Prescription Medicines

[masuk]

I've done a search on the forum and have not come up with anything recent on what seems to be a standard set of medications for aging westerners, and availability.

I've asked at a local pharmacy for Atacand 16/12.5, but maybe these are made for smaller Thai body weights as what's available is 50% less than 'standard'.

Lipitor generic is not a problem.

Aspirin seems to be only 81mg and not the usual 100mg. All the above as prescribed by my GP back in Oz.

I can't help wondering how a Thai can afford such things at 320THB each per 10 days. These are manufactured in Thailand, so it seems royalties are still going overseas.

I did take the opportunity to ask about the cost of Cialis, and was told that they did not stock such things! Ah well, back to the rhino horn, or is it sea slug?

[elektrified]

Aspirin is available in 100 mg. The formula is Cardiprin (Aspirin 100 mg. glycine 45 mg.) The problem is that it is imported and costs considerably more than 81 mg. For example: 90 Cardiprin costs about 289 THB where you can get 120 X 81 mg. Aspirin (Aspent-M or similar) for 50 Baht. Not sure what you are on about the drug that costs 320 THB every 10 days - but just like anywhere else in the world, some drugs are expensive.

Can't help you with the others except for the Lipitor which you indicate you have found.

[hellodolly]

I had always been told 81 mg for help to prevent stroke.

[sharktooth]

I had always been told 81 mg for help to prevent stroke.

I've been taking one a day for years, as do my parents. My dad is 76 and my mum 74.

[WinnieTheKhwai]

To get the best price you need to explore a couple brands. Typically they first give you the most expensive one, especially at fancy pharmacies like Boots, Watson's and some Pharma Choice stores.

BTW speaking of Pharma Choice, some are really truly excellent, with a great pharmacist rivalling a doctor's advice. (Like the Hang Dong road branch before you get to Tesco). And then some are a complete waste of time, with lousy, disrespectful staff, like the one on Moon Muang Rd. Strange to have such a difference within the same franchise.

Anyway, I recommend the Hang Dong road Pharma Choice. The lady pharmacist there gives excellent advice, will readily offer generic / cheaper versions and will just say so if she thinks you don't need a particular kind of medication rather than just sell it.

Edited April 25, 2012 by WinnieTheKhwai

[masuk]

thanks for the comments. I'll try the Pharma Choice as suggested.

The price quoted for "Atacand" is the same price as in Australia; however my doctor's prescription is for 16/12.5, which does not seem to be available here. As suggested, maybe the lower dose is for smaller people, but it is normallly in 8mg, 16mg or 32mg. Only the smaller is available here it seems.

What I am 'on about' is that Atacand here is sold in strips of 10, and costs 320THB for 10 tabs. Same for Lipitor. A lot for the average Thai.

Aspirin seems to have many benefits, and 100mg per day is what the doctor ordered for me.

Has anyone tried Singapore?

[Dante99]

Has anyone tried Singapore?

Yeh, it is really good. National Heart Center at Singapore General Hospital.

[uptheos]

I had always been told 81 mg for help to prevent stroke.

I wonder how they came up with the figure 81mg?

Why not 80 or 82?

[orang37]

http://www.mayoclini...therapy/HB00073

Before considering regular daily use of any medication, I think it's a good idea to be informed, fully, by qualified medical resources, about the use of that medication in relation to its long-term side effects, and its possible interactions with other drugs.

Aspirin regular-use recommendations may vary based on age, weight, presence of diabetes, whether or not a person has had a heart-attack, or is a prime candidate for one.

A recent study: http://archinte.ama-assn.org/cgi/content/abstract/172/3/209?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=aspirin&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT

Suggests: "Conclusions Despite important reductions in nonfatal MI, aspirin prophylaxis in people without prior CVD does not lead to reductions in either cardiovascular death or cancer mortality. Because the benefits are further offset by clinically important bleeding events, routine use of aspirin for primary prevention is not warranted and treatment decisions need to be considered on a case-by-case basis."

The OP here says that he is simply following his doctor's recommendations, so, hopefully, the possible interactions of Lipitor and Aspirin, and any other drugs, have been considered in his case.

As for Cialis: well you raise (possibly ?) other issues there

best, ~o:37;

Edited April 25, 2012 by orang37

[WinnieTheKhwai]

That you're mentioning brand names (Atacand, Lipitor) rather than the actual chemical name seems to indicate that you didn't ask yet for a generic version?

Of course when you import a brand name medication then it costs the same (or more) as abroad. Atacand for example is an anti-hypertension drug, of which there are MANY different kinds. (Seeing it's just about the most common condition possible)

Let me go back on my earlier advice now that your situation is clearer to me, and suggest instead of visiting a pharmacy that you visit a doctor or clinic, and with some regular check-ups get to something that's locally cheaply available, doesn't cause side effects and is effective in reducing hypertension. Some anti-hypertension drugs cost 18 baht for 10. These may or may not be suitable for your particular situation. Either way it answers the question of what most non-wealthy Thais use: the Atenolol for 1.8 baht per day. (And probably less when buying in bulk)

Edited April 25, 2012 by WinnieTheKhwai

[mcgriffith]

I wouldn't recommend the Atenolol.

(from Wikipedia)

"Atenolol is a selective β₁ receptor antagonist, a drug belonging to the group of beta blockers (sometimes written β-blockers), a class of drugs used primarily in cardiovascular diseases. Introduced in 1976, atenolol was developed as a replacement for propranolol in the treatment of hypertension. The chemical works by slowing down the heart and reducing its workload. Unlike propranolol, atenolol does not pass through the blood-brain barrier thus avoiding various central nervous system side effects.^[1]

Atenolol is one of the most widely used β-blockers in the United Kingdom and was once the first-line treatment for hypertension. The role for β-blockers in hypertension was downgraded in June 2006 in the United Kingdom to fourth-line, as they perform less appropriately or effectively than newer drugs, particularly in the elderly. Some evidence suggests that even in normal doses the most frequently used β-blockers carry an unacceptable risk of provoking type 2 diabetes.^[2]"

^{(My emphasis in red colour added).}

I second Winnie's advice.

^{OP, you need to go see a proper physician like Dr. Morgan, get a work-up (blood panel and physical evaluation).}

^{Not trying to scare you or provoke you in any way- just saying don't keep taking something that some doctor gave you previously, that you think is still safe and appropriate. Dozens of hypertension and statin meds available here, many way cheaper (either generic or brand-name) than in western countries.}

[mcgriffith]

A postscript added to my above comment.

1) don't take advice on appropriate meds to take, from a forum member (no matter how well intentioned) who was told to take this or that. Everyone is different, and believe me, I've seen members offer advice on meds that beggars the imagination. As in suggesting warfarin (something only prescribed for people who have coronary artery disease) in response to a question about aspirin. Go see a doctor for advice.

2) in reference to the above; there are flowcharts that determine what anti-hypertensive drug one must take. There is no number one or number 2 simple choice. It is very much more complicated than that. Again, go see a doctor for advice.

3) Try the Thai Visa health forum. Sheryl, our resident mod there, is an RN and has decades of experience working in the health field. Asking a pharmacy person is shooting in the dark; hit or miss. I understand many (especially elderly males) are very doctor-averse. I know, I am one myself. Post something here and you will probably get way better advice than that from a local pharmacy:

http://www.thaivisa....y-and-medicine/

[Grumbles]

I went to the local govt. hospital and the doctor changed my pills after doing blood tests. It cost me 45 baht for the months pills at the hospital pharmacy, opposed to the usual pharmacy bill of 2ooo baht. I figured it was worth the wait at the hospital for that kind of saving.

[elektrified]

I went to the local govt. hospital and the doctor changed my pills after doing blood tests. It cost me 45 baht for the months pills at the hospital pharmacy, opposed to the usual pharmacy bill of 2ooo baht. I figured it was worth the wait at the hospital for that kind of saving.

The medications dispensed at government hospitals in Thailand are the poorest quality generics available. Often they are only 3-6 weeks away from their expiration date. They have been stored in less than adequately cool and dry storage for a long time. I would not want to be getting nitroglycerin or digoxin or one of those to keep my heart going from one of those places!

Think about it. There is a reason they can dispense them for 45 THB vs. 2000 THB at a pharmacy or private hospital.

[Grumbles]

I went to the local govt. hospital and the doctor changed my pills after doing blood tests. It cost me 45 baht for the months pills at the hospital pharmacy, opposed to the usual pharmacy bill of 2ooo baht. I figured it was worth the wait at the hospital for that kind of saving.

The medications dispensed at government hospitals in Thailand are the poorest quality generics available. Often they are only 3-6 weeks away from their expiration date. They have been stored in less than adequately cool and dry storage for a long time. I would not want to be getting nitroglycerin or digoxin or one of those to keep my heart going from one of those places!

Think about it. There is a reason they can dispense them for 45 THB vs. 2000 THB at a pharmacy or private hospital.

As opposed to the more expensive pharmacy brands which of course are 100% kosher every time???

[masuk]

Thanks everyone for the comments and advice.

I should mention that I gave brand names as that's what my doctor prescribed when I had a full annual checkup in December. That included 100mg Aspirin.

As suggested, it is now obvious that a local doctor is going to know what's available here, and I'll follow that through.

[hellodolly]

A postscript added to my above comment.

1) don't take advice on appropriate meds to take, from a forum member (no matter how well intentioned) who was told to take this or that. Everyone is different, and believe me, I've seen members offer advice on meds that beggars the imagination. As in suggesting warfarin (something only prescribed for people who have coronary artery disease) in response to a question about aspirin. Go see a doctor for advice.

2) in reference to the above; there are flowcharts that determine what anti-hypertensive drug one must take. There is no number one or number 2 simple choice. It is very much more complicated than that. Again, go see a doctor for advice.

3) Try the Thai Visa health forum. Sheryl, our resident mod there, is an RN and has decades of experience working in the health field. Asking a pharmacy person is shooting in the dark; hit or miss. I understand many (especially elderly males) are very doctor-averse. I know, I am one myself. Post something here and you will probably get way better advice than that from a local pharmacy:

http://www.thaivisa....y-and-medicine/

For sure see a doctor and tell them every thing you are taking.

I tried to get Ibuprofen when I was in Canada and I told my Doctor there that my doctor here on the advice of a heart specialist had put me on warfari. The doctor told me that I could not take Ibuprofen with it as it as a real threat to internal bleeding in the stomach when taken with warfarin .

I don't know about the generic lipators but I do know the real ones gave me side affects that were to painful and when I first saw my Doctor here in Thailand she wanted to put me on it but I refused, I told her I was taking Niacin as it was supposed to be good for cholesterol. She looked at the bottle and said it was no good (obviously it was no good I had been using it for a year and it had not helped) and ordered me some from Bangkok that has been working.

When taking any medicine see a doctor and tell them every thing you are taking.

[Mekong Bob]

I just completed a quick survey of some prescription meds in 6-8 local Chiang Mai pharmacies. My interests are in meds for hypertension (high blood pressure); high cholesterol; high triglycerides; and high ocular (eye) pressure and/or glaucoma. Visited Fascino, PharmaChoice, First Drug, Dara, CMU Pharmacy (Pharmacy Faculty), and Chiang Mai Ram Hospital Pharmacy. Prices for brand name meds are outrageous! How in the world can people in Chiang Mai afford these drugs? I hope they have access to good, affordable generic drugs . . . . or a good health insurance plan!

What's the latest on an annual order of USA-origin prescription meds, shipped to Chiang Mai via FedEx, UPS, or DHL? Is it true that Thai Customs wilol nail you on this?

[elektrified]

I just completed a quick survey of some prescription meds in 6-8 local Chiang Mai pharmacies. My interests are in meds for hypertension (high blood pressure); high cholesterol; high triglycerides; and high ocular (eye) pressure and/or glaucoma. Visited Fascino, PharmaChoice, First Drug, Dara, CMU Pharmacy (Pharmacy Faculty), and Chiang Mai Ram Hospital Pharmacy. Prices for brand name meds are outrageous! How in the world can people in Chiang Mai afford these drugs? I hope they have access to good, affordable generic drugs . . . . or a good health insurance plan!

What's the latest on an annual order of USA-origin prescription meds, shipped to Chiang Mai via FedEx, UPS, or DHL? Is it true that Thai Customs wilol nail you on this?

Well first of all you picked some of the most expensive pharmacies in town to do your survey. In fact, I wouldn't shop at any of them. Many of the most popular drugs are available in generic form and manufactured here in Thailand. Some are made by top quality labs/factories and others are made by not so reputable ones. That is one thing I really like about Dr. Morgan is that she knows which are good ones and she won't offer low-grade generics or drugs, vaccines, etc. manufactured for example in India. Having said that, some are, like anywhere else in the world, expensive. Very few health insurance plans will reimburse you for outpatient medications. Many Thais spend a great deal of money each month on their medicine.

To the best of my knowledge it is illegal to order drugs from outside the country and have them shipped to Thailand via one of the carriers you mentioned. I'm sure someone will correct me if I am wrong.

Best to price shop at some of the smaller pharmacies or buy from a wholesale supplier rather than the names mentioned above. If you buy wholesale you do have to buy in large quantities however.

[Mekong Bob]

I have found that Fascino Pharmacy (Suthep Road) and PharmaChoice (KlaiMor Branch on Hang Dong Road) are best-stocked and best-priced for brand name prescription meds. Chiang Mai Ram Hospital Pharmacy offers these same meds at 400% to 600% mark-up above Fascino!!!

If you are an expat and need to buy such meds, and your health insurance will not cover, you are in big trouble. Best to follow the advice of "elektrified" (above) and start shopping for cheaper generic alternatives. Perhaps Dr. Morgan can advise you on which generics are best alternatives to your brand name meds.

[uptheos]

I have found that Fascino Pharmacy (Suthep Road) and PharmaChoice (KlaiMor Branch on Hang Dong Road) are best-stocked and best-priced for brand name prescription meds. .

Dr. Morgan has sent me to both of these for something she never had in stock.

Both times successful and not overly priced.

[hellodolly]

I just completed a quick survey of some prescription meds in 6-8 local Chiang Mai pharmacies. My interests are in meds for hypertension (high blood pressure); high cholesterol; high triglycerides; and high ocular (eye) pressure and/or glaucoma. Visited Fascino, PharmaChoice, First Drug, Dara, CMU Pharmacy (Pharmacy Faculty), and Chiang Mai Ram Hospital Pharmacy. Prices for brand name meds are outrageous! How in the world can people in Chiang Mai afford these drugs? I hope they have access to good, affordable generic drugs . . . . or a good health insurance plan!

What's the latest on an annual order of USA-origin prescription meds, shipped to Chiang Mai via FedEx, UPS, or DHL? Is it true that Thai Customs wilol nail you on this?

Well first of all you picked some of the most expensive pharmacies in town to do your survey. In fact, I wouldn't shop at any of them. Many of the most popular drugs are available in generic form and manufactured here in Thailand. Some are made by top quality labs/factories and others are made by not so reputable ones. That is one thing I really like about Dr. Morgan is that she knows which are good ones and she won't offer low-grade generics or drugs, vaccines, etc. manufactured for example in India. Having said that, some are, like anywhere else in the world, expensive. Very few health insurance plans will reimburse you for outpatient medications. Many Thais spend a great deal of money each month on their medicine.

To the best of my knowledge it is illegal to order drugs from outside the country and have them shipped to Thailand via one of the carriers you mentioned. I'm sure someone will correct me if I am wrong.

Best to price shop at some of the smaller pharmacies or buy from a wholesale supplier rather than the names mentioned above. If you buy wholesale you do have to buy in large quantities however.

The reason I buy all my drugs from Doctor Morgan is exactly as you said.

"That is one thing I really like about Dr. Morgan is that she knows which are good ones and she won't offer low-grade generics or drugs, vaccines, etc"

Saves me all the trouble of shopping around to find cheap drugs which I don't want. I prefer to pay a little more and feel secure that what I am using is good not just junk. For Instance I could not find any niacin that helped with my cholesterol but she ordered some in from Bangkok and it has put my cholesterol in the satisfactory category. I didn't change my diet just started taking medicine that had what it said it had in it.

When I first went to see her she had me bring in every thing I was taking. She didn't know what one was so she called the maker and asked them. She told me it was a mild pain reliever. My friend had told me it was for my joints. So I quit taking them and did not notice any change in my knee pain and it had never really helped any how. Now I get a Glucosamine Sulfate from her that really works for me. Mind you I had to take it for 60 days before I could start to feel the difference. But in the past I had tried different Glucosimine brands for months with no change. That is not to say they won't work for others. I know people who have had good experiences with them just not me. My brother takes them with Condrotin and MSM and they make a world of difference for him. His knee's were so bad the army wouldn't take him.

Edited April 30, 2012 by hellodolly

[Boifromoz]

In the interest of creating a new revenue im happy to send u aussie pharma's

[chiang mai]

From my experience Pharma Choice opposite Suan Dok Hospital has some of the best prices around.

Singapore: I've used the hospitals in Singapore, National University Hospital in particular and it's great from a helath care standpoint. Buying medication in Singapore is however a non-starter, prices there are at least 50% higher, in my experience.