Prescriptions - Cheaper In Los

[bmdailey]

I am coming over to Thailand at the end of the month and was wondering if I should try to get my hypertension med (Hyzaar) in Canada or LOS since I am uninsured.

For awhile George was protecting me from the tainted drugs in Canada by using the Homeland Security commandos to confiscate inbound Canadian drugs. I guess there was a fear of WMDs hidden in the tablets...

Anyway, sorry for the digression, is it possible to get prescriptions on a tourist visa and for low prices in LOS?

[Sheryl]

I am coming over to Thailand at the end of the month and was wondering if I should try to get my hypertension med (Hyzaar) in Canada or LOS since I am uninsured.

For awhile George was protecting me from the tainted drugs in Canada by using the Homeland Security commandos to confiscate inbound Canadian drugs. I guess there was a fear of WMDs hidden in the tablets...

Anyway, sorry for the digression, is it possible to get prescriptions on a tourist visa and for low prices in LOS?

Most drugs which require a prescrioption in the US are sold over the counter in Thailand -- pretty much everything except narcotics and IV meds. No prescription is required for anti-hypertensives.

In terms of price it depends on whether or not a Thai generic is available; where it is, costs are very low. Or in the case of patented drugs, if they are manufactured in Thailand, they will be less expensive than abroad. For patented imports, they will cost about the same as they would in Canada or Europe (but less than in the US unless they were for soem reason imported from the US; usually imports are from Europe).

Hyzaar is still under patent and is imported, so it will not be cheap here. May be cheaper than in the US but probabkly not cheaper than in Canada. Anyway no problems getting it.

Drugstores are abundant in Thailand but run the gamut from large air-conditioned places which buy directly from pharamaceutical companies and are staffed by qualified pharamacists to little hole-in-the-wall places or general stores whuich stock drugs often bought from a middle man and sold by people without the slightest idea what they are selling. Needless to say, avoid the former and shop at the latter, usually found in cities.

For those few drugs which must be prescribed by a doctor, your visa status is irrelevant, you just have to be seen by a doctor and obtain the medication at a hospital or clinic pharmacy.

[bmdailey]

Thanks Sheryl,

I am not wedded to Hyzaar. It contains two drugs: Losartan potassium and Hydrochlorothiazide

Hydrochlorothiazide is very cheap in the US so that should be no problem.

Is Losartan or equilvalent available as a generic in LOS?

Every doctor I've gone to has changed me to another med for my BP, and they all work, some a little better than others. Doctors all seem to have there favorites meds...

What are some of the BP meds that are easily available and inexpensive in LOS?

[Sheryl]

Thanks Sheryl,

I am not wedded to Hyzaar. It contains two drugs: Losartan potassium and Hydrochlorothiazide

Hydrochlorothiazide is very cheap in the US so that should be no problem.

Is Losartan or equilvalent available as a generic in LOS?

Every doctor I've gone to has changed me to another med for my BP, and they all work, some a little better than others. Doctors all seem to have there favorites meds...

What are some of the BP meds that are easily available and inexpensive in LOS?

Losartan is an Angiotensis II inhibitor and there are no drugs in that class available in generic form yet as they are rather new.

Hydrochlorathiazide is available dirt cheap in Thailand as are beta blockers and several ACE inhibitors.

Note that the mode of action of these drugs differs. Sounds like you don't have a regular doctor hence the bouncing around. You would do best to get stabilized on one class of drug and stay on it. Since you are uninsured and cost is an issue, you would be better off with a drug available in generic provided it works for you with no adverse effects.

Have you ever been on enalpril? If so and if it worked and you had no adverse reactions then that may be a good bet. Readily available in Thailand in severakl fdffiferent brand names locally made. It is an ACE inhibitor.

P.S. I suggest in future in the US you insist on a drug available in generic unless the doctor can give you a clear reason why you need something else. US docs are not very good at remembering the financial implications of their prescriptions, and unduly influenced by drug reps who of course are always pushing the latest patents. There are times when a new patented drug is necessary but from what you say, you don't sound like yours was such a case.

[endure]

Is the generic version of Adalat Retard available in Thailand? Cheap?

[think_too_mut]

I use Prophecia (hair loss prevention and regain), take it from Thailand on prescriptions (while I am already there, fully refundable by insurance) but it is not any cheaper than in Australia. 6 months worth of tablets are 13,000B.

Other things, semi-medicines like Berroca and Alka Seltzer could be 10% cheaper, if that.

[Sheryl]

Is the generic version of Adalat Retard available in Thailand? Cheap?

There are several generic equivalents to Adalat locally available, I think some come in sustained release form (which is what the Retard prep is). Don't know the cost but should be pretty cheap, certainly much less than Adalat.

Just ask by the egneric name at any large reputable pharmacy (nifedipine)

[bmdailey]

Thanks Sheryl,

I never heard of enapril but I loooked it up and I guess it is the same as Vasotec which I took for many years in the 80's.

I monitor my BP with a cuff so I can verify that the dose is working.

One reason I ended up with Hyzaar is that the diuretic alone wasn't sufficient.

Can ACE Inhibitors and diurectics be used in combination?

[Sheryl]

Yes, enalapril is the same as vasotec. Vasotec is a brand name, enalapril is the generic.

ACE inhibitors can be combined with diuretics, as can every other class of antihypertensive. HOWEVER, I caution you about being on diuretics while in Thailand as it can be risky combined with the hot climate and sweating.

Do you have (or have you had) any heart problems? (Congestive failure, etc) Any pedal edema (swelling of feet & legs)? (the second is actually an early symptonm of the first). If so then you may have to take a diuretic but if not it might be possible for you to control your BP without one. Consult a doctor familiaer with your history if in doubt.

Besides ACE inhibitors, another class of drugs availabkle quite cheap in Thailand are the beta blockers -- atenolol (brand name tenormin) etc.

Of course you may be fine with a diuretic back in the US and I gather your trip to Thailand is just a visit. Still, be careful of your fluid and electrolyte balance if you travel here while on them. You'd be surprised how much water & salt you lose and how quickly you can dehydrate. Short-term visitors especially as they are unused to the climate and also usually out and about a great deal.

[percy2]

Cozaar (losatan k) 30x50mg is approx B1,200, its made by MSD same as Hyzaar

Its legally available from a pharmacist without prescription.

Hope that helps.

Cheers

p.s. How much is it in Canada?

[bmdailey]

Cozaar (losatan k) 30x50mg is approx B1,200, its made by MSD same as Hyzaar

Its legally available from a pharmacist without prescription.

Hope that helps.

Cheers

p.s. How much is it in Canada?

The Hyzaar from Canada for the 100/25mg was about US$120 for 80 tablets. I've discovered the higher strength is always just slightly more expensive (for all the meds I've taken). So I break it in half and take 1 a day.

So 30 tablets is B1,200? Still a little expensive but maybe for the higher dosage and a larger quantity it might be a discount?

I've never had swelling in my ankles except once when I was on a flight to Tokyo about 5 years ago and I looked down and Holy Cow! my ankles were as big as Japanese watermelons - I almost fainted! s

[percy2]

The Hyzaar from Canada for the 100/25mg was about US$120 for 80 tablets. I've discovered the higher strength is always just slightly more expensive (for all the meds I've taken). So I break it in half and take 1 a day.

So 30 tablets is B1,200? Still a little expensive but maybe for the higher dosage and a larger quantity it might be a discount?

I've never had swelling in my ankles except once when I was on a flight to Tokyo about 5 years ago and I looked down and Holy Cow! my ankles were as big as Japanese watermelons - I almost fainted! s

I think 100mg would only be available from a hospital.

[bmdailey]

I looked up Cozaar and it is like Hyzaar but without the diuretic. Maybe I will try that. Is there a 100mg version of Cozaar in LOS?

What is a reputable pharmacy in Chiang Mai? Are there drug store chains in LOS?

[percy2]

I looked up Cozaar and it is like Hyzaar but without the diuretic. Maybe I will try that. Is there a 100mg version of Cozaar in LOS?

What is a reputable pharmacy in Chiang Mai? Are there drug store chains in LOS?

As per my previous post Cozaar 100mg is available but only from hospitals not pharmacists.

I don't know CM very well but there are many chains in Thailand including Boots and Watsons , though they aren't necessarily the cheapest.

Believe it or not most pharmacists around Thailand are reputable. Especially the ones not close to red light areas.

If you bring in a large amount of drugs from another country without a prescription for those drugs you may be breaking the law. Something really worth considering.

Imagine that Cozaar/Hyzaar was much cheaper here and you bought a 1000 tablets or so to take back how would US customs react if you didn't have a prescription for them.

Cheers

[Sheryl]

Cozaar isn't going to be a bargain even in large quantities for the simple reason that it is imported. Hence it is going to cost what it does in the country of manfacture plus a little more to cover costs of importing it.

The only bargains drugwise in Thailand are the drugs manfactured here, of which there is a large variety, pretty much every common drug that is no longer under patent.

The drugstore chains are mainly for toiletries, pharnmacetical stock is small and pricey. As to good pharmacies in Chiang Mai, if no one on this form can advise try posting in the CM form. There are probably quite a few.

[PeaceBlondie]

Chiang Mai has plenty of good pharmacies. Just inside the moat near Tha Pae Gate is an excellent one, and the university (faculty of pharmacy) store is on Suthep Road in the hospital area (south side, next to the pharm. school). There are plenty more, like downstairs in Central Kad Kaew next to the entrance to Tops. In those neighborhoods, the pharmacists speak English.

[PeaceBlondie]

Another question related to taking antihypertension drugs and buying them in pharmacies. I thought my BP readins were getting too high (160/110, for example) and went to physician about that. He looked through 3 years of my records and saw that the diastolic had usually been 140 to 160, and he put me on plendil 5 mg (felodipine). The BP has dropped, and I'm still on one pill a day, through the hospital pharmacy at 20 baht per pill.

Each visit costs 250 baht to see the doctor, and 600 baht for a month's supply. Of course, I would save a bit if I stopped seeing the doctor and found a cheaper source for the medicine. But at my age (Peter Pan is now 64 years old), is it best to be under a doctor's care?

[Sheryl]

Yes, at your age and with hypertension, it would be best to be under the care of a good internist (specialist in internal medicine). And should get a thorogh physical check (including stress test) once a year. For that, it might be worth a trip to Bkk. Personally I prefer Samitivej for annual check up as they are more thorogh in interpreting the results than I have found elsewhere.

The Plendil isn't going to much cheaper anywhere else as it is a patrented import. It's in the class of drugs known as calcium antagonists and is one of the newer of them, so not available as generic yet. Some of the older calcium antagonists are manfactured in Thailand e.g. Amlopine /Amvas (Amlodopine), Diltec (Diltiazem). You could ask your doctor about switching over to one of them, would probably represent a significant cost savings.

Current thinking is that you shold try to get your BP down to 135/80 or less, or as close to that as you can. Definitely not more than 140 systolic and 90 diastolic.

[lopburi3]

Will add that there may be a low limit with BP that you do not want to exceed. My active (white coat and supermarket tests) are almost always high but at home (where I am most of the time) remain quite low. This has resulted in doctor prescribing a little more than needed at times. At exam I showed about 130/80 using medication but at home it would get down to 95/65 or lower. This resulted in dizzy spells (almost a faint) (even without quick change of position) and dosage lowered. Had to buy a second monitor to believe and then checked with mercury in office and doctor agreed exactly the same readings so believe investment in home BP unit can be well worth the money.

[Sheryl]

Good point. I know several cases where unnecessary antihypertensive treatment was started based on elevated readings in the doctors office in people who otherwise did NOT have hypertension. Anyone with hgih BP or at risk of same would do well to make the modest investment of a home device.

[PeaceBlondie]

Thanks again to Sheryl and lopburi3 for their great advice. I went for my monthly checkup just now, and the BP registered 140/80 at doctor's office. He says 140 is too high. He recommended that I buy an electric, automatic BP tester and use it at home. I showed him Sheryl's list of calcium blockers and he switched me to felopodine, which costs 45% less (11 baht each). He's an internist and cardiologist.

About being overmedicated: an older buddy was on three anti-hypertension drugs here in CMai, and his pressures plummeted so low he almost fainted. He cut back to less than half as much medication, and is doing fine.

Ah well, at least I still have my hair, and my voice. Now to find where I left my brain....

[tc101]

I have psorisis. Do you know if the strong cortisone ointments like betamethasone are available, and what they would cost.

[STEELINOX]

Is the med "Mitotane or Lysodren" available in BKK?

http://www.rxlist.com/cgi/generic2/mitotane.htm

Thanks,

Randy

[endure]

I have the whitecoat problem too. At home I'm 135/80. Down at the hospital last week I was 160/110!

[CTM]

I use Prophecia (hair loss prevention and regain), take it from Thailand on prescriptions (while I am already there, fully refundable by insurance) but it is not any cheaper than in Australia. 6 months worth of tablets are 13,000B.

Other things, semi-medicines like Berroca and Alka Seltzer could be 10% cheaper, if that.

B13000 for 6 boxes of Prophecia? Your getting robbed. Try another pharm. Generic is not 20% of that price. Even name brand should be atleast 25% less.

[cwilliam]

I am coming over to Thailand at the end of the month and was wondering if I should try to get my hypertension med (Hyzaar) in Canada or LOS since I am uninsured.

For awhile George was protecting me from the tainted drugs in Canada by using the Homeland Security commandos to confiscate inbound Canadian drugs. I guess there was a fear of WMDs hidden in the tablets...

Anyway, sorry for the digression, is it possible to get prescriptions on a tourist visa and for low prices in LOS?

Very cheap if you consider the fact that you don't have to go to the doctor for refills etc.They cut out the middle man with expensive tastes here.

[ProThaiExpat]

Sheryl's posts on this subject are the best posts on almost any subject I am intimately familiar with. I have been on anit-hypertensives for more than 40 years and her posts are right on.

I would ask for an explanaion, Sheryl, on the comments rearding Calcium. I am clueless as to what this has to do be BP.

I went off anti-hypertensives when I retired to Hawaii and was still pill free until about two years here in Chiang Mai when indolence and poor diet started the pressure up. Medicated myself on generics of minimum dosage, Atenol as the beta-blocker and Diazide as the diruretic and my pressure is excellent.

I think there are some studies out there that document the "doctors office" increased blood pressure syndrome. Definitely get a home monitor, the new ones are incredible, and take it with you if you see a doctor to ensure it is accurate.

bmdaily, don't be concerned with doctors trying different anti-hypertensives on you as most doctors treating hypertension are faced with what is referred to as "titration", exploring different drugs and their effect on you to reach the ideal "recipe" that keeps your pressure down with the minimum of medication. My cardiologist had a reall problem with regulating mine until betablockers came along or he tried them on me, as it was the drug of choice for me for years. It does do the best job on diastolic pressure but doesn't work well with systolic on me. Lately, the internet medical advice is cautioning older patients to be concerned with systolic pressure, 150 is no longer acceptable and that is when I started the Diazide, which at 25 mg. and taken in the evening, prevents elevated systolic in the morning hours, the only time I ever measured increased systolic. Potassium loss with diuretics is always an issue, but the Diazide deals with that well. Generics for all my meds, for sure. Just found a generic for Diazide, thus my daily cost went from three baht to one baht.

[Gary A]

When I finally retired here, I was on three different hypertension drugs from the US. My blood pressure was NOT under control and I felt bad every day. A friend of mine was concerned and wanted to take me to see his heart specialist. The doctor quizzed me about my medical history and gave me a brief check up. He then asked what I was taking. I showed them to him and noticed his eyebrows raise a bit. He said nothing about those drugs but he advised me to throw them away and take one 20mg Enaril and one coated baby aspirin every day. (Enaril is spelled correctly). The Enaril price has gone up and is now 350 baht for a box of 100 foil wrapped tablets. In the US I had insurance and each prescription was costing me a co-payment of $20. I check my blood pressure at home here about once a week. Today it was 124/74 and I feel great. He asked me to watch my ankles for swelling and if I had swelling to come back to see him. I had no swelling.

[pumper]

the medications are definitely cheaper in Thailand

same as pricing as Canada.

meds from a large hospital may be slightly more expensive, but legit meds are guaranteed .. who knows what a Sukhumvet pharmacy is selling!

If US customs chooses YOU .. proper documentation will make your life much better!

to get the medications into the US you technically will require a 'legit package with your name on it'.

you are allowed a limited amount of each medication.

multiple / parallel meds / pharmaceutical brands for same Dx can get around this requirement.

docs at Bumrungrad have always cooperated on this.

I request separate prescriptions / packages for travel home .. & keep the medical records & labeled meds together.

when I provide my medical records, lab results & diagnostic film US customs NEVER question my meds .. & I always declare my meds! .. smuggling is not my specialty & it is so easy to be legit!

why not get a complete cardio work up while in Thailand.

appointments at Bumrungrad can be made over the internet & if you request complete diagnostic reports will be provided to you.

..both for your Doc in the US & US Customs .. show the customs agent you are under the legti care of a doc & they reasonable.

My US doc LOVES the medical records I bring home .. more valuable diagnostic testing than any insurance company will pay for .. He has spent more personal time with me reviewing those records than ever before .. shows him I am serious!

a complete physical including treadmill cardiac stress test is less than several nights of 'board approved' bar fines!

cardiac treadmill stress test: they hook you up to an EKG, put you on a tread mill & a cardiologist monitors.

& you get the EKG strips to carry with your meds.