatriptan 50mg (under brand name Siagran), from a local drug store in Pattaya for 195 baht.

Price is say 50 baht for one tablet.

Manufactured by Siam Bheasach, Bangkok.

Still unable to find Sumigran.

[lsemprini]

1 hour ago, John49 said:

I have now bought a box of 4 tablets, each containing Sumatriptan Succinate equivalent to Sumatriptan 50mg (under brand name Siagran), from a local drug store in Pattaya for 195 baht.

Price is say 50 baht for one tablet.

Manufactured by Siam Bheasach, Bangkok.

Still unable to find Sumigran.

 

I found Sumigran at a chain called Fascino in Chiang Mai; looks like they have 3 Fascino in Pattaya too.

[John49]

I did manage to find Sumigran at one drug store in Pattaya, price was 110 baht for 6 tablets.

Problem now is my other half, who actually suffers with migraine, says that both Sumigran and Siagran, allegedly containing the equivalent of 50 gram of Sumatriptan – ‘do not work’.

 

The bigger picture is that she has been using Ergotamine tablets for several years but these come with some side effects.

We switched from Ergotamine to Replax (40 mg of Eletriptan) and not Sumatriptan, as we read that Eletriptan gives longer relieve than Sumatriptan, etc.  

We cut one tablet of Relpax in half and it ‘works well’.

The cost 2 tablets of Relpax manufactured by Pfizer is 275 baht.

 

So, a bit on the expensive side and the recommendation is not to use more than 2 times in one week, but on the other hand, the maximum recommended dose is 80 mg in 24 hours.

For us, one 20mg dose (half a tablet), 2 times in one week would come to a restriction of 40mg in one week, 'low' compared with 80mg in 24 hours.

 

Anyone else with experience of both Sumatriptan and Eletriptan, and if Eletriptan is available generically in Thailand?

[Sheryl]

No generic version of Eletriptan here

[lsemprini]

On 8/17/2024 at 7:55 PM, John49 said:

I did manage to find Sumigran at one drug store in Pattaya, price was 110 baht for 6 tablets.

Problem now is my other half, who actually suffers with migraine, says that both Sumigran and Siagran, allegedly containing the equivalent of 50 gram of Sumatriptan – ‘do not work’.

 

Interesting...to be clear though, does your other half also feel that original sumatriptan (Imigran/Imitrex) does not work?  In other words, is the objection against sumatriptan in general or the generics Sumigran/Siagran specifically?

[John49]

She has not tried the original Sumatriptan, only the Thai generic.

 

Her history is several years of Ergotamine and then recently onto Eletriptan, and more recently again the generic Sumatriptan.

I tried to get her off the Ergotamine as she complained of stomach pain. I checked and found that it come with potential fibrosis of stomach tissue, etc.

 

The latest is that she is back on Ergotamine as apparently that is a good if taken ‘early’, but comes with stomach side effects. I’m trying to get her to eat and drink with the Ergotamine. We have just switched to a half tablet of Ergotamine from the full tablet, and that works just as well.

 

She says that half a tablet of Eletriptan is good and has the added benefit of still working, even if taken ‘late’. Not the case with Ergotamine – must be taken ‘early’.

Looks like we will not be going back to generic Sumatriptan.

 

We try to identify the triggers for migraine, especially foods, but the only definite trigger is very bright lighting. Migraine attacks come every 3 or 4 days, we do not exceed half a tablet though she may be ill for several hours. At a weight of 50 kg, the half tablet seems appropriate.

[lsemprini]

By the way, a little off-topic but sharing with this group of migraineurs.

 

I recently received some advice on meds to use for migraines from a Harvard Medical emergency doctor friend of mine.  These are the treatments he used for his patients and also his migraneur wife.  I ran these by another friend who is a neurologist and she says this is sound advice (with the only caveat being that some migraineurs are not so much struggling with how to abort their current headache, which the advice below focuses on, but rather have the problem of headaches coming back in subsequent days in a cycle, which the meds below do not address but also do not make any worse).

 

I have not tried any of these (other than sumatriptan) and don't know which are available in Thailand, but thought the advice might be useful to this group.  Be sure to do your research before trying any.

 

-----------------------------------

BEGINNING OF QUOTE:

 

On the migraines, yep, avoid caffeine, except that it can be an effective abortifacient.  Here are the tools you should have in your medicine cabinet.  All can be taken simultaneously with no safety risk.

1. You should use injectable or nasal sumatriptan at the earliest sign of a migraine.  Injectable sumatriptan is far more effective than the oral form.  The nasal form is not as effective as the injectable form, but is much more effective than the oral form.  So efficacy is injectable > nasal >>> oral.  (Those are “greater than” signs.)
    
2. Prochlorperazine (Compazine) is a fabulous migraine abortifacient.  It can cause some people to feel jittery or have a weird cramp in some part of their body...this is NOT dangerous but can be frightening...this side effect is easily treated with diphenhydramine (Benadryl) [though it is NOT an allergy], so, often, we just go ahead and presumptively give a Benadryl tablet or ½ a tablet when we administer prochlorperazine.  Take prochlorperazine 10 mg (perhaps with a half or whole tablet of Benadryl) at the earliest sign of a migraine.  [Those of larger physical size e.g. 100kg] may need to take 20 mg of the prochlorperazine, and that’s fine, so don’t hesitate to repeat the 10 mg dose after 20-30 minutes if no effect.
    
3. Metoclopramide (Reglan) is another fabulous abortifacient.  The aforementioned side effects can occur as with prochlorperazine, though somewhat less commonly.  Dosing is the same, and this medicine is so safe that it doesn’t even matter if you take both together.  For clarity, it’s okay to take sumatriptan + prochlorperazine 20 mg + metoclopramide 20 mg + Benadryl, all at the same time.  Of course you should figure out the lowest possible number of medications and the lowest possible doses, because we always want to avoid these chemicals, but I just want to be clear that I’d rather you take the above than have to go to the hospital and face that horror show.
    
4. Caffeine and NSAIDs are very effective abortifacients, but you face the risk of rebound.  For some people who get migraines infrequently, some caffeine and a couple Aleve tablets does the trick.  When my wife feels a migraine coming on, I give her 10 mg of metoclopramide and 1-2 Aleve tablets, together with a diet coke if it’s not bedtime, and this is almost always curative...almost instantaneously...usually after 10-20 minutes.

It is okay to take caffeine and NSAIDs together with all the other medicines (sumatriptan, prochlorperazine, metoclopramide, and diphenhydramine).  It’s a rare migraine that doesn’t get crushed by this combination, though usually just one or two of these meds is needed.

 

[retarius]

On 8/18/2024 at 9:07 AM, Sheryl said:

No generic version of Eletriptan here

When I was in the US I used to take Axert ( al long half life that kicked Imitrex's butt).

 

When I retired I moved to Thailand and my migraines more or less disappeared. I sed to figure at least one a week while I worked. I still always keep some Relpax handy (2 pills for 250baht) but I bet I don't take more than 2 pills a year.

I think the stress of the job, hundreds of long haul flights, time changes, poor sleeping, stupid deadlines, presentations to hundreds (or thousands) of people.....fortunately I was able to retire early at 54. 

[lsemprini]

Ok, well one more datapoint.

 

I finally tried some Sumigran.  I can say that it worked, but clearly it is somehow chemically different from the expensive Imigran/Imitrex even though both pills are supposed to be the same 50mg sumatriptan.

 

I had some mild headaches over a week and used 6 doses, 50mg a day.  The headaches did go away, but seemingly a little bit less quickly than with 50mg Imitrex and, more to the point, I didn't get the same distinct "nasal passages opening" feeling that I get 100% of the time with Imitrex when the medicine is finally working and the pain is receding.

 

While possible, it seems unlikely that the difference in "nasal passages opening" feeling is due to differences in the non-active ingredients between the brands.  This leads me to wonder if the Sumigran really has 50mg sumatriptan, or any sumatriptan at all, or if Imitrex has something extra.  If Sumigran has some other substance, I wonder what substance.  Wish there was an easy way to test the contents, or an FDA that we could trust to test for us.

 

Eventually I will try it for more severe headaches to see.