Talk to your pharmacist

by Yule Heibel on April 20, 2004

The plot thickens, even as — I hope — the congestion thins. I should have done this sooner, but today I finally sought out my neighbour at her place of work. She is A Pharmacist. I brought her a webpage print out that describes Zephrex, with pencilled annotations that the Long Acting version has 120mg of Pseudoephedrine and 600 mg of Guaifenesin (regular Zephrex has only 60 mg of the first ingredient). She took one look and knew right away that pharmacies here don’t carry this product. But, and this is where it gets interesting, it doesn’t seem to be a case of banning anything in Zephrex, but rather that Zephrex’s competitor in Canada, Entex LA, formulated its product with Phenylpropanolamine (aka PPA), which is a banned substance in Canada. I’m speculating, but I would guess that Zephrex was never marketed here because Entex had the market covered, but when Entex was effectively banned sometime after 2000, nothing comparable took its place. Also, Entex didn’t formulate its “speed” (PPA, which is what Zephrex’s Pseudoephedrine delivers too) and Guaifenesin in the same ratio as Zephrex.

However, Entex has just reformulated its product, taking PPA out and putting Phenylephrine in. (Hit the Entex link in the first paragraph and compare to the one in the last sentence.) As it happens, my neighbour’s pharmacy is receiving its very first shipment of the stuff tomorrow. Saints be praised, sinners, too. Best of all, even though Zephrex was always by prescription only, Entex is OTC. Flying into Los Angeles, bringing in a couple of kilos of meds, la la la…

I’m convinced, and my pharmacist neighbour confirmed, that Zephrex LA’s high dosage is the key to its success. Unfortunately, and this is the bit that doesn’t bode well, the reformulated Entex LA has only 30mg Phenylephrine, which I suspect doesn’t quite compare to the 120mg of Pseudoephedrine in Zephrex LA. But I know the numbers that work for me, and will go from there. Perhaps my pharmacist will have some more useful information when I see her tomorrow. She told me today that Guaifenesin, for example, is available in liquid form and can be taken by the teaspoonful. …The local health-food stores should still have some ephedra (ma huang) lying around, eh? Maybe I can smoke and free-base my meds?

(PS: This entry carries on from my Big Sinus Kvetch in Search of Drugs on April 19.)

Big important update: I just picked up a package of Entex LA today (Apr.22) and am delighted to find that it’s identical to Zephrex LA, with 120mg of pseudoephedrine and 600mg of guaifenesin. Won’t have to cook anything up myself after all. This is Entex LA distributed by Purdue Pharma Inc., General Partner of Purdue Pharma in Pickering Ontario.

Meanwhile, didn’t the French invent the bidet? I’m using a French product called Hydra Sense Nasal Care, which is basically the same old saline-solution-up-the-nose habit I pursued in the past. Ah, but Hydra Sense offers a totally different, sensually French delivery. The product comes in a pressurised, sealed, green-on-white container, and delivers French sea water (Atlantic or Mediterranean? Atlantic, I hope) via a detachable, cleanable nose-bidet: shaped like a dolphin’s snout, you can stick it waaayy up your nose, give a little squeeze, and wheeee, thar she blows!

Strangely satisfying.


Joel April 22, 2004 at 1:19 am

You can always come down here and try your luck in the Tijuana pharmacies.

Yule Heibel April 22, 2004 at 8:43 pm

Looks like I won’t have to! I don’t understand why Entex LA’s formula (as per webpages) lists the ingredients it does (phenylephrine, etc.), or whether it means that Entex LA in the US is different from what is sold in Canada, but the stuff that’s for sale here in is identical to my beloved Zephrex LA’s formula: 120 mg of pseudoephedrine & 600 mg of guaifenesin. (I just picked up a package via My Pharmacist and am reading the ingredients list…) Amazing. Also, it’s OTC here, and it’s cheaper than Zephrex: each tablet of Entex LA costs just under 61 Canadian cents. I seem to remember paying around US$90 (at least) for 60 tablets of Zephrex…

Wow. Maybe Canada is a drug heaven after all, eh?

maria April 23, 2004 at 2:08 am

Glad to hear your drug issues have been resolved … without any serious damage to your wallet, too. A little research went a long way in this case, didn’t it? Here is to the clearing of sinuses!

Yule Heibel April 23, 2004 at 8:11 pm

Thanks, Maria! I found the official Canadian link to Entex LA, as well as the announcement for it in the Pharmacists’ News (it wholesales for just under CDN $7 for 16 tablets), but I’m still not sure if it’s available in that specific formulation in the US. If nothing else, this little exercise has been really interesting in learning something about the politics (and economics?) of prescription drugs and their availability. It’s not all objective science; the dollar and the market share rules everywhere.

Kate S. April 25, 2004 at 7:16 pm

Am I the only one to get a real sense of tickling satisfaction at the bidet up your nose part of this story? LOL! Dolphin snout!
“Whee! Thar she blows!” LOLlololol……
(Sorry. I know you’re sick. It’snot funny….)

Yule Heibel April 29, 2004 at 1:45 am

Haha, I AM sick, Kate, and not just with sinusitis either! Yup, you got it: bidet, made-in-France, dolphin up the nose. I’m so glad you picked up on that!

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