Q. Medications

A reader asked me how to obtain Lipitor, a cholesterol lowering drug.

I have only had limited experience with local pharmacists and therefore will make the following suggestions with a caveat.

Yes, Lipitor is readily available as are many brand name medicines. However, prices vary and therefor you need to do due diligence and find a pharmacy you feel comfortable with.

Drugs manufactured in Western countries or elsewhere but under the guidance of the parent company need to meet very high standards of production. Unfortunately, this is not true for drugs coming from some of our neighboring countries. I believe that generic Thai pharmaceuticals are fine, especially if the cost of medication is a consideration. So ask your pharmacist where the drug is manufactured and by whom before making a decision. You will also notice that some brand name drugs are cheaper here than back in the West. The simple reason is that the parent company has subsidiaries in this part of the world. Cheaper brand name drug doesn’t mean that it is fake, however, fake drugs are common, especially on the Web. Fake drugs are not only ineffective but can be quite dangerous. They are usually made with highly toxic chemicals. They can look uncannily real. Therefore it is important to work with a pharmacist whom you can trust. Finally, about 80% of generic drugs are just as effective as the brand name. Therefore, when taking a generic medication, make sure that it is doing whatever it was designed to do. So for example, if you were taking a brand name drug to lower your cholesterol and then switch to a generic med and a follow up cholesterol check reveals a markedly elevated blood level for no apparent reason, it would be possible that the generic med is less efficacious. For this particular article, I will not comment on other means of lowering your cholesterol.

All the Best, Philip Bhark, M.D., FACC

Email: newsletter@chiangmaiexpatsclub.com for a chance to have your health questions published in Expat Newsletter and online at www.chiangmaisos.com/d-o-c

Q. Drug Side-Effects?

Dear Dr Bhark,

Following on from your very interesting talk last Saturday (@ChiangMaiExpats), may I ask you a question. 

Our daughter aged 45, suffered an unexpected ‘cardiac event’ about 18 months ago, following a period of overwork and chronic stress.   

Thankfully she fully recovered after treatment at a leading cardiac hospital in the UK.    Her own GP put her on Simvastatin 40gms, Ramipril 10gms and Congescor 2.5mgs.  Since then there has been a radical and negative change in her personality.  

Have you experienced similar personality changes with patients on statins? 

Q. Alzheimer’s Test?

Dear Dr. Bhark,

Are there valid tests for Alzheimer’s for people over 70? How do you distinguish between dementia and Alzheimer’s?

Al

Dr Philip Bhark – Doctor On Call

Introducing Dr. Philip Bhark who will be offering free medical advice in Expat Newsletter in response to your emails from the December issue onwards.

Philip Bhark, M.D., FACC is a Columbia and Harvard trained cardiologist. He has also worked as a volunteer physician in Korea, Nepal and Tibet. He is currently living in Chiangmai with his wife Isabelle.

Email: newsletter@chiangmaiexpatsclub.com for a chance to have your health questions published in Expat Newsletter and online at www.chiangmaisos.com