Substitute for Pseudoephederine?

[otherstuff1957]

It's hay-fever season again, at least for me! I used up my last Actifed yesterday and I know that I cannot buy this or any other pseudoephederine based medicine in Thailand any more.

Can anyone tell me what is the best substitute for Actifed that is available here?

Thanks in advance!

[FBN]

Try Phenergan or any of the non-drowsy antihistamines.

[lopburi3]

I have had good results with Zyrtec (cetirizine dihydiochloride 10mg) which seems to be available everywhere.

[Sheryl]

Tiffy is back on the shelves now but with phenylephrine rather than pseudoephedrine. Unfortunately, doesn't work as well.

You can still get meds with pseudephedrine but only at a hospital.

Zyrtec works well for the allergic aspect of things, as done loratadine, and this may be enough, but if there is still congestion after taking antihistamines there are steroidal nose drops that often help but should see an ENT for advice first. An ENT can also provide a script for a product containing pseudoephedrine if that is indicated, but I think for seasonal rhinitis ("hay fever") there are better approaches.

If you are in Bangkok Dr. Songklot at St Louis is very good.

[jmccarty]

doctors will prescribe maxiphed. Works well enough. Why not try a neti pot?

[tfc]

Tiffy is back on the shelves now but with phenylephrine rather than pseudoephedrine. Unfortunately, doesn't work as well.

You can still get meds with pseudephedrine but only at a hospital.

Zyrtec works well for the allergic aspect of things, as done loratadine, and this may be enough, but if there is still congestion after taking antihistamines there are steroidal nose drops that often help but should see an ENT for advice first. An ENT can also provide a script for a product containing pseudoephedrine if that is indicated, but I think for seasonal rhinitis ("hay fever") there are better approaches.

If you are in Bangkok Dr. Songklot at St Louis is very good.

What would you suggest as a better alternative for seasonal rhinitis?

Have you found that zytrec clears the sinuses?

Loratadine just seems to make me drowsy.

As for phenylephrine my doctor and pharmacist in Australia just straight out told me that that is a waste of money and should never have been substituted for psuedoephedrine. At least in Australia they regulate psuedoephedrine by limiting purchases to one box at a time and you need to show your driver's license. It makes it easy to get on with work and life. I would think that it would only raise suspicion if a person came in asking to buy a case of a thousand.

[tfc]

doctors will prescribe maxiphed. Works well enough. Why not try a neti pot?

They prescribe Maxiphed with psuedoephedrine?

Neti gives makes my sinuses worse though my wife likes it.

[Sheryl]

Agree re phenylephrine being pretty useless.

Maxiphed = pseudoephedrine and yes, can be gotten from a hospital on prescription as can various other pseudoephedrine preparations. These have not ceased to be available, just become controlled (a big nuisance, of course)

Loratadine should be taken at bedtime. If that still makes you drowsy, could try cetirizine (Zyrtec and other brands) instead. These drugs do not "clear the sinuses" as such, they mediate the allergic response so if the cause is allergy, will help.

Sometimes nasal sprays containing steroids, such as Nasonex, are helpful but again suggest you see an ENT before self treating with them.

I would also suggest supplemental zinc. Redoxan brand has zinc + Vit C. If your D3 levels are low, supplementing that may also help.

[tfc]

Benadryl doesn't seem to do anything except make me sleepy so from experience and my prior diagnosis from doctors in Australia I'm going to make the educated guess that I don't have allergies. I'm going to make an appointment to see an ENT and see what can be done. It's gotten to the point where my sinusitis makes me useless for anything. Considering that it's gotten beyond annoying I'd happily jump through the hoops at a hospital and pay to get this sorted out.

I'm currently also taking wholefood multiminerals, ZMA (zinc, magnesium and and vitamin D but they don't seem to help my current issue. I find it weird that nothing at a normal chemist can help with what should be a fairly simple and straight forward issue to help.

[tfc]

I got back from the ENT and and he prescribed me psuedoephedrine and surprise surprise it cleared up my sinuses straight away, well within 30 minutes. He also agreed that phenylephrine doesn't work for sinusitis. I forgot to ask him what it actually does work for. Interestingly he said that I should not use any of the nasal sprays as after a few days they could make my symptoms worse. In any case, I'm happy that my sinuses are clear. Worth the trip to hospital.

[MadMac]

I just got a pack of Cyzine for 45B at a small neighborhood pharmacy. Same as Zyrtec, generic stuff. Hope it helps, I got some allergy which I believe is from our dog.

[sanuk21]

I have tried a lot of cures for seasonal rhinositis.....decongestants, antihistamines, corticosteroids, neti pot and diets......

They all seem to have there place but there are no magic bullets. Though I haven't tried immunotherapy.

Nasonex seems to be the most reliable and have the least side effects for me.

Contrary to popular belief it can be taken for long periods of time without any "rebound effect".

It is expensive, curiously it is 50% cheaper here than in the west.

sanuk

[mommysboy]

If your problem is exclusively hay fever as suggested then the only 2 priorities are:

1. Avoidance/Reduction. Relocation or lifestyle change if possible.

2. Nasal Rinsing. To wash out the pollen.

The meds will probably only work for mild symptoms, however, you might strike lucky.

Non- steroidal sprays such as Beconase or Nasocort are particularly useful for longer term relief of congestion which after all is the main annoyance.

I use relaxation tapes downloaded as apps on my android phone to help me get to grips with pain, and counterpain on the back of the neck and pressure points also provide temporary relief if pain is radiating.

[bobo42]

Go see a doctor in a hospital and have them get you some. Nothing works as well as the real thing. There are many brands and mixed formulations available, but they can only be dispensed in a hospital (as far as I know).

Another suggestion I that works incredibly well for me is Nasonex nasal spray - available in many pharmacies, but pretty expensive. Using during allergy season clears my nasal allergys right up, no need for pills.

[infinity11]

I am not familiar with the names Beconase or Nasocort.

However the best thing i ever took for seasonal hay fever allergies was flonase.

As if i had NO symptoms at all in a very short time, like magic.

Is it available in thailand?

I think at least now it is also available in generic.

Possible a steroid, not sure.

Nothing else like it works like a charm zero side effects. (YOUR results may vary)

Edited February 10, 2014 by infinity11

[Sheryl]

Flonase is indeed a steroid (fluticasone), as are nasonex and beconase.

Fluticasone nasal spray is available in Thailand under brand name Avaymys and Flixonase

[infinity11]

A bit off topic but very curious about the price and how easily it can be obtained please.

Stuff worked like a charm.

Why would anyone NOT use it?

[Sheryl]

It will be of most help to those whose problems are allergic in nature, which is certainly not everyone. It is also pretty expensive.

[JimShortz]

Actifed is still available on prescription - I believe; just not over-the-counter.

Go see a doc...

[JimShortz]

Or you try ephedrine... Lol

[TallGuyJohninBKK]

Went to my local pharmacy in BKK this afternoon. They had both of the items I was looking for:

-- Rhinocort Aqua 64 mcg/dose nasal cortico-steroid spray (budesonide), 120 doses -- 280 baht.

--Nasacort AQ 55 mcg/dose nasal cortico-steroid spray (triamcinolone acetonide), 120 doses -- 450 baht.

Obviously, both were available OTC, no doctor prescription required.

Interesting that, the WebMD website in the U.S. has user reviews of both drugs by people who have used them. And there are, IMO, a surprisingly large share of those reviews complaining about various side effects including sleeplessness, dizzyness, headaches, nasal irritation and even nasal bleeding.

http://www.webmd.com/drugs/drugreview-17970-Rhinocort+Aqua+nasal.aspx?drugid=17970&drugname=Rhinocort+Aqua+nasal&sortby=3

http://www.webmd.com/drugs/drugreview-16244-nasacort+aq.aspx?drugid=16244&drugname=nasacort+aq&sortby=3

Edited July 21, 2014 by TallGuyJohninBKK

[lopburi3]

But such "reviews" are normally mostly negative as written by those having issues rather than a random sample or everyone buying/using the product.

[jmccarty]

Anything with corticosteroids should be used sparingly. It burns out your nasal membrane if used too much and the bleeding nose is no better than the congestion.

Some are just born with it and have to live with it if you can't find something that does more damage than good.

[TallGuyJohninBKK]

But such "reviews" are normally mostly negative as written by those having issues rather than a random sample or everyone buying/using the product.

That certainly CAN be true generally speaking, and people with negative experiences are probably more likely to post than those who are satisfied.

However, WebMD isn't exactly the typical crank internet forum. And as the person who actually read thru every comment posted for the two drugs I mentioned above, I'd actually say that about half the posters thought the medicines were great and the other half complained of the various significant side effects I mentioned above. (The proportion of reported bad experiences for both drugs was higher than I would have expected).

It's kind of hard to understand how the same drug(s) can have such different impacts on different users from all different kinds of walks of life.

Part of the reason I would prefer to use pseudoephedrine is that in taking it periodically thru the years, I've never had any bad experience or noticeable side effects from it, and it really works well for me.

On the flip side, the reviews posted on the two nasal spray cortico-steroids along with their manufacturer acknowledged side effects make me hesitant, especially for any kind of ongoing use.

[TallGuyJohninBKK]

Just to double-check, since some time has passed, I stopped by my friendly local BKK pharmacy the other day, to ask;

Not only did they not have any pseudoephedrine product, which was no surprise, they also said they had nothing of any of the past products that were a combination of pseudoephedrine along with some other medicine.

When I asked about alternatives, the best they could offer was a couple different versions of phenylephrine, which I wasn't the least interested in.

[JesseFrank]

Ny son was the other day prescribed Triprodrine, which I think is a pseudo ephedrine based medicine.

[TallGuyJohninBKK]

Pseudoephedrine is still available from hospital pharmacies with a doctor's prescription (meaning you have to pay for a hospital visit and doctor's appointment).

But you can no longer just go to a regular commercial pharmacy and buy it or refill a prescription yourself, like you used to be able to do prior to 2012 when the government changed its status to being a controlled substance.

Edited July 27, 2014 by TallGuyJohninBKK

[inbangkok]

Many people still have luck with Phenylephrine. The FDA still claims it is suitable for nasal congestion. Unfortunately, it does not work as well as pseudoephedrine for me, but is better than nothing.

The other medications mentioned (Zyrtec, Loratadine , etc.) do not help with nasal congestion, but rather with runny nose, itchy eyes, etc.

I personally use Fluticasone spray every day. As mentioned, it is only available under brand names here (no generics) and is a bit expensive (about 800 a bottle which is a one months supply). You have to use it everyday though (or at least throughout your allergy season) as it is a steroid.....you cannot just use it when you feel congested.

If you need instant relief, nothing is better than Oxymetazaline nasal spray. It can be purchased at any pharmacy for very cheap. Works within minutes.....The label, as well as most Dr.'s warn not to overuse it though as you can become dependent on it. I have personally never noticed any form of tolerance or dependency using it though.