Question to GP Maarten: I am looking for a cheaper medicine against high cholesterol
Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand and writes about medical facts.
Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information such as:
- Age
- Complaints)
- History
- Medication use, including supplements, etc.
- Smoking, alcohol
- Overweight
- Optional: laboratory results and other tests
- Possible blood pressure
You can send photos to [email protected] everything can be done anonymously, your privacy is guaranteed.
Note: The response option is disabled by default to prevent confusion with non-medically substantiated advice by well-intentioned readers.
Dear Martin,
A stent was implanted last April and I have suffered from high blood pressure for a long time. I am now taking the following medication. Amlor, half a pill of Nebivolol, and normally also co-lisinopril and Atorvastatin 40 mg. I simply forgot to take the last two to Thailand with me at home. I went to the local doctor here, but apparently he is afraid to change the import medication. That means that I have to pay 1 euro per pill for the Atorvastatin.
Now my question, can you recommend me a local substitute and the dose please, for the Atorvastatin and possibly the co-lisinopril (its diuretic has been replaced by 12,5 mg hydrochlorothiazide).
My blood pressure the day before yesterday was 100 over 60
Special thanks in advance
D.
*****
Dear D,
The stent is believed to have been placed in one of the coronary arteries. You are also somewhat frugal with your data.
Instead of the expensive Atorvastatin you can take Simvastatin (Bestatin) 40mg. Then check the cholesterol after 3 months. That Atorvastatin is better has never been proven.
Depending on your age and cholesterol level, a statin may be appropriate, although there is growing evidence that they are not very effective. 100 people need to be treated to prevent one heart attack.
Your blood pressure was already low yesterday. Is that normal? If so, instead of co-lisinopril, try lisinopril alone. Combination preparations are much more expensive than the sum of the individual preparations.
For you, a good blood pressure is: 120/80
Unless there's a good reason for hydrochlortiazide, you probably don't need to take it. What strikes me is that you are not taking any anticoagulant. Usually they are quite generous with that in NL. If it's stopped, leave it alone.
Yours faithfully,
Dr. Maarten