Counterfeit Medication?

[colonelsing]

I am in USA but blood pressure medication I take,prenolol, is from pharmacy in Thailand. My blood pressure is still high which maybe is from any number of reasons but I was thinking maybe these pills are counterfeit. I have heard of alot of cases of fake medicine there but I wondered if anyone on forum had this problem.

[AmeriThai]

Maybe you should have a check up with your physician in the US. I'm not sure if prenolol is available in the US. It's possible you need a different medication.

There may be some small out-of-the-way pharmacies in Thailand with dodgy medications, but I'd think most pharmacies carry authentic meds. In some small pharmacies, it's possible some meds in stock are past the expiration dates though.

[Sheryl]

Prenol is atenolol, a beta blocker, best knwon in the Us under brand name tenormin.

It is extremely unlikely it would be counterfeit as it uis a cheap generic and thus little profit to be had in producing counterfeits.

What does however often occur is that medications can become inactivated by exposure to heat or subnlight. Small non air-con pharmacies are best avoided for thsat reason as the ambient tempretaure is going to easily reach the high 30's if not m ore, and virtually no drugs can be safely maintained at cuch temps.

The exact same thing can occur with your meds at home if not stored properly. So this could be one reason.

The other possibility is that the drug simply isn't working fior you any longer. In addition recent research has in dicated that beta blockers may not be as good a choice of drug as previously thought so it would be worth discussing a change of meds with a doctor. If tyou are planning to return to Thailand and want to be sure what you take is available there and inexpensive, ask about enelapril, an ACE inhibitor. It is available wisdely in inexpensive generic form in Thailand.

[BEENTHEREDONETHAT]

Prenol is atenolol, a beta blocker, best knwon in the Us under brand name tenormin.

It is extremely unlikely it would be counterfeit as it uis a cheap generic and thus little profit to be had in producing counterfeits.

What does however often occur is that medications can become inactivated by exposure to heat or subnlight. Small non air-con pharmacies are best avoided for thsat reason as the ambient tempretaure is going to easily reach the high 30's if not m ore, and virtually no drugs can be safely maintained at cuch temps.

The exact same thing can occur with your meds at home if not stored properly. So this could be one reason.

The other possibility is that the drug simply isn't working fior you any longer. In addition recent research has in dicated that beta blockers may not be as good a choice of drug as previously thought so it would be worth discussing a change of meds with a doctor. If tyou are planning to return to Thailand and want to be sure what you take is available there and inexpensive, ask about enelapril, an ACE inhibitor. It is available wisdely in inexpensive generic form in Thailand.

Sheryl........Just wanted to say it is really nice to have someone as knowledgeable as you on medical problems posting on TV. You are appreciated.

[lopburi3]

I have been on atenolol for 20 years and it is very cheap in the US. I was shocked at the price here in Thailand (many times higher) as they would only advise use of Tenormin and to avoid the generic as not up to standards. Doctors continue to specify Tenormin, although have halved the dose to 25mg and added amlodipine at 2.5mg recently. As said above storage is a major concern here, as well as out dated if sold in bulk.

[Shotime]

I just bought my first BP meds here in Thailand as my supply from home is about to run-out. I, too, am taking atenolol (50mg/day) and amlodipine (5 mg/day). A months supply of both cost about 250 baht which didn't seem too high. When you said it was expensive, I was a little concerned.

The 50mg atenolol has ATENOL 50 with a TO logo on the sheet of ten, and the 5mg amlodipine is from LOVAS. Does this sound right to you? Should I be getting the Tenormin instead of the TO generic (maybe that's why it sounds cheap)? The expiration date on the ATENOL looks like ?0/03/11 (the ? might be a 2). The expiration date on the LOVAS looks like 28/4/10 with a manufactured date 28/4/07.

I also was never aware of any special storage requirements, so I'd be interested if anything special is required.

As I said, I'm concerned when it comes to my heart. Any help would be greatly appreciated.

I'm also taking Hyzaar, and the Hyzaar I bought here yesterday is manufactured by Merck Sharp & Dohme. The dates on the box are 26 June 2007 and 26 June 2010 (which I take to be the expiration date) so that looks OK.

Edited September 6, 2008 by Shotime

[AmeriThai]

As I suggested, and Sheryl expanded on, it's possible the OP might need a different medication. My wife has BP problems and had to go through several kinds of meds until finding out what worked for her. She's now taking Metoprolol, Paroxetine, and Hydroxyzine which seem to be working pretty well for her particular circumstances. But different people may require different medications. The main thing is you shouldn't delay medical check ups very long if you have high BP problems. If the OP is not going to be in Thailand anytime soon, then seeing a doctor in the U.S. needs to be done.

I agree that medications from hospital pharmacies or larger pharmacies that are better climate controlled (in Thailand) reduce the risks of ineffective medications for the reasons already mentioned.

I also agree that many medically-related things are much cheaper in Thailand than in the U.S. But not always. I'm wondering how old the OP is?

Edited September 6, 2008 by AmeriThai

[colonelsing]

Thank you everyone for advice. I am 55 years old, and have had high blood pressure for a long time but only recently take medication. I have often thought about the whole issue about storing the pills. I was living in Thailand without aircon so it was always hot where the pills were kept. I thought of putting them in refrigerator but thought maybe that would harm them. Is keeping them in fridge a good idea?

[endure]

Is bendroflumethiazide 2.5mG available in Thailand?

[Sheryl]

Thank you everyone for advice. I am 55 years old, and have had high blood pressure for a long time but only recently take medication. I have often thought about the whole issue about storing the pills. I was living in Thailand without aircon so it was always hot where the pills were kept. I thought of putting them in refrigerator but thought maybe that would harm them. Is keeping them in fridge a good idea?

Yes, if no air con then should keep all meds in the fridge but down low (produce area) where it is cool but not outright cold.

[deejah]

i keep my vits in the fridge but not my meds

and am starting to think

its better dry and warmer than cold and moist

i think its too moist in the fridge

i use silicon packs from rice crackers and foods to help reduce moisture

any thoughts???

[AmeriThai]

i keep my vits in the fridge but not my meds

and am starting to think

its better dry and warmer than cold and moist

i think its too moist in the fridge

i use silicon packs from rice crackers and foods to help reduce moisture

any thoughts???

Seems to me many meds, including vitamins, recommended storage at "room temperature", and avoid direct exposure to sunlight and moisture. Exceptions to moisture would probably be liquid based meds or medicated lotions and salves.

By "room temperature", it's fair to understand that to mean it shouldn't be too cold or too hot. Silicon packs can reduce moisture, but if temps are frequently high, you might have some risk (over time) with maintaining maximum quality. Cool, but not necessarily cold, is probably a safer option. Best to read the labels or ask your physician or pharmacist about storage requirements if you're not certain.

[colonelsing]

I went to hospital here in US and they told me these medications are neither counterfeit or expired. They are just the wrong medicine. Now they put me on half the dose of atenolol plus a diuretic pill called HDLZ or something like that. Doctor at hospital here says Thai doctor screwed up by not checking to see if medication worked and also said they gave me too high of a dosage to start with. To be fair though, according to my daughter who is an RN, hospital here is screwed up too as they sent me home from ER while my BP was still tooo high.

[Sheryl]

i keep my vits in the fridge but not my meds

and am starting to think

its better dry and warmer than cold and moist

i think its too moist in the fridge

i use silicon packs from rice crackers and foods to help reduce moisture

any thoughts???

Depends on what room temperature at your place is like.

Most drugs are best stored at under 30 C. I don't offhand know of any that are recommended to withstand 38+ which, at my home at least, is what it reaches in the hot season when the a/c is off.

I think it also has to do with the quantity of medication you are storing. Living out in the boonies, I tend to buy in bulk and also to pre-purchase against possible future needs, so I'm storing things that will not be used for many months, even a year or more.

If you are keeping only small amounts on hand and your place is cool enough (e.g. doesn't ever get much over say 30 C) then you may be fine.