¡Hijole! How time flies when you’re having fun south of the border. It’s been a dozen years since I wrote my first series of articles on purchasing medicines in México. I look in the mirror and my reflection fairly screams “Senior Citizen!” Medications I once wrote about from a spectator’s perspective are now part of my life and require a goodly part of my monthly budget. Perhaps it is time to take a deep breath and peek at what has and hasn’t changed in the Mexican farmacia world. Despite several years of negative headlines about violence, the country has grown and prospered. Now that the drug war has died down to a shadow of its former self, once again even timid tourists are crossing in droves to purchase their medications in a friendly farmacia.
More and more medicines become available in the Mexico. Except for orphan and extremely expensive medications, most non-narcotic medications that are available north of the border are also available in Mexico.
Several years ago, a few shady border town pharmacy owners decided to yield to the temptation of selling phony brand-name cholesterol medicines. The profits were enormous but it wasn’t long before the deception was exposed and Mexico’s federal health department (Sector Salud) and federal police ended that scam. Unfortunately journalists who milk every penny out of bad news grabbed a hold of the scandal and turned it into something that isn’t realistic – an attempt to scare people (and sell newspapers) who depend on affordable medications from purchasing them south of the border.
NOT ALL MEDICINES ARE CHEAPER IN MEXICO.
Since the turn of the century, many pharmacy chains in the US have implemented programs to provide low-cost basic generic medicines on a 30 and 90 day basis. It is darned difficult to beat a ten dollar price tag for a three month supply of medications. So the first place to look for affordable medicines is at pharmacies like Wal-Mart, and membership stores like Costco and Sam’s Club. No farmacia in México can even come close to the prices that the US chain pharmacies offer to the public. But there is one huge caveat to all this – the list of cheap medications available under the US program is quite limited.
HOW DO I KNOW WHICH MEDICINES ARE AVAILABLE ?
With the stupendous growth of the Internet came the inevitable appearance of several Mexican farmacia websites. Some have search engines and current prices. But delving deeper into this area I have to warn you that many Mexican medications have different spelling than their American cousins. Some medicine names both in generic and brand names have been latinized, for example Relifexmr rather than Relafen®. Ampilicina rather than Ampicillin. The name difference even for generic medicines can get extreme – you won’t find Paracetamol north of the border but in México, asking for “acetaminophen” (Tylenol®) may draw a blank stare. Both are the same medicine, and so is Glibenclamida versus Glyburide. Don’t take any medication without making damned sure you’ve figured out the correct name.
HOW TO SEARCH FOR THE MEXICAN EQUIVALENT TO A PRESCRIBED DRUG
I go to GOOGLE and type in the American name of my medicine followed by the word MEXICO
If I get a bunch of hits with Latin sounding names, I’ll write down the names, realizing some of them may be brand names as well as the Mexican generic equivalent. Multiple GOOGLE listings displaying the same brand or formula name is an excellent clue you have hit upon the magic name for your medication.
I then source professional information. Some of this I do online. With Mexican medicines sometimes I have to wait until I am in a Mexican pharmacy so I can have them verify the name of the medicine in their huge tabletop medicinas reference book. Don’t be afraid to point to the book, then point to your eye – they’ll spin the book around and let you see for yourself. This is so very important – make absolutely sure those chemical diagrams* match exactly!
A good source for professional information is http://www.rxlist.com. Go to the site search engine and type in your medication name. The first page that pops up won’t have the symbol on it, you have to go to the second in a list of many pages of information on that drug. Some medicines sites only list “patient information.” You won’t find a chemical formula there. If necessary go back to GOOGLE and retype the name of the medicine followed by the words PDR, or CHEMICAL FORMULA. Be absolutely sure whether or not your medication is “ER”–extended release. This point is critical. You must not change from one to another without permission from your doctor.
It is a good idea to check the chemical atomic structure diagram for the medication: that strange symbol string of hexagons with letters and numbers attached. I always compare the two diagrams; the one for my American medication, the second one in the Mexican book. The diagrams must be identical. No matter how different the language or text of both references may be, the chemical structure of medications is worldwide universal and exact. If the symbols match exactly, and the farmacista nods their head in agreement , then I have an exact match. The medicine formula is exactly the same.
The medication must have the same dosage strength. You may be taking an “ER” an “extended release” form of medicine. In México extended release medicines are called “Liberacion Prolongada.” Some Mexican ER medicines vary in strength from their US cousins. Ask your US doctor or pharmacist if you are allowed to take this medicine at a SLIGHTLY higher or lower dose. I would not recommend varying beyond a 5% difference, but the key is getting an OK from your doctor or pharmacist first.
Here’s a potential trap – you may find a 2 in 1 medication with two of your medications included in a single medicine. I would not consider a switch to a multiple-medication if my doctor has originally prescribed two medications in two different pills or capsules. There may be a critical difference between the two – such as the rate of dissolving or length or duration of action. I would ask my physician before making a switch.
THE DANGERS OF SLIGHT VARIATIONS
A few months ago I happened to run out of a NSAID medication I have been taking for a herniated disc. An NSAID is a drug like Celebrex® and Voltaren®. Pretty safe, huh? I had been prescribed both drugs in the past and took them without incident for years. So I diddy-bopped on down to the farmacia and purchased the other medicine. Can’t hurt, right? They were out of Celebrex® . I substituted the correct dosage of Voltaren®. A half-hour later I found myself on an operating table, surrounded by concerned doctors and nurses and connected to an I.V. a stainless-steel tray lay near my head. On it was a scalpel and medical gear to perform a tracheotomy. My breathing was in the form of a wheezing – my throat was constricting. Anaphalactic shock. My skin was beet red and itched like crazy. Had not the I.V. Solutions counter-acted the shock, my windpipe would have been slit. Twenty minutes later I wobbled out of the door of the clinic with a newly-reinforced respect for the power of medications. Oh, I had suffered an attack of hives from a relative NSAID drug (Daypro®) I had been prescribed a dozen years before, but never have I experienced anything like what I went through this time with Voltaren®, and the medication was brand-name–not generic.I ignored common sense and I almost paid dearly.
THE ABSENCE OF NARCOTIC (OPIOID) MEDICATIONS
Mexico does not have narcotic opioid drugs like Ocycodone or Hydrocodone. The strongest prescribed narcotic medicine is called TYLEXmr, Tylenol®, with an extremely modest dose of codeine. To be specific, morphine and other narcotic medicines are not exactly absent but please realize the following point: Each dose of stronger narcotic medications has to be administered by a specially licensed medical doctor (of which less than one-tenth of one percent of the doctors have a license for) and the cost is phenomenal because of the paperwork and licenses. Even the controlled medication Tylexmr is expensive at more than a dollar a dose. For all intents and purposes you will find gold nuggets in México easier than narcotic based medications. Doctors in México sigh this draconian restriction is a scandal.
A REAL-LIFE “PROOFING” OF THE QUALITY OF MEXICAN MEDICINES
In those first articles about purchasing medicines in México I happened to mention how sensitive many heart medications are. Fate decided to dictate that I was to come to have to prove it – I am now prescribed those very same medications! Because my cardiologist decided to prescribe time-release (“ER”) medications, I was forced to find affordable “Libereracion Prolongada” equivalents in México.
Armed with a good quality blood pressure and pulse monitoring machine, I decided to try Verapamil, and Metopralol liberacion prolongado from Farmacias Similares, a discount chain. To my surprise, one of the medicines in the farmacia is sold under the trade name (medicina patente) LOPRESSOR®, which is a flagship medication brand and the medication is manufactured in Germany the shipped to Mexico. The dosage was appropriate so I purchased it. The other medication is VERAPAMIL, and the Farmacias Similares brand of Verapamil is manufactured in México.
Oh boy! There I was – two of the most sensitive medicines, and the only way I was going to tell if they “worked” or not was if my heart decided to malfunction! Well much to my relief, the medications have proven to be indistinguishable from their US counterparts – as a matter of fact, the flagship brand-name LOPRESSOR® has proven to have even more dependable effects (predictable) than its US generic equivalents. But, and this is a gigantic caveat – you have read just how careful I was to ensure that the medications worked as they should. The end result of this is now I feel even more confident that medicinas Mexicanos are reliable. But I did not guess – I would have consulted a Mexican medical doctor or clinic had I not had a reliable blood pressure measurement machine.
I have been through trial by fire – excellent results and a very scary unexpected allergic reaction to medicines I have purchased in México. The latter was no one’s fault, but it certainly reinforced my belief that due precaution is always needed around medicines. Oh, by the way, LOPRESSOR® costs me one-seventh as much as the version sold in the USA. Even though I can get generic form of this medicine under Medi-Care I have decided to stick with the Mexican flagship brand! Farmacias Similares has regular 25%-off discount promotion days and hours and that just tickles my elbow!
For more information, visit our archives and read “Buying Prescription Drugs in Mexico.”
Editor’s note: This is friendly advice, and no more. The People’s Guide to Mexico is not liable for any of the opinions put forth in this article.