QUESTION: Can a United States physician prescribe to a Canadian pharmacy? I take Wellbutrin XL 300, and the price is absolutely outrageous in the U.S. The generic does not behave the same as the brand. I don’t doubt that there are 300 milligrams in the generic pills, but the way the drug is released is the problem.
My wife also pays a lot for brand-name Toprol XL to control high blood pressure. She says the generic metoprolol also has a release mechanism issue.
ANSWER: A doctor in the U.S. can fax prescriptions directly to a Canadian pharmacy. Patients could also attach a photograph or scan their prescriptions to an online pharmacy.
Prices for brand-name Toprol XL could average about $58 a month. In Canada, the same prescription might average $80 for a three-month supply.
You are right about the price of Wellbutrin XL 300. We found prices over $2,000 per month in the U.S. You could purchase this brand-name antidepressant from a Canadian pharmacy for a bit over $50 a month.
QUESTION: You wrote recently about the proper time of day to take medication for high blood pressure. The idea of medicating at bedtime is correct in most cases. This timing minimizes the risk of orthostatic hypotension, or dizziness on standing.
However, there is a notable exception to that advice. One should avoid taking anti-hypertensive medications at bedtime if being treated for glaucoma, particularly low-tension glaucoma. Perfusion pressure to the optic nerve is normally greatly reduced at night. Reducing it further with blood pressure medicine dramatically increases the risk of optic nerve damage.