Singapore Expats

I don't get it... and maybe someone can explain it.

I can buy aspirin off the shelf.
I can buy paracetamol, a tylenol type drug, off the shelf.

But, if I want to buy ibuprofen (aka Advil), I have to get it from the pharmacist. There is only one brand, Nuprofen, and it is quite expensive.

What's with dat???

That is because ibuprofen, is a kind of NSAIDs (non-steroidal anti-inflammatory). The possibility of adverse side-effects from NSAIDs can be rather high. In fact, the most common group of drugs to bring on a drug allergy are NSAIDs. It is probably overly cautious of the authorities to still keep it under a Pharmacy Only drug, but knowing how poorly eductaed the general public is with medications, it is possibility a sound decision. Of course it frustrates the hell out of people who do now how to use the drug.

There are cheap generic ibuprofen available, just not usually sold at the retail pharmacies, they are usually found at the restructured hospitals.

Anonymous wrote:There are cheap generic ibuprofen available, just not usually sold at the retail pharmacies, they are usually found at the restructured hospitals.

Many thanks for the information. What is a "restructured hospital" and where can I find one?

Aspirin, your your info, is also an NSAID and has more adverse reactions than ibuprofen. I agree with Strong eagle, the rules are strange.

Also, I noticed you can purchase pseudoephedrine in supermarkets in Singapore - a product only available from pharmacies in Australia due to back-yard operators converting it to amphetamines.

sometimes the reason why some medicines from same category are 'OTC drug' and others are 'Prescription drug' are purely based on licensing. (even though they both may have exactly the same potential adverse effects)




=====================
CDM - Asia Hub
Global Development Operations
Bristol-Myers Squibb Company
[ www.bms.com ]

IntoxInc wrote:sometimes the reason why some medicines from same category are 'OTC drug' and others are 'Prescription drug' are purely based on licensing. (even though they both may have exactly the same potential adverse effects)

:arrow: question : how would i know?
:arrow: answer : part of the job...

Sohaib Khawaja
CDM - Asia Hub
Global Development Operations
Bristol-Myers Squibb Company
[ www.bms.com ]

not so much licensing- but rather government scheduling, which dictates how (eg supermarket, vending machine, door to door, or pharmacy) and what quantities are legal to sell in an unscheduled manner.

For eg, up to 20 tablets of drug A is legal to sell in supermarket, with so many mg of the drug per tablet, but go one tablet up or a mg higher & it falls into the pharmacy medicine category (S2) in the case of australia, or S3 which is "pharmacist only" whereby pharmacist needs to be a part of the transaction to ensure there's a therapeutic need, safety etc,.

Occasionally scheduling does change with more information as in the case of Nurofen. Previously it was in the S3 category which required pharmacists to be a part of sale process,.. Later, there was a study done which proved that nurofen in children gave no more adverse reactions than liquid paracetamol, which opened the door to all the childrens iburprofen products on the market and the downscheduling. Now, it's available in supermarkets in aust - although with controversy, as the medicine does interfere with some medications and can be potentially harmful, like lithium for example.

Anonymous wrote:For eg, up to 20 tablets of drug A is legal to sell in supermarket, with so many mg of the drug per tablet, but go one tablet up or a mg higher & it falls into the pharmacy medicine category (S2) in the case of australia, or S3 which is "pharmacist only" whereby pharmacist needs to be a part of the transaction to ensure there's a therapeutic need, safety etc,.

Occasionally scheduling does change with more information as in the case of Nurofen. Previously it was in the S3 category which required pharmacists to be a part of sale process,.. Later, there was a study done which proved that nurofen in children gave no more adverse reactions than liquid paracetamol, which opened the door to all the childrens iburprofen products on the market and the downscheduling. Now, it's available in supermarkets in aust - although with controversy, as the medicine does interfere with some medications and can be potentially harmful, like lithium for example.

i understand what you mean, but your example of 'so many mg of drug A per tablet' is too general in this case... Drug A and Drug B may not have the same 'mg' in a typical dose. So you can't classify them based on that. However, I don't know the regulations in Australia, so can't comment on that.

Restructured hospital simply means the public hospitals like Tan Tock Seng Hospital (TTSH), NUH etc.

And yes, aspirin does belong to the NSAID family, though it has a slightly different chemical structure to ibuprofen (Tradenames: Nurofen, Advil) or naproxen (Tradename: Synflex).

Perhaps because aspirin has been around for a much longer time than any other NSAIDs that people (in Singapore) are much more cautious when using it than other NSAIDs.

It is also partly true with regards to licensing. A drug company may apply to have a drug 'downgraded' from Pharmacy Only to General Sale (aka OTC), and if the reasons are valid (endorsed with clinical evidence of safety).

I should add that the Aussies do seem to have quite a few 'backyard chemists' around. I remember that when I was doing pharmacy in Oz, uni kids were tampering with codeine, in an effort to convert it to morphine, all for recreational use. Unfortunately, there are far less chemically motivated souls here.....hahahahah. Perhaps explaining why pseduephederine is available rather readily.

IntoxInc wrote:

Anonymous wrote:For eg, up to 20 tablets of drug A is legal to sell in supermarket, with so many mg of the drug per tablet, but go one tablet up or a mg higher & it falls into the pharmacy medicine category (S2) in the case of australia, or S3 which is "pharmacist only" whereby pharmacist needs to be a part of the transaction to ensure there's a therapeutic need, safety etc,.

Occasionally scheduling does change with more information as in the case of Nurofen. Previously it was in the S3 category which required pharmacists to be a part of sale process,.. Later, there was a study done which proved that nurofen in children gave no more adverse reactions than liquid paracetamol, which opened the door to all the childrens iburprofen products on the market and the downscheduling. Now, it's available in supermarkets in aust - although with controversy, as the medicine does interfere with some medications and can be potentially harmful, like lithium for example.

i understand what you mean, but your example of 'so many mg of drug A per tablet' is too general in this case... Drug A and Drug B may not have the same 'mg' in a typical dose. So you can't classify them based on that. However, I don't know the regulations in Australia, so can't comment on that.

it's got nothing to do with comparing how many mg between two drugs. In australia, the SUSDP (Standard of Uniform Scheduling of Drugs and Poisons) dictates what quantities of each drug, and how many tablets per packet are allowed, and it doesn't bundle Drug A into same category necessarily as Drug B based on amount of mg. I think I might have confused you there.

My point was that licences doesn't dictate this, which is what your original explanation was. A manufacturer can lose their licence, yet the scheduling remains still for other manufacturers to produce the medications within the predefined parameters of the scheduling. Singapore, I'd imagine would have a similar scheduling system, although they may not use that terminology necessarily.

Strong Eagle wrote:I don't get it... and maybe someone can explain it.

I can buy aspirin off the shelf.
I can buy paracetamol, a tylenol type drug, off the shelf.

But, if I want to buy ibuprofen (aka Advil), I have to get it from the pharmacist. There is only one brand, Nuprofen, and it is quite expensive.

What's with dat???

I recently read that ibuprofen is connected with heart attacks. Does anyone have anymore information on this?