Regular Medication

[SpitfireJEJ]

Apologies if this has been dealt with before (I am quite new here). Can anyone advise the best way to go about acquiring necessary regular prescription medication in foreign waters? How, for instance do liveaboard diabetics manage? And particularly, are there any liveabords who require thyroxine for an under active gland condition?

 

[Amari]

Hello Spitfire
I liveaboard in Turkey 3 months spring and again autumn. I get my UK GP to prescribe for 3 months and take the pills with me.
Being a medic myself I would think thyroxine could be purchased in many parts of the world over the counter or in UK on private prescription for say 6 months at a time. It SHOULD be dirt cheap. Interestingly, tho' label will say take 1 or 2 daily, it does in fact have long half life in the body so not disastrous if missed for a few days

 

[Anonymous]

Welcome to the forum!

As you probably know, the NHS restrict the amount of NHS-provided prescription medication you are permitted to obtain for your use when abroad. GPs seem to be happy to prescribe 3 or 6 months worth.

I buy my asthma inhalers over the counter, no problem. Much better than the UK where you have to go to the GP surgery and teach a 'nurse' how to manage asthma, every so often. You'd think the NHS would train them instead of asking long-term sufferers to do it, but that's the way of things these days, I suppose. Also, the inhalers are cheaper than paying UK prescription prices even for the branded and the generic are quite a bit cheaper.

My wife takes thyroxine (no thyroid) and we buy it over the counter from the Spanish pharmacy - she gets her bloods done by our local (private) doctor. It could be that you would be able to get your insulin over the counter here in Spain. If Spain is your destination, I will happily ask our local pharmacist, but you'd need to tell me what kind of insulin in case the one you use isn't available in Spain.

As for the insulin elsewhere - I think that the British Diabetic Association might be helpful for a detailed look at availability of different types of insulin in different countries.

 

[lenseman]

[ QUOTE ]
Apologies if this has been dealt with before (I am quite new here). Can anyone advise the best way to go about acquiring necessary regular prescription medication in foreign waters? How, for instance do liveaboard diabetics manage? And particularly, are there any liveabords who require thyroxine for an under active gland condition?

[/ QUOTE ]

Try this link:

http://www.expatps.com

If you are from the UK, you could try writing to the above asking about similar service to UK Citizens?

 

[LadyJessie]

My experience in the Med is that the further east you go, the easier it will be to get drugs over the counter. I.e. if you just know what "your prescription drug" is, by brand name or preferably the generic name you should be able to get it easily in either Greece or Turkey. Don't know about the Middle East part of the Med yet. BTW, you should not worry about not getting the "NHS subsidy" on drugs. It seems to me that the pharma companies price their products to the purchasing power of each nation, so the same drug that is very expensive in the UK could be cheap in Turkey.

 

[Oliveoyl]

Is there not some website covering this info? There ought to be!
Recent experience as follows:
Viagra 'n' stuff - over the counter in Turkey
Heavy duty antiobiotics (repeat foreign perscription, without perscription) - over the counter in Italy
Nicotine patches - perscription only in Switzerland (went back to the ciggies)

 

[Anonymous]

I was in Italy in January and it was hard to get ordinary painkillers (ibuprofen) - very small packs absurd price - around €8, I think, for 12 pills! You used to be able to get almost anything you wanted OTC but I think things have changed.

 

[VicMallows]

Similarly, my wife has to take an anticoagulant (Warfarin) . No problem stocking up with adequate medication... but getting an INR (simple blood test) not so easy abroad. It is dead simple to work out any dose correction needed once you know the INR.

Believe it or not, self test "pin-prick" meters are advertised and readily available to buy in the UK, but you STILL NEED A PRESCIPTION to buy the necessary test strips!! (just like a litmus paper). Protectionism?

Interested to hear from anyone who's tackled this particular problem.

Vic

 

[Anonymous]

We go to local doctors privately. There have always been English-speaking ones where we have been but for a simple INR I guess you'd manage with any local language...just write down what you want to do using the dictionary, etc.? We are charged €20 per visit (£14) which is considerably less than a modest meal out. Doesn't seem too bad once in a while when you put the expense into context with everything else.

I'm sure you'd be sold the test strips OTC here in Spain but you might need to show the bottle/pack to the pharmacist for a repeat prescription of any anticoagulant - but maybe not, if you clearly seemed to know what you were about.

 

[PlanB]

You seem to be able to buy just about anything over the counter in Spain. Also, a lot of British stuff is available off prescription in Gibraltar, also by mail order from there.

 

[lyralicious]

Welcome!

Yours is a reasonable concern, and one that I have had myself. I am hypo-thyroid too and take thyroxine every day. My doctor gave me 10 months worth when I left the UK in December. I'll be back in July for a couple of weeks when I shall have another blood test (to check the dosage) and a further year's prescription. However, I'm planning to circumnavigate in 2008, so it is important to get this problem sorted out.
My doctor told me that I should be able to buy thyroxine in most places and advised that I keep a copy of the packet with my prescription details shown on it, in case of any problems.
Turkey'll sell it over the counter and the doc said it should be relatively easy to buy it in most places.
My biggest concern is checking the dosage, as those with an under-active thyroid can get progressively worse, but having read the thread I'm going to get one of these do-it-yourself kits.

Good luck!

 

[Anonymous]

I don't think you'll find a DIY kit for thyroid testing, it is quite a difficult subject even from the doctor's perspective as there are different levels that go together to give the complete picture. You might remember when you were first evaluated talking about T3, T4 and TSH? It isn't like blood glucose and INR, which are very DIY-able.

 

[lyralicious]

Thanks for that, Lemain. Yes, I thought it would be too good to be true!

Oh well, if I start getting fat and psychotic I'll know it's time to up the dosage... /forums/images/graemlins/wink.gif

 

[Abraxas33]

Just a note on INR readings while taking Warfarin. We left the UK in 2003 and cruise 6 to 7 months; before we left we purchased a Coagucheck meter from Roche, at first we needed to purchase the test strips but we can now get them on prescripton (48 in a box - we use about one per week unless INR goes funny). There's no doubt in my mind doing your own INR and deciding your Warfarin dose is a sight more accurate than letting profesionals do it.

 

[VicMallows]

Re: Coagulate & INR

Many thanks for the feedback on Coagucheck. Fortunately my wifes INR is fairly stable and typically she only needs checks every 6 week or so.

I certainly agree that the algorithm used by our local NHS Trust seems too simplistic .... it seems to calculate using just the previous reading with no reference to the ongoing trend. I can do much better in my head! ... but that would then skew their future calculations!! (I fully understand that going outside the desired therapeutic range could be dangerous and therefore abrupt changes to dosage might occasionally be necessary). Further, I believe 0.25g variations (rather than 0.5g, the usual minimum) could be useful.

(maybe we're straying off-topic and into controversial waters and future discussion should be by PM).

Vic

 

[lille_bee]

[ QUOTE ]


Believe it or not, self test "pin-prick" meters are advertised and readily available to buy in the UK, but you STILL NEED A PRESCIPTION to buy the necessary test strips!!

Vic

[/ QUOTE ]
No, you can buy the Roche Coaguchek test strips without prescription, but... the trade price ex VAT is £123.83 for a box of 48 strips, so most patients find it cheaper to pay a £6.65 prescription fee (or £6.85 after April 1st 2007, or zero if you're from Wales and have your script issued and dispensed in Wales)

 

[VicMallows]

Many thanks for that info. I assume that the strips are still within patent, and as a corollary NHS doctors will be 'reluctant' to prescribe. ( cf: STATINS until recently?).

Vic

 

[lille_bee]

Test strips are considered to be "medical devices" rather than drugs, and therefore they are often not only protected by patents but also by copyrights, which last a lot longer...
Besides, by the time an eventual patent would expire, say in 10 years' time, Technology will have advanced so much anyway that your 2007-vintage Roche Coaguchek will look positively prehistoric, just like 1990's mobile phones appear to us today...!
I believe NICE (national Institute for Clinical Excellence) is currently reviewing its guidance on anticoagulation self-monitoring- try Google? British society for Haematology?

 

[Captain_Cava]

This thread seems to have got a bit specific about thyroxine, Warfarin and test devices.
Does anyone have any information about ACE Inhibitors, Calcium Antagonists, Diuretics and Statins, in France, Portugal and Spain?

 

[lille_bee]

[ QUOTE ]
Does anyone have any information about ACE Inhibitors, Calcium Antagonists, Diuretics and Statins, in France, Portugal and Spain?

[/ QUOTE ]
What sort of information? Prices? availability?
I don't know about Spain & Portugal (but I can find out fron spanish colleague pharmacists), but in France & Belgium all the drugs of the classes you mention are available on prescription only, and they tend to be dearer than in the UK; Also, bendroflumethiazide (or bendrofluazide) is a lot less common on the continent than here, so it could be difficult to find.
As long as you carry an empty box or a patient information leaflet out of the box with you where you travel, the local pharmacists should have no problems finding the local equivalent brands to your medicines. The generic names are pretty international!