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» LymeNet Flash » Questions and Discussion » Medical Questions » Mexico (Cancun) Bicillin Shots -- Anyone Recently Been?

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Author Topic: Mexico (Cancun) Bicillin Shots -- Anyone Recently Been?
kj15
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Hello,

I am wondering if anyone has recently obtained Bicillin LA Shots while in Mexico as I have plans to go to Cancun soon and wish to take advantage as the price makes them unobtainable in the US.

When I was in remission several years ago I had GREAT results (while they were still covered by my insurance in US) and can't resist getting a script from my LLMD again as long as I'm already going to be there for a wedding.

Questions:
-How easy was it for you to find them in the quantity of Bicillin shots you needed around Cancun and transport the meds home through customs (flying)? Any tips to make it go smoother?

-Will the Rx from my US LLMD do or do I need to see a Mexican MD (supposedly associated with many pharmacies there) to obtain an Rx they will fill in Cancun?

-How many were you able to bring back? I'm thinking about asking my MD to write them for daily (although I'd really only take them 3x/week)

i.e. bring back qty 90 as per what I understand you can bring back a 3-Month personal med supply (which would end up really being a 6-Month supply for me doing it this way).

-Is there a specific brand of Bicillin LA or "Benzathine benzylpenicillin" in Mexico that is "better trusted" than others?

I have read elsewhere that "Benzetacil" brand made by Sandoz may be a good choice--is this correct info? Are there any others that will work like the American Bicillin LA?

I have just heard to stay away from anything that has the word "combinado" in it because that would be more like Bicillin CR than LA.

-What should I expect to pay per package (within last few years)?

-Does the Mexican pharmacy take US credit cards or should I have my bank exchange enough cash for Mexican currency before I go?

-Did you feel safe going to the pharmacy (I won't be going alone and only in daylight)?

-Any names of specific pharmacies that you found the Bicillin at or worked with you to get them in for your date of arrival? Please PM me with this info if you would feel more comfortable telling. Cancun area only please!

-Would a pharmacy need to order for me say if I had an Rx for 90 shots and would I need to call them before hand to arrange this qty? Do they speak English at the pharmacies?

This is what I would do in the US so I assume Mexico may be similar procedure? Sorry, I've never traveled there before and have no idea where to start with this!

-I assume I'd have to put the product in *cringes* checked baggage due to the Bicillin in Mexico being sold as powder along with an ampule of liquid to reconstitute at home (per TSA liquid requirements) and take my chances? Include copy of Rx in luggage with Bicillin?

-Anything else I need to know to get me and my Bicillin back safely to the US?

I know my doc will need to order needle and syringes here so that shouldn't be an issue. If I remember correctly I used to use a 1.5" 21g needle for the injections.

Does anyone know what size syringe is needed to reconstitute the powder and what size needle I would need to "draw it up"' from the vial?

I'm sure my doc knows this but want to be prepared in case she doesn't have the info at her fingertips so I don't waste precious Office time.

As always, thanks much, all! Again, if you feel more comfortable telling about your experience or giving tips via PM, please feel free to do so!

I understand some people and doctors are leary of obtaining non-US meds and I am lucky to have an open minded MD to help me obtain something I can afford.

Regards,
KJ

(breaking up the text for easier reading for many here)

[ 06-08-2018, 11:33 PM: Message edited by: Robin123 ]

--------------------
SICK AUG 2010 / DIAGNOSED AUG 2011
LYME IGENEX WB CDC POSITIVE IGM: 31++ 34IND 39+ 41+ 83-93+
CLINICAL DIAGNOSIS: Bartonella and Babesia
REMISSION MAY 2012-DEC 2014
SEVERE RELAPSE JAN 2015
STILL WORKING SLOWLY TOWARD REMISSION AGAIN IN 2019

Posts: 39 | From N. Illinois | Registered: Jun 2011  |  IP: Logged | Report this post to a Moderator
gz
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Let's see here...

I've only used Bencelin that I'd ordered online, so have some info.

Bencelin was the brand of benzathine benzylpenicillin I used. I did not need an Rx, but there was one accompanying the meds in the box written by the pharmacy's doctor. Whether it was for the benefit of dispensing or sending through customs I don't know.

You should be able to purchase it OTC, but it probably wouldn't hurt if you can easily obtain an Rx or letter from your llmd.

Some of the larger pharmacies may have an online presence. You may trying checking before you go. You may even be able to check inventory and prices and some have English speaking reps if you would like to call. It might be possible to have one order in what you are looking for in the quantity needed.

Yes, avoid the "combinado." Triple check your purchase, sometimes the packaging for both types are deceptively similar (most certainly the case for Bencelin!)

I think my online order was $3-something USD per dose plus shipping. We inquired in person in a rural village and were quoted a price of around $10 USD per dose (meds typically are more expensive in that particular location though).

As a tourist location Cancun may be used to filling Rx's for foreign visitors. You might try asking around on an online expat community or immigration forum to get recommendations.

Also be careful the areas where you would be traveling. Tourists are prime targets for crime and there seem to have been a lot of stories coming out of Cancun these last couple years. There are most certainly places to avoid. A good taxi driver is invaluable, but be 100% sure they are vetted and trusted.

[ 06-05-2018, 11:15 PM: Message edited by: gz ]

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gz
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Prescription meds are not subject to the same liquid restrictions as carry on. If needed you can probably get sterile water amps here in the US although it would add to the expense.

Recommendations for traveling with meds suggest including a copy of the Rx, dosage instructions from the treating provider, and that meds are for personal use. So a paper Rx and letter from LLMD could be helpful for re-entry.

Some folks are Rx'ed bicillin in the 2.4 mu dose, so they would need 2 amps each time and this should be detailed in such a letter.

Looks like FDA rules also say we're not supposed to import meds for personal use if they are available here (?)

Don't want to cause undue stress or alarm but you may want to research that and be mindful of what regulations are in place. Many never have issue flying with meds but that doesn't mean someone else won't.

It could be possible to send them to yourself from Mexico. Nothing with liquid is allowed to be sent to the US so the water amps would have to be removed.

When I asked the pharmacy I used before, they still could not send bicillin to the US this way, so it's something else that may warrant research.

If you do, the Mexican post can be very slow and there will be a huge (up to 2 weeks) lag in tracking, so a courier like DHL might be better.

As far as quantity, I think FDA says up to 90 days but customs up to 50 or 60? There seems to be a grey area, and I'm not sure if that info is dated.

If you carefully pack them in checked luggage they should be okay even with rough handling (I would wrap them throughout clothes). If you do that make sure you include a copy of the Rx and doctor letter in the bag.

90 doses would take up a lot of room in a carry-on. If kept in their original packaging I'm not sure if the maximum size luggage permitted as a carry-on would contain them all.

If on your person you might be able to remove the water amps and double pack the vials in their boxes (I checked and Bencilin boxes will fit this way.) This would save space but make them more fragile.

Physically this should be fine but if your carry-on is big enough sometimes it can be gate-checked and then subjected to the rough handling of baggage handlers.

You probably could use your US credit card at a Mexican pharmacy, but there may be a foreign transaction fee imposed by the issuing bank each use.

We were unable to pay with a US credit card in some places for whatever reasons. If you know ahead of time where you will be purchasing you can ask in advance.

When visiting Mexico we find it much easier to go to a bank and exchange for cash to do our spending. The exchanges in the airport are usually more expensive than the banks outside.

You may also be able to exchange for pesos here in the US before your trip, which is probably the safest way to go the cash route.

If you exchange for pesos, make sure every bill is crisp and new looking without creases. Every merchant we've encountered there will refuse bills that are not in pristine condition. Carefully check the bills and exchange any that look questionable.

If exchanging in Mexico be very mindful of surroundings, people, and activity. Tourists at exchange kiosks can make for an obvious target if the situation allows.

(breaking up the text for easier reading for many here)

[ 06-08-2018, 11:35 PM: Message edited by: Robin123 ]

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gz
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Needles and syringes - If your location is accurate it looks like you may need an Rx for needles and syringes, or maybe over a certain amount? Doesn't sound like it would be an issue for you either way since your LLMD is on board.

It is *possible* to use the 21 gauge thin wall needle (which is what comes with the Bicillin-LA sold in the US), but difficult due to clogging. The powdered bicillin does not dissolve, only stays in solution and briefly at that before settling.

You'll need to be able to stab, aspirate, and inject fairly quickly to avoid clogging and having to pull out, change the needle, and inject a second time.

Both Nipro and Terumo manufacture 20 gauge 1.5 inch ultra thin walled hypodermic needles. Terumo may only be available in Canada, but Nipro can be easily found online.

The product number for the Nipro 20 gauge 1.5 inch Ultra Thin Walled hypodermic needle is AH+2038 and the box and needles are coded yellow.

The ultra thin walled needles allow more to pass through compared to regular walled needles, so an ultra thin walled 20 gauge should be comparable to a 19 gauge or better.

I purchased 5 mL syringes at Amazon and the UTW Nipro needles on eBay. You may have to go through your pharmacy with an Rx depending on the your state's laws.

Using a larger syringe like a 10 or 12 mL may be easier to handle, since the plunger wouldn't have to come out as far.

Syringes can be Luer lock or slip tip. I prefer Luer lock in case I am unsteady or when injecting in awkward or hard to reach areas.

Adding lidocaine helps with injection discomfort. LLMD prescribed, here I pay around $20-some (no insurance) for 20 mL. It comes packaged split into 10 2mL vials, it is 1% which is 10 mg per mL.

You may be able to purchase this in Cancun, what I pay might be $1-2 per mL, if needed to make a comparison. What I have seen for sale in Mexico is usually in a large, multiuse vial.

Approximately 0.5-0.7 mL of lidocaine is effective for me. I usually only fill the syringe up to around 4 mL total.

Compared to the brand Bicillin-LA sold in the US, the reconstituted generic bicillin will inject quickly with little to no resistance unless you hit a clog.

If it clogs do not force it. Withdraw and re-inject the remainder with a fresh needle. Adding more water might make it less likely to clog,

but you really don't want to inject more than 5 mL in one spot (that seems like an awful lot to me personally, which is why I don't go over 4 mL).

You can reconstitue and withdraw with whatever needle size you have on hand that works. Some like to use 18 g needles for this (I think 18 g is what comes for injecting the Bicillin-LA 2.4 mu dose).

I have a bunch of regular wall 21 g that I ordered as extras for injecting Bicillin-LA. I can make them work okay for mixing and drawing, but they usually clog up on me when injecting and are too much hassle for that.

(breaking up the text for easier reading for many here)

[ 06-08-2018, 11:37 PM: Message edited by: Robin123 ]

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Evin98
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I got bicillin in Mexico a year ago. I had no prescription, so I was only able to get Bencelin, not Benzetacil.

Bencelin is made in Mexico by a Mexican company. The batch I got was no good. I tested it and it was bunk.

Try to get Benzetacil (from Sandoz labs), and make sure that it is "no combinado."

I brought back an enormous quantity walking across the border and didn't have too much trouble. They flagged me to secondary and gave me a little bit of runaround, but no big deal.

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Keebler
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-
Consider HEAT and jarring from travel, if stored for some time, the temperature, again, could affect any Rx.

& consider authenticity.

http://flash.lymenet.org/ubb/ultimatebb.php/topic/3/30238

Topic: Counterfeit Drugs - check yours with mfr. photos


https://www.opb.org/news/article/npr-fake-and-faulty-drugs-a-problem-no-one-wants-to-talk-about/

Fake And Faulty Drugs: A Problem No One Wants To Talk About

by Susan Brink - NPR - May 19, 2018

Article & Book Review of: Bitter Pills: The Global War on Counterfeit Drugs


Here, vials of a counterfeit cancer drug are highlighted.

Counterfeit drugs are not just pill form, vials, topicals, just about any form can be at risk of being made fake. There's even been counterfeit toothpaste which was (is?) toxic.

https://www.cbsnews.com/news/cbs-news-reports-on-counterfeit-drugs/

CBS News' reports on counterfeit drugs

July 3, 2012
-

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Evin98
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Also: with Mexican bicillin, you'll probably need to use a 19g 1.5" needle. Even those get clogged a lot, so I think anything smaller would not work.

Use a 5cc syringe. You can get the needles and syringes onlin without a prescription.

Ventrogluteal is much less painful than dorsogluteal. It's also easier to do yourself. I was doing 3x a week and it wasn't too bad.

Bencelin was $3-4 a dose. Benzetacil was about $5.

Most tourist pharmacies will have an english speaker. They take credit cards.

They will likely not have 90 doses. They will need to order it. It will take them a few hours to get it together.

Make sure your doctor writes "Benzetacil 1,200,000 NO COMBINADO" on the RX. They might not know what bicillin is.

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Evin98
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Also, to keep the needle from clogging, squirt a drop out immediately before plunging the needle.
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sammy
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Often your insurance will pay for the Bicillin shots when given in the doctors office.This is a medical code.

They tend to deny payment through pharmacy benefits. (Filling the script through CVS, Walgreens, etc.)

Purchasing meds overseas should be your last resort. You will have no guarantee of quality control, high possibility of chemical & medical contaminants.

Is your doctor aware of your medical & financial situation? I think it’s hard for them to accept that we’re in such difficult situations. It took several conversations with my doctor, being very direct & clear about my situation.

My doctor is used to taking care of very wealthy patients. It was hard for him to accept that I’m trying to survive on the other end of the spectrum.

My doctor still wants me to have the best treatments available, our ultimate goal is health. Now that he understands my situation we spend more time weighing options. Deciding what should I spend that dollar on? (What supplements actually help? Same idea for RX, you don’t want to waste!!!)

When it comes to deciding on primary treatments, be a partner. Allow your doctor to give their best recommendations, then share your thoughts & experiences.

There are ways to save money on meds here in America, it’s not easy but you can get help. there’s a whole long post in General if you want to check it out.

Take care

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k84
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Only buy Benzetacil. The rest clog badly....very badly - as in bordering on unusable (even with a 18ga needle).
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