Pills,thrills And Bellyaches

[syd barrett]

When I go to a Thai pharmacy and ask for medicine I get authentic, brand named pills and potions, stamped or embossed with the makers name.

When a Thai goes to the pharmacist with a common complaint, eg. aches and pains etc. they come away with unmarked pills, clearly unmarked costing 20 baht for half a dozen. I guess they are coloured chalk/placebos, but it seems wrong that this practise is allowed. Surely all tablets should be packaged with their generic/brand name and surely it is wrong to fob Thais who are short of cash, off with absolute rubbish pills and potions.

I would be interested to hear your views, except for the poisonous goblin;THE MOOG.

S.B.

[taxexile]

plenty of authentic looking tablets and packaging are in fact fake, and plenty of unmarked tablets are genuine generics.

depends on the pharmacy, and the ethics of their suppliers

some "pharmacists" in thailand are not in fact pharmacists, but just regular shopkeepers who have opened up a pharmacy shop. the licensing rules here are not enforced, or non-existent. some are excellent pharmacists who have surprised me with the accuracy of their knowledge and prescribing skills.

i would imagine pharmacies like boots,the ones in tesco-lotus,etc. will only be selling the genuine article. with others i suppose you pay your money and hope for the best.

actually placebos have been found to work in a surprisingly large number of cases.

thai doctors are far too ready to prescribe vast amounts of powerful drugs for the most minor of complaints, the abuse of antibiotics is alarming and will only serve to encourage the proliferation of resistant bacteria for which there are no antibiotics.

far better to lead a healthy lifestyle in the first place ,therefore avoiding the lottery that is the thai pharmacy.

i'm sure you will agree.

[HEXtaB]

Most "unmarked" medications are actually generic drugs - much cheaper than the branded equivalents, by no means 'placebos', and equally as dangerous if mixed or taken without due consideration.

E.g. My wife (28) once complained of back pain for a few days, she flatly refused to go to my farang "paeng maak" hospital. So we traipsed down to the nearest "ya" shop, and 70 Baht later had a few bags of brightly coloured tablets.

I (rightly) was a tad concerned with this, and being a chemist myself asked to see what they had "prescribed". After I discovered that we now possessed a potentially lethal mixture of generic arthritis, anti-biotic, and pain-killing medication (to cover all the bases). None of which had any proper caveats or even accurate directions for dosage. And after the shop refused to take the pills back, I threw them in the sewer.

This, as usual, resulted in a bit of a strop-fest from the wife, but we later went to the hospital and got the correct diagnosis and medication.

Don't even get me started on the special "weight-loss" concoction I caught her with once...

The major problem here in LoS is that pharmacies seem, and are apparently allowed, to do the diagnosis on the spot from what the "patient’s" symptoms are.

Beware.

HEX.

\

[taxexile]

The major problem here in LoS is that pharmacies seem, and are apparently allowed, to do the diagnosis on the spot from what the "patient’s" symptoms are.

and i'm sure in many cases the diagnosis is related to which pills are likely to bring in the most profit for the "pharmacist".

this is also the case when visiting doctors in their practices here.

a lot of them have their own mini-pharmacies by the reception area and each patient is prescribed vast amounts of pills from them.

in any other country this would be seen as a conflict of interest, but here we have to put our faith in the professionalism and ethics of the doctor.

it might be useful for the customer to look up in MIMS or the BNF(the pharmacists' and doctors' bibles.... most pharmacists will have one on the premises) the drug recommended by the pharmacist before actually purchasing them and see if they match the symptoms and dont have any lethal side effects.

[Thaiquila]

I realize the answer to this question is probably no, but, anyway, here goes.

Does anyone know of a web resource of what pharmaceuticals are generally available in Thailand, which have generics, and what the rough market prices are for the meds.

From my American point of view (we are being raped by the pharmaceutical companies here and millions of people are resorting to buy meds in Mexico, Canada, etc.), this would make interesting and useful reading.

[Guest IT Manager]

I have been buying meds in Thailand for about 6 years. Among them are anti-retrovirals, and other parts of the HAARTS regime. Starting with AZT and running the full gamut to Acyclovir.

I have the MIMS book, supplied annually by the pharmacy where I buy them, since no one else who goes there knows what a MIMS is, and the pharmacist is referred to as "Mohr" by the locals. We talk about what is happening in medication and we discuss trials we have heard about and who we know of who is doing trials.

As well as the AIDS drugs, I buy heart medication. We discuss the generic Thai brands and the comparisons with the local versions. Usually I get a mixture of brands, same drug. Differences of 700-1000 percent in price are not uncommon.

I need to buy GPOvir, from the Doctor or the hospital. The Government Hospital said it would cost about 2,200 baht for 60, the doctor charges me 1,250 baht.

Go to the Pharmacist and ask to see his copy of MIMS. Look at the cover and locate the year. If it is not for the current year, go to another pharmacy. If they don't have one or don't understand MIMS go to another pharmacy.

If you know enough to ask for the MIMS they know enough not to play games.

You can subscribe to MIMS through their Bangkok Office. Cost is 900 baht per year. Email [email protected] tel 02 398 6273.

Astounding the information you can get at thaivisa.com isn't?

[KevinN]

You are being fukd raw in the USA by the drug and pharmacy co.s

There you pay $10 for a 500mg. cipro by BAYER here it is $1,and for an advair inhaler I payed $200 every month at Wal-Mart,which is the cheapest pharmacy around,,here I pay$26.

My farang ex mother in law was on a drug for muscle problems which she paid $2 each for pills,I was living in mexico at the time and bought for her bottles of 500 pills for $40.

You can go to the pharmacy here and get a bottle of glacousamine caps.,or get the same thing in bulk for a few baht less.

I have found in my travels around the world that if you need an operation,go to a hospital,if you are sick,go to a druggist.

But it helps if you have some kind of an idea just what you need,so a MIMS is not out of line.

I think that there is to much,GOVT protecting us from ourselves in this world,and whats the worry anyway,you will just live all your life and not a day longer ..

[The_Moog]

You'll be fine with pharmacies at Boots here.

There are weird little pharmacies tucked away in Patpong 2 - don't know if i'd trust them.

The great thing about chemists here is that they are so casual about prescriptions - you don't need em! What Boots in UK wouldn't serve me, Boots here does !!

Here's a tip to fellow baldies out there. Don't buy Propecia, buy Proscar and cut the tablets into 4 using a pill splitter. Proscar available OTC here - same drug (finasteride) as Propecia - and save 75%

MOOG

[The_Moog]

..I forgot to say...

Prices here are no cheaper than in Europe, and in some cases (especially medications subsidised by the NHS), can be more expensive.

I heard a tale that unscrupulous Health officials in Thailand were taking the budgets for HIV anti-retrovirals, - pocketing the cash and buying chalky placebos instead to hand out........... 'nuff said. A case of TIT.

[translator]

First respectable and most probable correct thing you have typed in a few days Moog.

Alleged thought only......

[Silvercharm]

thai doctors are far too ready to prescribe vast amounts of powerful drugs for the most minor of complaints, the abuse of antibiotics is alarming and will only serve to encourage the proliferation of resistant bacteria for which there are no antibiotics.

I agree with that! Not only do pharmacists and doctors over prescribe antibiotics, many have no real idea of the side effects of many of the antibiotics prescribed. Some by the way can be very serious and debilitating.

A few weeks back I was prescribed norfloxacin. At the start of the third day I could hardly walk. Thought my tendons were going to blow. I still haven't fully recovered from this, and I have to take this on a day to day basis. I did educate my doctor about these side effects from the quinolone family of antibiotics. He really had no idea about the dangers of this. The pharmaceutical companies readily deny their drugs will cause danger. If you're offered any antibiotics from the quinolones, ask for something else. There are forums about these dangerous side effects. Ruptured tendons in the feet, legs, arms and shoulders, disablities, loss of eyesight, constant pain and suffering, to name only a few. Be careful, it could come back to haunt you a few years down the road.

Peace,

SC

[taxexile]

"side effects of quinolones can include:

nausea,vomiting,dyspepsia,abdominal pain,diarrhoea,headache,dizziness,sleep disorders,rash,( rarely stevens-johnstone syndrome,and toxic epidermal necolysis)

less frequent side effects can include photosensitivity, and tendon rupture.etc.etc.etc.and another 20 effects

the tendon rupture may occur within 48 hours of starting treatment."...copied from mims.

sometimes the cure is worse than the disease....... and most doctors i'm afraid are not very knowledgable about side effects and interactions between drugs, they never take a medical history at consultation and rarely ask about drug allergies.

their diagnostic skills are not that great either.

hospitals very luxurious though.

once walked past a doctors office in chiang mai, in the window was a large framed photograph of the doctor, in an operating theatre,in his green overalls and white boots, mask under his chin with a big smile on his face. behind him was an operating table with a patient asleep on it, huge red abdominal incision. the good doctor was holding big bloody lumps in each hand, looked like ovaries,holding them up and grinning in much the same way as a fisherman or pigeon hunter would hold aloft the biggest catch of the day for the mantelpiece photograph.

amazing thailand!!!!

[djinn]

I even experienced overprescription in Bumrungrad hospital.

If you are in the Pattaya aera;one good doctor :Dr Olivier Meyer(038 72 35 21);swiss,speaks fluently english,french,german and...thai

No overprescription,very good dialog.Works closely with Bangkok Pattaya Hospital

[lopburi3]

When I go to a Thai pharmacy and ask for medicine I get authentic, brand named pills and potions, stamped or embossed with the makers name.

When a Thai goes to the pharmacist with a common complaint, eg. aches and pains etc. they come away with unmarked pills, clearly unmarked costing 20 baht for half a dozen.

As a foreigner you are expected to be able to pay the higher price of brand name so unless you ask for the 'local' pills they will probably not be offered. Also there is a feeling that imported or brand name are better (sometimes true).

For most Thai the only option for treatment is the pharmacy and both proscribing and selling will be done there. With the 30 baht payment now being used there is less requirement at those areas served but it is still the corner drug store that does the bulk of treatment AFAIK. The pills they receive are real enough in most cases. Bulk produced local product. But in most cases all bases will be covered so you end up taking much more than needed (if anything really needed at all) and the chance of reactions to one or more is high.

Price of Tylenol (paracetamol 500) ranges from about 89 to 110 baht per hundred in container while local brands sell for about 30-35 baht. Zimmex (simvastatin 20mg) costs from 285 to 530 per 30 box. Other brand drugs also sell for a huge markup at some places so shop around. Not all drug stores sell at the same price.

[Guest IT Manager]

You guys blow me away. This is exactly what I see this forum as being about. We all have experiences, it's useful to share them.

As good a thread as I have seen on here. Thank you one and all.

[drbones666]

A few weeks back I was prescribed norfloxacin. At the start of the third day I could hardly walk. Thought my tendons were going to blow. I still haven't fully recovered from this, and I have to take this on a day to day basis.

This from www.drugvictims.org

Taking a Quinolone Antibiotic?

Stephen Fried, author of the book Bitter Pills, has offered the following advice to those who decide to risk taking a quinolone antibiotic:

From STEPHEN FRIED: Friday's (26 October 2001) Wall Street Journal reported that employees of American Media who were given Cipro are already experiencing the adverse reactions -- seizure, psychiatric symptom, severe sleep disorder -- which I know all too well because of my wife's experience with just one pill of a quinolone antibiotic in 1992. As a journalist who has spent almost a decade researching and writing about the safety of quinolones (as a way of investigating the entire legal drug culture), I offer the following advice for how to take them, if you must. And, keep in mind that, at this moment, both penicillins and tetracyclines -- antibiotics that most of you have already taken successfully in your life, or at least you know how you react to them -- will treat anthrax as successfully as cipro or the other quinolone antibiotics, with many fewer side effects.

1) Never take the first dose of a quinolone in the morning before you leave the house: you don't want to have a manic reaction or a seizure or get disoriented in the car alone. it is preferable to take the first dose at home in the evening or at a time when you don't have to drive right away. And, preferably, someone else should be around. Many of the drugs' adverse reactions come with the first dose.

2) Never take quinolones with grapefruit juice. The reason quinolones cause central nervous system side effects (seizures, mania, psychosis, agitation, insomnia) is because they reach a very high concentration in the blood quickly and cross the blood-brain barrier. Grapefruit juice causes many medications to remain in the bloodstream longer than usual, which can exacerbate any adverse reaction.

3) Do not take quinolones -- unless you have a full-blown anthrax infection that hasn't responded to penicillin or tetracycline -- if you are being treated for or have been treated for psychiatric disorders or seizure disorders. (Other predictors of adverse reactions are history of head trauma and any decreased renal function which causes your body to improperly metabolize the medications.) And, even though you may be feeling panicky about the world in general since Sept. 11, try to separate those feelings from any panic, anxiety or agitation symptoms that began or got worse immediately after taking Cipro. CNS reactions are often dismissed as being caused by external stressors.

4) At the first sign of an adverse reaction in the central nervous system, stop taking the drug. Then call your doctor and insist he or she switch you to a non-quinolone antibiotic. This advice is right on the label, but many doctors ignore or countermand it.

5) If you have a seizure or a severe manic reaction from a quinolone, do not accept the commonly offered advice "just wait for the drug to leave your system and you'll feel better." There are treatments for all the common side effects of the drugs, and they should be administered immediately to prevent further problems: anti-seizure meds, anti-manic agents, sleep-inducing agents are all useful.

6) If you have an adverse reaction, report it to your physician and to the FDA's MEDWATCH system. (There is a link to medwatch at my website www.bitter-pills.com.)

7) There is another set of unusual adverse reactions to these drugs involving spontaneous tendon rupture: there are cases of people just sitting drinking their coffee in the morning and then, pop, their achilles tendon ruptures. If you experience the rapid onset of tendon pain after taking cipro or other quinolones, talk to your doctor about going off the medications immediately. There have also been a growing number of reports of peripheral neuropathies--anything from tingling to burning pains, often in the extremities--which are linked to the drugs.

8) If you have questions, I'm at [email protected]. My wife and I have been taking questions from the "floxies" all over the world for the past nine years, and we're happy to help.

From Jim Romenesko's MediaNews Letters

Posted 28 October 2001

www.poynter.org/medianews/letters.htm

drugvictims.org