I have a gazillion tablets of Doxycycline from late 2003; would they still be good? They're in the original foil bubble "sheet."

In shopping for Malarone -- day-amn, that stuff isn't cheap! -- how far ahead of my trip can I pick the stuff up without it going bad? So far, it looks like the best game going is $49 (U.S.) for 12 tablets... this price being in Canada.

I have no problems with Doxy and, if it's still good, I'll use it instead of Malarone... unless the latter is much, much more effective than the former.

Much obliged, as always.

Russ

Russ,

The 4 packs of Malarone I still have were bought in 2002. They expire in 2007.

The "tons" of Doxy I have were also bought in 2002 and still have years of good use left.

Hoever, I got malaria even though I used Doxy, and have been told that Malarone is more effective. Alas, Malarone was too expensive to use for such a long time as I needed, so I only bought (and used) it as a cure. And as a cure it worked well.

I would say it depends a little on where you are going. In a low risk area during the winter season, I'd stick with the Doxy (or even skip using it, although this is up to each individual to decide for themselves). In a high risk area, where help is further away, I'd go with the Malarone if the duration isn't so long as to make it prohibitively expensive.

Dr. ErikD,
Thanks for the good advice.

Best Regards,
Dr. Rip

Dr. RIP,

I can only pass on what I've learned from those more knowledgable than me! But I did pick up a bit of relevant info on the subject (and dealing with other tropical problems) since we were all by ourselves for so long.

Do you disagree with my post?

Russell,

Doxy is not the way to go, not effective enough. Malarone is prefferred to Larium (this from people with more experience than myself) (lots of prior posts here on AR, and I just asked Adam Clements about it today).

And by the way, being from the U.S. pharmaceutical industry myself, I think it is positively Un-American of you for considering Canadian imports for drugs. Seriously!!! If you want the next wonder drug for the the inevitable pandemic somebody has to be supporting the research of pharmaceuitcal products. And you can bet your bottom dollar it is not going to be Canada! Unfortunately, like most things in life, the US Pharma industry foots the bill for the rest of the worlds R&D. Please excuse my soapbox. Good Hunting. Hugh

Are there any statistics as to the relative effectiveness of Doxy vrs. Malarone? I have taken them all and much prefer Doxy. Somewhere I read that you can come down with malaria when taking any of the three.

quote:

Originally posted by crane:
Somewhere I read that you can come down with malaria when taking any of the three.

No malaria prophylactic is 100% sure.

And although I don't have any numbers to give you, I've been told by doctors specializing in tropical medicine that Malarone is "best", Lariam comes in second, and Doxy in third place.
Of the 3, I can unfortunatly not use Lariam as it gives me random dizzy spells! My wife however used it for almost a year without problems. Thus my use of Doxy and Malarone as I mentioned in my above post.

Very informative responses, thank you.

"Un-American?" Indeed.

I reckon your question/assertion is understandable. Might I ask, what the big bosses make at your company? If they're making anything over $100,000 a year, may I then ask what they're doing to earn it? Are they really whiz-bang studs with PowerPoint? I mean, what are they "DOING," daily, to rack up anything over $100K??? I'm talking PERSONAL income. Why not take everything they're making over $100K and dump it back into research?

Let me share with you my Un-American perspective. Some years ago, Illinois was attempting to pass a CCW law. Not only did it not pass, it got butchered in the writing and went from carrying a loaded firearm in your car being a misdemeanor to a loaded firearm in your car being a felony. This, the compliments of the Illinois State Rifle Association.

Now, at the time, they (the ISRA) were all hot-to-trot about getting this sucker passed. They needed money. Okay, fine. Seemed like a reasonable request, so I pumped in as much money as I could at that time. Not a lot by many folks' standards, but "a lot" is relative to what one makes. Anyway... not only did it not pass, it got butchered.

I've been throwing money away at "causes" for years. Without listing my medical problems, of which I have a few, there's no cure for one disease I have, and I've been pumping it with cash for almost 30 years. I'm an impatient man. I've also funded research for other diseases, social problems, efforts to stop domestic violence, et cetera. You know the only thing where I "see" a difference? Dogs. I give a lot of money to "the dogs." Rescue dogs. Abused dogs. Racing dogs dumped because they can no longer break mach five anymore. Dogs for the deaf. Dogs for the blind. Dogs that got too big and became "inconvenient" for their owners. I give money to no-kill shelters, locally and nationally.

Personally, I'm pretty much done with funding cancer research. And while we're on it... all these "my wang ain't hard enough" commercials are really torquing my lugnuts. I find them offensive and demeaning. THIS, from the wonderful pharmaceutical industry. Every expletive-deleted channel I see, every magazine ad, every radio ad, et cetera, has some guy or some gal hyping one "wang-hardening" drug or another. I know little children are seeing and hearing these ads too and I feel they're incredibly inappropriate for public airing. That's just me. I'm a pretty old-fashioned guy in a LOT of ways and I'm pretty insulted that the big thing we're teaching our youth today is "sexual performance is where it's at."

Well, that's just my take on it. I'm Republican. I'm all for profits. I think an American should be able to keep every dime of what he makes, whether he works for it or sits on his duff and collects it. I don't really care what your CEOs make. However, where MY un-American income is concerned, I'm going with who is providing me the most bang for the buck.

I'm sorry you're personally disappointed with my lack of patriotism.

Russ

quote:

Originally posted by ErikD:
Russ,

The 4 packs of Malarone I still have were bought in 2002. They expire in 2007.

Thanks for your posts, Erik, I'll go with Malarone. Thank you.

Russ

Russ,

Excuse one aspect of my post. I should not have questioned a man who has served this country with regards to being an American. That I aside though I stand by my statements.

The US Pharma industry does provide the extreme bulk of the world-wide R&D effort. So yes, unfortunately Americans do shoulder more burden than lots of the less developed world in cost. Yes, Upper Level Pharma execs do make more than 100K a year, but show me any other major industry where they don't.

The mentality of good health care should be a privelege is crap. People that do not appreciate our health care system here in America need to go live in England for a year or two. There are no free lunches and you get what you pay for.

Hugh,
I'm a physician. I practice in an economically depressed corner of Idaho. We are into our eighth year of drought and crop prices are very low. 90% of the people in my county, me included, are working poor. More than a few of my patients make the drive north twice a year to stock up on meds. Out of necessity.
I am grateful for the patient assistance programs for my destitute patients.
God bless the R&D programs, but it is slightly disingenuous of you to not mention that the advertising budget is significantly larger than the research budget.
You sound like a Pfizer rep. I was married to one for a while.
lawndart

Russ,
A lot depends on where you are going. Send me your itinerary and I'll check to see what is the "gold standard" and what is "adequate" for that AO.
lawndart

Lawndart- Are you saying that the effectivness of the different meds vary by location or genetic variation? And in your earlier post, "significant" is an understatement!

The prevalence of the various forms of malaria varies by location throughout the world. Various iterations are susceptible to milder meds. Others require the biggest hammer you can find, or even doubling up if the local bugs are multidrug resistant. One of the principles of chemotherapy (antibiotics are a form of chemotherapy) is to use the least toxic medicine that you can get away with and still have a very good chance of preventing or ending the infection of interest. These are disease and resistance factors.
Your choice of medicine or even the choice to not use medicine also depends on who your patient is. It is a different case when making a recommendation to a tourist from North America who is naive to the various tropical viruses, bacteria and parasites than to a person who has grown up in an endemic area and is the offspring of ancesters who have survived contact with the bugs in that area for three to three hundred generations. These are host factors.
Can someone afford a medicine? Economic factors.
Are the side effects so onerous that a person stops taking the medicine? Medicine factors.
Is the dosing schedule so frequent that a person misses too many doses? Convenience factors.
Did the sub-human POS's running the country sell all the donated medicine on the black market to line their pockets, leaving none for the downtrodden citizens? Distribution factors.

It all boils down to this:
If I were to prescribe an antimalarial with a high rate of medication induced psychosis as a known side effect to some middle aged, whiny, spoiled PITA, I'd make sure I'm sitting close enough to enjoy the show, but far enough that they don't come after me as the agent of their misfortune. That and a syringe of Haldol in my pocket. Then I could be hero for the day and get a free ticket voucher.

lawndart

Russ & LawnDart, I with you all the way!

I can't figure out why the same meds manufactured in the US, are cheaper in Canada.

Enough ED ads, so far my 8 yo hasn't asked what they're talking about. The only one's I liked were Bob Dole's, cause I couldn't tell if it was Saturday Night Live sketch or a Pharm ad.

Jerry

Minkman: The reason as to why US made meds are cheaper in Canada is simple: The socialist goverment up there FORCES US companies to sell at a price they deem adequate, usually at a loss, so they gave to make up the difference elsewhere. Reality is the stock market and stockholders, after all, we are not communists. jorge

KEEP IT SIMPLE....When you go to Tanzania with us you take Lariam or Malarone..I take Lariam, it has 0 effect on me, and 99% of all our hunters...Doxy is not effective according to the many doctors I have hunted over the years...
Malaria is a horrendous disease, don't play games with this stuff...

quote:

Originally posted by Hugh W:
Russ,

Excuse one aspect of my post. I should not have questioned a man who has served this country with regards to being an American.

Noted. Excused.

quote:

Yes, Upper Level Pharma execs do make more than 100K a year, but show me any other major industry where they don't.

Precisely true and my point. However, there's no "public outcry" about computers costing too darn much, cable TV costing too darn much, cars costing too darn much, skim milk costing too darn much... but Lord howdy, there IS a public outcry about all the gosh-dang drug prices AND nothing to show for it.

The problem is motivation. The drug companies are not well motivated. As a result, they are not producing.

I could motivate them. My methods would not be legal, and I'd go to prison (well, actually, I wouldn't, because I'd eat a bullet), but I "PROMISE" you, with the right opportunity and a "free hand" in the matter, I could apply the "proper motivation" that the people boiling these drugs, or whatever the heck they do, needed -- to come up with EFFECTIVE TREATMENTS and CURES for lung cancer, psoriasis, ovarian cancer, leukemia, and a whole bunch of other things.

My comment on salary was that the top guys don't care. They're not in the car industry, they're in the drug industry. If they gave a hoot, and if it really was a matter of "more money needed" like they're always whining about, they'd sacrifice a big chunk of their salary and dump it back into research... but they don't, because they don't REALLY "CARE." And hey, that's okay, they don't HAVE to care. And whatever money they make is theirs -- that's fine, I don't have a problem with that.

I DO have a problem that the money all us peons have dumped into the past three decades of medical research, by "buying American" or donations or cookie sales or whatever, has gotten zilch for results.

Where are the cures for ovarian cancer, prostate cancer, lung cancer, arthritis, Alzheimer's, and so on? "We're close" they say, "We're REALLY close." Yeah, well, I stopped kissing Jerry Lewis' posterior a long time ago, too, after I'd dumped a bunch of money each year into his telethons.

You know, I can't run my life this way. I have to produce or I get written up, kicked out, or something "bad." My position is, if you don't produce, YOU'RE OUT OF THERE. Fired. No severance pay, nothing. Fired. "Bye." Get someone ELSE in there and give THEM a chance. You had yours, you didn't do squat, you're gone.

I expect something for my money. If the major phamaceuticals want my dough, they'd better produce something other than wang-hardening drugs. See, THAT'S where the emphasis is these days.

Lastly, I'm not sure the drug companies WANT to find cures. Sounds conspiratorial, I know -- and maybe it's just a B.S. point of view, but it's one that's gaining some acceptance. Personally, I have to wonder. If they DID cure major diseases, what would they do? No one would need them anymore... well, not as many, anyway. Mass layoffs, the whole bit. What would the drug companies do? Go into making shoes? I don't know, maybe it's all ca-ca, but I wonder about it sometimes. What would they do if they cured cancer and AIDS and so on? They'd be out of work. Peace with the Soviets and there went the U.S. military... BRAC lists, the works. That kind of thing.

I don't know. I just tend to think a lot of the "big guys" in your business aren't motivated to produce. No passion, just profit margin.

Whatever. Like I told Erik, above, I'll do the Malarone.

Russ

quote:

Lastly, I'm not sure the drug companies WANT to find cures. Sounds conspiratorial, I know -- and maybe it's just a B.S. point of view, but it's one that's gaining some acceptance. Personally, I have to wonder. If they DID cure major diseases, what would they do? No one would need them anymore... well, not as many, anyway. Mass layoffs, the whole bit. What would the drug companies do? Go into making shoes? I don't know, maybe it's all ca-ca, but I wonder about it sometimes. What would they do if they cured cancer and AIDS and so on? They'd be out of work.

Sadly, I think you might be pretty close to the truth... But then this goes for all industies nowadays. Why build a car that'll last a lifetime? Won't sell many cars that way...

On the otherhand, if you cured cancer, AIDS and whatever, the world would get pretty crowded pretty quick. Look at what happended in africa after the west started fighting sickness etc down there. The population has exploded in the past 3-4 decades...

I guess there's no easy solution.

Larium has a long history of severe side effects. I took one and thought I was on LSD. You never know how severe the effects will be until you try it.

You could not pay me enough to take another dose of Larium.

Malarone is not supposed to cause the side effects, and is supposed to be very effective. I'd try it.

Good to see Don G back at it. Reregistered, "New Member" eh?

ErikD,
Yes, you give good poop. I charge for my medical poop, and dope.

Glad to see you passing along the good advice.

quote:

Originally posted by RIP:
ErikD,
Yes, you give good poop. I charge for my medical poop, and dope.

Glad to see you passing along the good advice.

Howabout if I give the advice, you send them a bill, and then give me a percentage?

quote:

Originally posted by Hugh W:
Unfortunately, like most things in life, the US Pharma industry foots the bill for the rest of the worlds R&D. Please excuse my soapbox.

A bit off-topic but I thought the reason companies with a profit motive engage in R&D was to make a profit from the latter sales. In this case the "US Pharma industry foots the bill for the rest of the world's R&D" in order to make billions of dollars of sales in the USA and the rest of the world.

Or have they suddenly become non-profit organisations? Maybe having global altruism as a motive all of a sudden.

And isn't this the same industry that when drugs are banned in the USA and First World, they dump them on the third world to still make a sale?

Finally amazingly there are Pharmaceutical R&D programmes outside of the USA as well. Quite amazing isn't it?!

Is my industry perfect, not hardly; I doubt any are. But before you focus on one single entity of healthcare lets look at the big picture. Do all doctors, just get by? Do insurers just get by? Do hospital administrators just get by? What about plaintiff attorneys? None of them clean up, now do they? Show me a single industry that is surviving today that does not strive to make a profit.

I suppose all of you that I have been doing this bashing job on the pharma industry work for free. You are all of the highest ethics and are only concerned with the welfare of others. You are pleased to just get by in life.

Before you pass judgement on others look at yourselves and your industries as well.

Good Hunting!

Hugh

Take a pill.




I couldn't wait to say that.

NitroX,

Now you've got the spirit! Judging by some of these posts I've read on this thread there are plenty of members that could use Zoloft, Prozac, Buspar, heck even Valium!!!!

quote:

Originally posted by Hugh W:
Judging by some of these posts I've read on this thread there are plenty of members that could use Zoloft, Prozac, Buspar, heck even Valium!!!!

Hugh,

Can you please send me a sample package of the above mentioned medications? I promise to give them a good writeup here on AR!

Without getting into the political discussion here....I take Doxycycline and will continue to. It is dirt cheap and when combined with permethrin on one's clothes and some deet during peak mosquito hours, the difference in its effectiveness relative to Malarone or Larium is marginal if not non-existent from what the people at my US travel clinic tell me. Further, it is a good pill to have around to take care of other infections that one may encounter. I got an eye infection a while ago and just upped my dose and took care of it. One of the first things I did before moving to Cairo was dramatically increase my supply of Doxy. Cost me next to nothing! In fact, if I recall correctly, the cash price of the medication was less than my insurance co-pay.

JMHO,

JohnTheGreek

quote:

Originally posted by jorge:
Minkman: The reason as to why US made meds are cheaper in Canada is simple: The socialist goverment up there FORCES US companies to sell at a price they deem adequate

Political Mode: ON

Really, how do they do that? I would be really curious to know! Willing buyer + willing seller = fair price....does it not? Now, if you are asserting that the Canadian government has such significant purchasing power (monopsony power) as to insist on a lower price then you are really talking about the influence of power relationships...very similar to those that place corporations at a distinct advantage over consumers. Do corporations exploit consumers the same way you describe the centralized Canadian health care system exploiting U.S. pharmaceutical companies? hmmmmmm? You cant have it both ways...if power relationships matter, they matter everywhere. What are you some kind of commie?

Best,

JohnTheGreek

Political Mode: OFF

quote:

Originally posted by Don G:
Larium has a long history of severe side effects. I took one and thought I was on LSD.

Before starting this thread, I'd researched many, many previous AR posts related to this topic, as well as seeing what was out there on the 'Net, and this was the main thing that concerned me... the "LSD effect," with bad dreams and other things. I ALREADY have bad dreams, so I sure don't need to compound things.

As for Doxy, I have to agree with you, John, I was never sick after we went on that stuff. No coughs, sore throats, or anything. Almost hated to come off the stuff once I came back to the land of sinus headaches... which, by the way, I have one now as I type this. Arizona certainly has its appeal: dry like Iraq but without the mortars and rockets and IEDs. And where am I? Illinois... with a sinus headache... "again."

Does the Permethrin stop the tse-tse flies any? From what I've read here on AR, lately, it seems those suckers get through any kind of anti-bug clothing.

Russ

Interesting reading... on page two of the document, where it starts "In Zambia..." about the use of DEET on skin and insecticides on clothing.

Russ

quote:

You are pleased to just get by in life.

Well Hugh,
It wasn't my original plan, but since it is working out that way lately I really can't complain. There is one very bright spot in my condition of genteel poverty; many of the female drug reps are hotties.

lawndart

Russel, have used malerone for two safaris..with wife and son..a little pricey but did not bother any of us on either safari...Would take it every day at noon time with lunch and worked great...
As for pyrthin...I sprayed all colthes socks, gaiters, shirts and hats and I even took a can with me and sprayed the inside of the truck dashboard underseats any where those GD bugs would hide..used 3M ultrathon as my bug juics..Absolutely no bites...

Mike

Russ, ole buddy don't play around with this stuff,malaria is bad news,, when I came home for over younder I had malaria and liver flukes I was told,very ,,very sick for along time

Russ, I would sure stay away from the Larium as you do not know if you will be affected by the side affects until after you start using it. Trust me though, if you are affected with the side affects it will ruin your safari. I would go with the Malerone first, then the doxy second. I can tell you from experience that I have had several clients that were seriously affected by the Larium and it really made their safari unpleasant. I even had a doctor client who ended up leaving early due to the affects that he had.

I have had malaria so many times, that I can not count how many times, and almost died 3 times from it. So, it is something that you do not want to get if at all possible. But also keep in mind that none of these pills will prevent you from getting malaria, and only serve as a purpose in that you are not supposed to get it as bad if you do get malaria. I was on malaria pills my whole life growing up in Tanzania, and still got malaria.

What is really weird though, is that I have not taken any malaria pills at all for the last 5 years or so, and have not gotten malaria at all, and I spend a lot of time in Tanzania every year. Knock on wood. So go figure, but would suggest that you do take pills just as a precaution in case they do actually work.

quote:

Really, how do they do that? I would be really curious to know! Willing buyer + willing seller = fair price....does it not? Now, if you are asserting that the Canadian government has such significant purchasing power (monopsony power) as to insist on a lower price then you are really talking about the influence of power relationships...very similar to those that place corporations at a distinct advantage over consumers. Do corporations exploit consumers the same way you describe the centralized Canadian health care system exploiting U.S. pharmaceutical companies? hmmmmmm? You cant have it both ways...if power relationships matter, they matter everywhere. What are you some kind of commie?

The Canadian government does put a cap on the percetage price increase that can be instituted each year. It is linke to inflation, cost of living or some such formula that I cant remember offhand. The are in fact in a position to dictate as a social medicine provider. As such they are a huge buyer. Economies of scale. Last and this one most people seem to overlook intentionally or otherwise is the exchange rate. Up until now it has been aroun 1 1/2 to 1 for a long time on average. That in itself accounts for a huge difference.

Weighing in on the medical price "debate"-- I have zero problem with the pharm cos. charging as much as the market will bear. I have a HUGE problem with the market distortions that various governments have created in the drug marketplace. Sure, Americans fund most of the drug research that the rest of the world benefits from. And this isn't fair. But the solution is not to force prices down in America (which will completely kill innovation), it's to raise them elsewhere.

And there's a very simple way to do that: legalize re-importation. This will force the pharm cos. to make a choice-- demand higher prices outside the US, or quit shipping the drugs to those countries. Frankly, I don't care if free-riding foreigners can't get their new wonder drug-- and I doubt many other Americans do either. Anyway, this is a simple unilateral market-based solution that has no downside for Americans.

(Of course, some countries will just start violating the patents on the drugs. Tough break for the pharma cos. stockholders.)

And of course, reducing the cost of FDA approval would also help immensely. Thank goodness we have a Republican administration in power that champions smaller government... Oh wait; we don't. The budget's growing faster than under Clinton. So I guess we can't expect any improvement in the FDA any time soon.