Lovenox in Bangkok

[bellecat]

So I recently got a pulmonary embolism which required me to push back my travel plans to Thailand/SEA for at least seven months while I go on blood thinners and the testing afterwards to see if I'll need to go back on them etc etc. Do not really want to deal with the INR testing while living the low budget backpacking life and having to be more cautious/avoid rural area in case I get hurt.

My hematologist also said that I should take Lovenox if I fly super long haul (USA-Thailand). It's no problem for me to source them at home but I plan on backpacking and I do not want to carry around some syringes in my backpack. The hematologist agreed that it would be a bad idea to keep them in my backpack and said I probably could source some in Bangkok before my flight home (arriving in Thailand on an one way, no idea when I'll be heading back home). I did a search on TV and only found one result for Lovenox and heaps about heparin which I might ask him about the next time I see him to see if it's a viable option in case Lovenox is hard to get.

Is it possible for me to get 2-3 syringes of Lovenox in Bangkok and if so, how easy is it? Is it OTC or do I need a prescription? If prescription is required, can I just give them one from my doctor or do I need to see a Thai doctor to get one?

And if yes to all the above and you have any idea, is the cost reasonable? I'd prefer to pay up to a max of 600 baht or so per syringe since I would only need 2-3 for my trip back home. I would rather not have to pay ripoff prices since past that point (or 1500+ baht a syringe, ouch), it'd probably be cheaper to have someone buy them at home and overnight it to me :/

[Sheryl]

Lovenox = Enoxaparin Sodium which is available in Thailand under the brand name Clexane.

It is an import and will be quite expensive. While it does not require a prescription in Thailand, not many pharmacies carry it so you may have to get it at a hospital. Having a US prescription will not be honored in a hospital pharmacy but will be useful to show a Thai doctor for ease in getting it prescribed here.

It comes as a pre-filled syringe and has to be stored at temperatures below 25 C which precludes taking them around with you in a backpack and in general will make traveling with it difficult. Remember that temperatures here are in the 30's.

The other point to be wary of is possible trouble with police given that Western backpackers have something of a reputation for drug abuse. Be sure to have medical documentation with you at all times when carrying around syringes.

[Sheryl]

P.S. same issues (heat exposure, syringes) would apply to having it shipped to you here.

Even transient exposure to temperatures above 30 C will inactivate it.

[bellecat]

My hematologist did mention the lack of chilled storage when recommendating aganist carrying it in my backpack. I definitely plan on getting some documentation about my PE and the recommendation for Clexane usage to take with me and getting it shortly before I fly back home so I don't have the syringes on my person for very long. I'm thinking that it'd be a good idea to stay in Bangkok for a week or so before my flight home to ensure that I can get it in case there's any issues in sourcing them too. Going to splurge a bit on my hostel in Bangkok too to make sure it has AC.

Thank you for the information! Google was pretty unhelpful when I tried to search for Lovenox Bangkok but Clexane gave me useful results.

[Sheryl]

"Store at 25°C (77°F); excursions permitted to 15–30°C (59–86°F)".

Temps in Thailand this time of year are well over 30 C. So having it out with you even for a brief period would be a problem. You'll need to have it in some type of a cooler, but take care not to freeze it either.

[bellecat]

Even in an airconditioned hotel room? Or would I need to make sure I have a minifridge or ask for permission to store it in the hotel fridge if they have one? Not in the freezer :x I wouldn't carry it around in Bangkok on my person since it seems like that I only need to take it right before I fly then 12 hours later if still traveling. I don't really want to carry around a cooler bag in my backpack for months for something that I'll only use for a few days but I guess I could if it's really necessary to do so + try to find another use for it so it's not a total waste of space.

I'll take an airconditioned taxi direct to my hotel after getting the meds to reduce the time outside a cool environment and possibly ask for some ice to take with me. Then I could try to source some more ice for the trip to the airport if necessary. It would be in my hand luggage at all times.

It's been around 30-35C outside where I am but my doctors didn't mention about storage in a cooler so I just left the box out in a room with AC on. Not sure about that tho, I was still out of it at the hospital and let my mom sort out the things.

P.S. Sorry about all of the questions, I'm still trying to adjust to the new normal and just want to make sure that I can do all of the things I did pre-PE.

Edited October 15, 2014 by bellecat

[Sheryl]

Air con hotel room will be fine as long as the a/c stays on when you are out (usually not the case..most places have the system whereby it goes on only when key is placed in a slot near the door, and less expensive places keep track of their guests' movements and turn off the a/c as soon as they go out) - or, you do not go out after you bring the med back there until your departure for airport.

I was of the impression you needed to use this regularly. If it is just a dose before flying and another 12 hours later then that is more feasible to arrange. But as it may prove hard to fund the med suggest sussing out pharmacies in advance of day of departure. Airport and plane temps will be fine.