Meds

[biplrbr]

hey guys and gals

i have a problem

i need meds (medrol dose pack) which is essentially prednisone for a swelling problem in my neck that cropped up originally 4 1/2 years ago and was promptly resolved

with the medrol dose pack. My doctor tells me this medication is not available in thailand and wants to proceed with expensive biopsies etc...

i found and bought the meds on line and am having them shipped to my in laws in the US but i am told they cant send them be a commercial express company like DHL or Fed Ex

because the incoming packages of these couriers are searched and confiscated. Sending by a courier will shorten the delivery time by at least a week.

does anybody know about such a policy and am i at risk for trying to have DHL for instance try and deliver my package or must (should) I go with the old USPA.

thanks for any help/light you can shed on this question

since i need to get this asap and find out if it will cure my problem without the expensive and invasive tests my doctors are pushing for.

biplrbr

[Tywais]

I'm moving this to the Health Forum as I suspect will get better response.

[jfchandler]

I would imagine you could go USPS Express Mail International, and have it in a few days... A single Medrol dose pack is a small box that would pretty easily fit into one of their small flat rate boxes or envelopes...and unlikely to get a lot of attention from Thai customs...and then delivered here by Thai Post.

I wouldn't try sending something like that thru Fed Ex, DHL, and the like...

[BarnicaleBob]

Almost everything that gets shipped via commercial carrier (DHL, UPS, Fed-ex) is more subject to customs and even more subject to Thai commercial carrier employees that want you to pay extra to have it delivered in order to boost their personal incomes. If you have it sent by plain old regular U.S. Postal Service it should arrive in 7 to 12 days.

Also, I had the same problem a month ago about getting a drug refill for my arthritis. The Thai doctors told me they did not have it in Thailand and several pharmacies confirmed that they did not have it. By using Thai Visa I was told about a pharmacy that had many rare drugs and also did not require scrips to get them. I went there and sure enough they had it and the pills have been working well for me every since. This pharmacy has no English name on it's front so I do not have the name but it is located about 100 meters east of the Dara School on the opposite side of the street, almost directly across the street from a Shell gas station. Now there are several pharmacies in that block, this is the one with an open air front, no glass. I also purchased several other of my script drugs there and they were all cheaper at that location than the pharmacy I had used before.

Good luck and I hope it all works out well for you.

[Shurup]

it is located about 100 meters east of the Dara School on the opposite side of the street, almost directly across the street from a Shell gas station.

Could you be more specific please? Which city, area, etc...? I am going back to Canada in about a month and will need to get a refill from my doctor for my anti-depressant pills, or perhaps even try ask him to try a different medication... I won't have a lot of time as I am coming back not for very long, but will try and met with him either way. Also I am not going back that often so if I could get my refills here that would be good.

[BarnicaleBob]

it is located about 100 meters east of the Dara School on the opposite side of the street, almost directly across the street from a Shell gas station.

Could you be more specific please? Which city, area, etc...? I am going back to Canada in about a month and will need to get a refill from my doctor for my anti-depressant pills, or perhaps even try ask him to try a different medication... I won't have a lot of time as I am coming back not for very long, but will try and met with him either way. Also I am not going back that often so if I could get my refills here that would be good.

It is located in Chiang Mai on Keao Nawarat Road about half way between the Super Highway and the Ping River.

[Thanyaburi Mac]

FYI, that USPS Express International mail service has worked well for me in the past. Their "envelope" is limited to four pounds and now runs $13.45 for postage, arrives at my POBox in 6-9 days. If you use this, including some magazines or newspapers to bulk it up a bit. It is magazine sized.

You might also check out http://www.mims.com/index.aspx for further info.

The hard copy of the Thai MIMS book lists the following possible alternatives for methylprednisolone that are available here:

-- depo-medrol

-- solu-mederol

-- neo-medrol acne lotion

Mac

[Sheryl]

Actually, here in Thailand, for anything other than a document, sending by a courier will not result in your getting the time sooner than if sent by normal postal services. It will greatly lengthen it and introduce unnecessary customs problems and duties. FedEx is the most notorious for thsi but can happen with the others too. (And if you live out in the boondocks like I do, even a simply document will be vastly delayed if sent by a courier service).

Use normal postal service.

i have heard of people being told at the sending end that US postal regs do not allwo them to mail medications and that only the pharmacy issuing the drug can do so, I do not know if this is true or not, but plenty of people do ger meds mailed to them by their families/friends.

As for laws on the receiving (Thai) end, what you need to be aware of is

(1) technically you are not supposed to bring in more than a 30 day supply. My impression is that the "30 day" bit is related to the average length of stay of foreign visitors, and I have not heard of anyone counting out number of tablets, but certainly there is concern (and regulations in effect) that people not import pharmaceuticals for resale unless they have an import license. So be careful as to quantity and make sure it is not so large that a cuistoms official might think it is for resale/business purposes rather than personal use.

(2) whether it is controlled drug in Thailand and if so, what category. Many drugs which in the West are prescription-only are sold OTC in Thailand (Thai FDA category D) in which case it is no matter whether or not it arrives in a prescription bottle. If however it is a prescription-only drug in Thailand ("special controlled drug, Thai FDA category S), you must be sure it comes in a clearly labelled prescription bottle (your name, doctor's name).

(3) should the drug in question be a controlled substance (narcotic or many pyschotropics, Thai FDA categories N2/N3 and P2/P3/P4, you must also have a doctor's letter or certificate stating this has been prescribed to you and why, and in this instance I would absolutely advise limiting quanitity to a 30 day supply.

Prednisone/prenidsolone and related drugs are category 'S' - require a prescription but otherwise not a controlled substance. So make sure it is in a clearly labelled prescription bottle.

Now the more important issue, to my mind, is that you say the doctor you saw here said medrol pack is not available and wanted to "proceed with expensive biopsies". Medrol pack is simply a packaging of methylprednisolone to make it easy for patients to know how to take it in a sliding dosage. Methylprednisolone does not significantly differ from prednisolone, and prednisolone is availabel in Thailand under m,any, many brands.

In other words if the doctor you saw thought that this treatmwent approach was approrpiate he could easily have continued it giving you prednisolone, although under a different brand name and without the conveneince of the way the Medrol pack arranges the daily dosages. While he was technically correct that Medrol pack exactly is not available here, it seems he beleived that a different approach was called for. And, since apparrently the problem has recurred, he could be right.

Thai doctors are not accustomed to patients being medically informed nor to explaining the medical reasons for what they recommend. It would be entirely typical for a doctor to say "not available here" rather than explaining that he thought the treatment unadvisable on medical grounds and why.

You did not supply enough information about the problem for me or anyone else to advise you as to whether or not a repeat course of steroids, without biopsy or other investiagtions, is advisable. I suggest you either do so, or get a second opinion from a local specialist, ort at the very least contact the doctor who originally treated you back home, tell him the swelling has recurred and that a local physician recommended biopsy and see what he says.

A biopsy is the only definitive means of ruling out malignancy.

[jfchandler]

Actually, USPS has two similar, but different price international delivery services....

Priority Mail International: a bit slower, maybe a week plus to Bangkok, a bit cheaper than Express Mail, and no tracking for the least expensive flat rate envelopes.

Express Mail International: a bit faster, maybe less than a week to BKK, a bit more expensive than Priority Mail, and tracking and insurance.

Both would be delivered on the Thai end by Thai Post, and both would typically avoid all the hassles incurred with using the private courier delivery services... Though if the customs value is over maybe $50, still likely to get flagged for some duty... Lesser valuations usually not.

FYI, that USPS Express International mail service has worked well for me in the past. Their "envelope" is limited to four pounds and now runs $13.45 for postage, arrives at my PO Box in 6-9 days. If you use this, including some magazines or newspapers to bulk it up a bit. It is magazine sized.