People’s Pharmacy: Why did Canadian pharmacy ship drug from Mauritius?

Q. Some time ago, you wrote about legitimate Canadian pharmacies as a source for brand-name drugs. My wife uses a very expensive brand-name inhaler called Breo Ellipta. We were able to save well over half the price by buying it from Canada.

I purchased from the pharmacy offering the best price. Though we are satisfied, I wanted to report something that I felt was very curious. In filling our prescription with this Canadian pharmacy, we expected to receive it from them directly. Instead, the brand-name drug was manufactured in Turkey and shipped from the African island of Mauritius! That’s quite a circuitous route to get our prescription. Is this unusual or common?

A. Brand-name medications usually are quite a bit less expensive in Canada than in the U.S. Consequently, ordering from a legitimate Canadian pharmacy can result in substantial savings.

Many of the online Canadian pharmacies have arrangements with pharmacies all over the world. When someone orders from a “Canadian” pharmacy, the brand-name pharmaceuticals may come from New Zealand, Australia, the U.K., Turkey or Mauritius. In theory, they are all high-quality brand-name products made by the original manufacturer.

PharmacyChecker.com provides price information from legitimate online Canadian pharmacies. You will find that those shipping exclusively from Canada are pricier but still substantially less expensive than brand-name U.S. prescriptions.

To learn more about this process, you may wish to consult our “eGuide to Saving Money on Medicines.” This online resource can be found under the Health eGuides tab at www.PeoplesPharmacy.com.

Q. My doctor recommended NasalCrom a few years ago. It works very well to lessen allergy-related sinusitis. The only downside is that my sense of smell is heightened when I use it frequently. Since I have a low tolerance for fragrances or other odors, this is a bit of a drawback.

A. NasalCrom (cromolyn) is a spray that stabilizes mast cells in the nasal passages. These cells release histamine and other inflammatory compounds when they are exposed to allergens. Stabilizing them prevents the symptoms that accompany histamine release.

Cromolyn was introduced as a prescription medicine in the early 1980s. It was originally developed from a natural compound found in bishop’s weed (Ammi visnaga). NasalCrom became available without a prescription in the 1990s.

Some people complain about sneezing or irritation initially. Others report a bad taste. You are the first to tell us that the sense of smell is heightened. We will be interested to learn if others have a similar experience with this under-appreciated allergy medicine.

Q. I have long suspected that my thyroid function changes with the seasons. My doctor only orders a thyroid test once a year before my annual physical. Should I request more frequent blood work?

A. You might find that your thyroid lab results are different between summer and winter. A recent letter to the editor of Clinical Chemistry (March 1) states that TSH (thyroid-stimulating hormone) peaks in the winter and is lowest in the summer. As a result, thyroid function may be lower in the winter than in the summer. Symptoms may include sensitivity to cold, constipation, weight gain, low energy and dry skin. You may want to ask your doctor to order blood tests for T3 and T4 as well as TSH twice a year to better assess seasonal variations in function.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”