Son going to India for 6 months and doctors don't want to give malaria medicine for that long?
Jun 22nd, 2007, 05:10 AM
#1
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Son going to India for 6 months and doctors don't want to give malaria medicine for that long?
Has anyone else had a problem getting doctors to give malaria pills for a 6 month stay in India? My son is going for an internship in northern India for 6 months leaving next week and our doctor does not want to give malaria meds for more than one month at a time or diarhea pills. He says that it would be better for him to fax an order wish to him and then he will fax to a pharmacy in India....what?????? Doctor says he is concerned that he will be taking pills for an extended period. He wanted doctor to prescribe maladrone or dioxycline(sp?).I am frustrated and am trying to figure out what else we can do. Any thoughts besides getting a new doctor?
Jun 22nd, 2007, 06:00 AM
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I have to tell you that is very odd. Is the doctor a travel medicine specialist? If not, get to a travel medicine or tropical medicine doc, Most medical schools have a travel medicine clinic. Print out the cdc pages to take along to talk with the doc.
Of course, malarone is not available in India, so the "faxing" idea makes no sense on that count. Your son can buy doxy over the counter in India. Doxy does break down faster in the heat and humidity, so (giving the doctor the benefit of the doubt) perhaps what the doctor was concerned about that. Your son could get a one month supply of doxy before he goes and buy one month of doxy at a time in India. If that's what he decides to do, I'd suggest he go to a hospital pharmacy or a busy air-conditioned pharmacy and ask for Vibramyacin (which is manufactured by Pfizer and will be more expensive, but guarantees what he is getting).
Pills for diarrhea? If you mean immodium, that is available over the counter here in the US. He should stock up, but only take it if really necessary. If you are taking about a supply of emergency antibiotics, his doctor should be willing to prescribe a small amout (enough for perhaps three or four episodes) for him to take along. He can be treated in India if he has more problems or if that antibiotic does not work.
It would be useful to know the doctor's thinking on all this, as third hand, it makes little sense to me. Armed with all of the relevant info, perhaps your son could talk with teh doctor again and clarify what the doctor's concerns are.
Of course, malarone is not available in India, so the "faxing" idea makes no sense on that count. Your son can buy doxy over the counter in India. Doxy does break down faster in the heat and humidity, so (giving the doctor the benefit of the doubt) perhaps what the doctor was concerned about that. Your son could get a one month supply of doxy before he goes and buy one month of doxy at a time in India. If that's what he decides to do, I'd suggest he go to a hospital pharmacy or a busy air-conditioned pharmacy and ask for Vibramyacin (which is manufactured by Pfizer and will be more expensive, but guarantees what he is getting).
Pills for diarrhea? If you mean immodium, that is available over the counter here in the US. He should stock up, but only take it if really necessary. If you are taking about a supply of emergency antibiotics, his doctor should be willing to prescribe a small amout (enough for perhaps three or four episodes) for him to take along. He can be treated in India if he has more problems or if that antibiotic does not work.
It would be useful to know the doctor's thinking on all this, as third hand, it makes little sense to me. Armed with all of the relevant info, perhaps your son could talk with teh doctor again and clarify what the doctor's concerns are.
Jun 22nd, 2007, 06:43 AM
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Thanks Kathie! I too cannot figure out what the deal is on prescribing the malaria pills for him. The diarrhea pills are the ones that are 3 in one day for a round of cure.He tole him that he was hestitate to prescribe more than one round. The travel specialist that he went to to get all his vaccines wants over $1000 for the maladrone(cannot use the prescription co pay) here in Chicago so I will try and see if one of the medical schools around us can help.
Jun 22nd, 2007, 07:32 AM
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The travel specialist shouldn't be selling the malarone - it's a prescription you fill at a pharmacy. The least expensive place to buy Malarone is at Costco pharmacies. It is still expensive, but it shouldn't be $1000.
By the way, have you called your insurance to see whether it is covered? My insurance covered it with a copay. Since it is six months worth, the insurance may require six co-pays, but it may well still cover it.
By the way, have you called your insurance to see whether it is covered? My insurance covered it with a copay. Since it is six months worth, the insurance may require six co-pays, but it may well still cover it.
Jun 22nd, 2007, 08:12 AM
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Malaron is about 5 dollars a pill and your insurance may pay for up to one month per year. Malaria is not very prevelent and many people I met on my trip were not taking anything (i took malarone). He should bring some if he travels to high risk areas like orissa, goa and the andaman islands. On my malarone perscription it does say do not use for extended periods. THat is because no long term tests have been done and many doctors won't perscribe it for more than 3 months. Make sure to get the typhoid and hep shots as those are the most important. Healthcare in india is very good and very cheap as long as you go to hospitals that are recomended by the CDC. I had a great experience when I was there but I would not want to get surgery. Doxy does make you more sensitive to the sun which is very strong in India (maybe not so bad right now because it is the monsoon). I have read that malaria is worse right after hte monsoon as the mosquitios are breeding. Most people I met bring a few malarone pills in case they start feeling sick (fever, nausea headache) to hold them over untill they can get to a good doctor or hospital (if he is in a remote area). If he is in a big city I wouldn't freak out about this. I actually got most of my malaria covered by filling the perscription at 2 different times (over a one month period) for my 3 months in India. It slipped by the insurance company. Doxy can be bought in India but as my doctor pointed out Asia has rampant trade in counterfeit drugs so I would make sure he gets to a reputable pharm. Remember this, Malaria pills are not 100%. Many people still get malaria while on the pills so its not a 100% deal. A second opinion is great but travel docs can be very expensive.
Jun 22nd, 2007, 08:34 AM
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Just a couple of points to follow up on the above post.
No medication (or vaccine) is 100% effective. Malarone is about 98% effective, doxy is about 95% effective. Taking along a treatment course of malarone is an option, but your son would need specific instructions on how and when to use it. He would still need to get a blood smear to diagnose the specific strain of malaria (as there are different treatment issues). Note that the UK felt there wasn't enough long term data with Malarone initially, but no longer restricts the use of malarone. The has never been a restriction on the length of time to take malarone in the US and there have been plenty of reports of people using it for 6 month periods.
By the way, the use of premerthin-treated bead nets is quite helpful. (I know I've botched the spelling on that) Since malaria-carrying mosquitoes are most active from dusk until dawn, he can reduce his risk with a bed net. A deet-containing repellant (25-50%) should be used on all exposed skin where he is out and about.
No medication (or vaccine) is 100% effective. Malarone is about 98% effective, doxy is about 95% effective. Taking along a treatment course of malarone is an option, but your son would need specific instructions on how and when to use it. He would still need to get a blood smear to diagnose the specific strain of malaria (as there are different treatment issues). Note that the UK felt there wasn't enough long term data with Malarone initially, but no longer restricts the use of malarone. The has never been a restriction on the length of time to take malarone in the US and there have been plenty of reports of people using it for 6 month periods.
By the way, the use of premerthin-treated bead nets is quite helpful. (I know I've botched the spelling on that) Since malaria-carrying mosquitoes are most active from dusk until dawn, he can reduce his risk with a bed net. A deet-containing repellant (25-50%) should be used on all exposed skin where he is out and about.
Jun 22nd, 2007, 08:49 AM
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I agree to definitly take a net and use it. Make sure to have comfortable long pants and a comfortbale long shirt to wear at night. I bought a quick dry breathable long sleeve shirt to wear at night because it can still be very hot in parts of India at night. Also, tell your son to have a grea time in India. It will be difficult at first but India is an amazing place and by the end of his trip I hope he learns to love it as much as I did.
Jun 22nd, 2007, 10:06 AM
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Does anyone have a website with regard to the length and use of Malarone and/or Doxycycline? I have seen some of the CDC websites and other health sites but his doctor is insisting that he have "in writing" some sort of paper that indicates that these pills can be given as long as 6 months. He won't budge. Please help!!
Jun 22nd, 2007, 10:24 AM
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Can't help you on a web site but my daughter took Larium for 5 months- started while at home so I could watch for weid side effects- and she had no problems whatsoever. She and her classmates all took the pills together on "Malaria Mondays" to mak,e sure they'd remember and so they could share their Larium dreams over breakfast on Tuesdays!
Jun 22nd, 2007, 10:32 AM
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As I had written in the other post Mefloquine (brand name Lariam ) is available in India, he can buy it there, and musquitos will be a problem till September only in Dehra Dun, and in India you can buy medicines without priscription, he can buy from a chemist shop, there is a big shop near clock tower can't recall name, it is old shop but they have all the medicines. And we never had any side efect with larium--bought here or mefloquine--bought there. Give him 2 sets of OFF, I have taken regular OFF only, unless he is planning to go for hiking in woods. And I take lotion and spray both.
Jun 23rd, 2007, 04:56 AM
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AFter hitting Walgreens and another pharmacy to try and see if they had a "written" definitive on doxycycline for its length-I found another doctor to get prescription from. Now Aetna his insurance company refuses to pay for the pills as they say there is too many....210 for 6 month stay and back.I can hardly wait to see Michael Moore's SICKO film about the healthcare in the USA-this is typical!
Jun 23rd, 2007, 05:32 AM
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dutyfree -
If you son's insurance co won't pay for meds (malarone) for his entire stay, let me suggest, you get a script for yourself and another family member. Submit your two scripts to your respective pharmacies/insurers (if not the same as yours; even if they are, you can all be going to India) and see what they'll pay. Then give your son all the pills.
If you son's insurance co won't pay for meds (malarone) for his entire stay, let me suggest, you get a script for yourself and another family member. Submit your two scripts to your respective pharmacies/insurers (if not the same as yours; even if they are, you can all be going to India) and see what they'll pay. Then give your son all the pills.
Jun 23rd, 2007, 07:27 AM
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Your son's doctor is perfectly capable of looking at a PDR himself. There is, of course, the www.malarone.com website that gives prescribing info. And I find it hard to believe that he is unaware of the use of doxycycline for treatment of acne (given daily for years at a time.) I'd find a new doc (and not just for travel medicine.
Dutyfree, often insurance companies make allowances for travel. I would call the insurance company directly and ask if they can give extra pills to cover the whole time he is away. My own insurance company will give an extra month or two because of travel. I do have to make the appropriate number of copays.
Dutyfree, often insurance companies make allowances for travel. I would call the insurance company directly and ask if they can give extra pills to cover the whole time he is away. My own insurance company will give an extra month or two because of travel. I do have to make the appropriate number of copays.
Jun 24th, 2007, 02:31 PM
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One son went to Africa for a month two years ago. Our Travel MD recommended Malarone for the entire time -- felt there were fewer side effects with Malarone than other malaria pills. However, the month's supply was very expensive and my insurance company refused to cover it -- said they only cover when you have malaria not preventatively! We tried to argue with the company but to no avail. Another son is now in China for a year and Travel MD prescribed one week's supply of Malarone as son is unsure of where he might travel. Travel MD prescribed several antibiotics as well as meds for diarrhea. My pharmacist felt son needed more meds for China so we contacted internist for additional prescriptions. He took Zithromax for URIs and Tigan for nausea. For traveler's diarrhea, he took Imodium, lomotil, and cipro.
Jun 24th, 2007, 04:25 PM
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I'm confused as to why a Travel MD would prescribe a week's worth of Malarone as you need to take for 2 days before entering Malaria risk area, while in the Malaria risk area and continue for 7 days after leaving the risk area. A 7 day supply isn't enough for protection.
If you carry Malarone as an emergency standby treatment option, you need 12 pills...4 pills daily for 3 days.
A 7 day supply is not enough for protection or treatment, and not taking enough for long can possibly help along resistence. Malarone is not widely available in Asia, and where it is available, it is not cheaper. Get enough pills to begin with, or get something else, but don't just get 7 pills.
If you carry Malarone as an emergency standby treatment option, you need 12 pills...4 pills daily for 3 days.
A 7 day supply is not enough for protection or treatment, and not taking enough for long can possibly help along resistence. Malarone is not widely available in Asia, and where it is available, it is not cheaper. Get enough pills to begin with, or get something else, but don't just get 7 pills.
Jun 25th, 2007, 04:47 AM
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KimJapan -- oops, you are right. Son saw Travel MD and filled RX himself so am not sure of exact number; thought I saved RX receipts to check but cannot find thme. Son in Nepal was told he did not need Malarone but to bring strong DEET spray which might be needed for a day or two.
