HCT

[roger101]

At the moment one of the drugs I take is Diovan (160mg). Due to swollen ankles my specialist wants me to take Co-Diovan (160/12.5) instead.

What's the most cost effective way of doing this. Taking Co-Diovan or keep taking Diovan and taking the Hydrochlorothaizide separately. I already spend 10,000 Baht a month on drugs so I'm just trying to keep the cost down. I don't buy from the hospital but from Fascino.

[Sheryl]

There is probably going to be little or no cost difference between Diovan and Co-Diovan.

 

However you can save a lot of money by switching to a locally made brand of valsartan (which is what Diovan is) and taking that along with a local brand of HCTZ.

 

Local brands of valsartan are:

 

Valatan

Diforge-160

 

 

 

 

[roger101]

Thanks for that. Will I be able to buy these at Fascino?

[Sheryl]

Should be, but no guarantee..sometimes especially with drugs not in wide use, Fascino stocks only one brand.

 

If not, and if you have occasion to go into Bangkok, there is a pharmacy not far from the Ekamai bus terminal on Soi Onnut which has a large stock of generics at good prices -  called Rung Rote and about 70 meters down the soi from Sukhumvit on the right hand side. There is also another on the opposite side of the street. But try Facsino first.

 

Alternately if you have occasion to go into Chonburi town, pharmacies near the provincial hospital would be a good bet.

 

 

 

 

[roger101]

Thanks. I'm on my way to Fascino later, I'll let you know.

[roger101]

Went to Fascino. They only have Diovan. Chonburi is a bit far on my scooter so I'll probably go to Bangkok next week. I'll check on the internet for other locally produced drugs that I need before I go.

[roger101]

Can you tell me which of the following drugs are made locally and their names. If I am going to Bangkok I might as well try to buy all the generic versions.

 

Vytorin

Cardura XL

Xarelto

Cordarone

Zanadip

 

Also the Pharmacy Rung Rote in Soi On Nut, is it before Big C.

 

Thanks

[rodknock]

yes from sukhumvit before the big c

[Sheryl]

20 hours ago, roger101 said:

Can you tell me which of the following drugs are made locally and their names. If I am going to Bangkok I might as well try to buy all the generic versions.

 

Vytorin

Cardura XL

Xarelto

Cordarone

Zanadip

 

Also the Pharmacy Rung Rote in Soi On Nut, is it before Big C.

 

Thanks

 

 

Vytorin has no locally made generic equivalent. It is a combination of 2 drugs" simvastatin, which has m any local brands, and ezetimibe  which has none.  There is also no other drug with exactly the same action as ezetimibe, which works by decreasing cholesterol absorption in the intestine, but there are other drugs with different modes of action that can be combined with statins when statins alone are insufficient  and most doctors would try those first before resorting to such an expensive drug as this. Were you first on statin alone with insufficient results, or did the doctor start you on Vytorin from the very beginning? (If the latter he is intentionally putting you on most expensive treatment. If the former - did he then try other types of medication in combo with a statin?)

 

Xarelto has no locally made generic equivalent either. There are 2 other drugs with same mode of action but these too are available only as expensive imports. However, there are other drugs with different mechanisms of action which have similiar therapeutic result and would normally be tried first before resorting to this (starting with simple low dose aspirin). Same question/ comment as above.

 

There are locally made brands of Doxazosin  (Cardura) but not AFAIK in  extended release form. You can probably switch to non-XR but it needs to be doen under doctor supervision/advice.

 

Cordarone is actually off market in Thailand now. However there are other brands of Amiodarone  (the generic name for this) available and likely less expensive.  One brand (Aldarone) is made in India,  and another two (Cardilar and Amiodarone 200) are made in Thailand.

 

There are no less expensive forms of Zanidip (Lercanidipine) - the only other brand of it here is also a Western import. However there are many locally made brands of drugs in the same family (calcium antagonist) with same mechanism of action and most patients will do as well on them as on lercanidipine - for example,   amlodipine.

 

You seem to have been placed on the "Cadillac" version of all meds -- newest brands of everything.   Unless these were all selected after first trying with older drugs,then I suspect you were either prescribed by a doctor in a Thai private hospital seeking to provide the newest drugs/most costly treatment or a doctor in a western country where there is universal health care and thus patient does not have to pay for meds.  There is probably   scope for switching to older formulations of drugs with either same mode of action (calcium antagonist) or same clinical effect albeit through different mode of action (cholesterol-lowering drugs, drugs to reduce blood clotting). However this is not something you can do on your own - it needs to be done under medical supervision. From the meds you are on, you have some serious and complex health problems.

 

Suggest you see a good cardiologist, bringing all your records with you, explain that you are paying out of pocket for meds and cost is a consideration and ask for guidance in getting in a less costly regimen. If you tell me where in Thailand you live I may be able to suggest a doctor.

 

Savings in med costs, even if you are able to change just one of these meds, will easily offset the cost of the consultation within a month's time.

 

As it presently stands the only med you can get an exact local brand equivalent for is the Cordarone.

 

 

 

 

 

 

 

 

[roger101]

Thanks for your reply Its given me a lot to think about. I live in Pattaya and go to Bangkok Pattaya hospital. At least my specialist lets me buy my drugs from Fascino instead of the hospitals pharmacy.

[dddave]

Regarding Hydrochlorothyozide, a friend who is a retired physician warned me that it tends to deplete potassium in the body and that I should either take a supplement or take care to eat foods high in potassium such as bananas, sweet potato, watermelon and spinach.

[roger101]

10 minutes ago, dddave said:

Regarding Hydrochlorothyozide, a friend who is a retired physician warned me that it tends to deplete potassium in the body and that I should either take a supplement or take care to eat foods high in potassium such as bananas, sweet potato, watermelon and spinach.

Thanks Dave. Funny enough my specialist said that next time I have a blood test (at Lifecare, not the hospital) get them to check my Potassium.

[Sheryl]

Hctz was not on his list of meds?

[dddave]

22 hours ago, Sheryl said:

Hctz was not on his list of meds?

In his opening post, the OP mentions taking Hctz among other medications.