Home Forums Hunting & Shooting Africa Doxycycline Question

I am headed to South Africa the last week of July. I am going with my father and brother and we have decided to take Doxycycline while there (even though the area we are going to is a very low malaria risk area). I acquired three bottles of Doxycycline through a pharmacy supply company (I am a dentist but don't hold that against me). My question is this, do I need to have these pills in a bottle with a prescription from a medical doctor, or can I take them in the original pharmaceutical bottles? Thanks!

To play it safe, I would suggest they be in a regular prescription bottle.

As a pharmacist I would say you need to have prescription labels, because federal law says those are drugs that can only be taken with a valid prescription and whether you can prescribe those for yourself or not will depend on your state licensing board and scope of practice and on and on...

I always have a presciption label on the outside of the bottle. I figure customs agents can't identify what's inside the bottle.

Got a typewriter?

This question comes up often for me with my hunters. Many want to bring those pill dispensers with the days of the week on the little snap down lids. Going to RSA is not much problem, coming home through customs not a huge risk of anyone caring. However Perscription meds should be with the perscription bottles or they can screw with you.

July is winter across all of the nothern part of the country. Malaria is about as low risk as a lightning strike. Tick bites are more likely but even then almost zero problems in winter. Tick bites have about a 10 day incubation anyhow so you never get the fever til your done hunting anyway. Then you feel sick and run down when you get home.

I would not just take Doxy every day "incase" it will make you very sun sensitive and can cause bad sunburn and vision issues from the bright sunshine. My father inlaw is a medical doctor. I've learned what I know about this from him. I have no medical background at all to base this on myself.

I have howeever had well over 300 hunters through my hunting camp and know that in all that time I've had about a dozen with tick fever, Zero with Malaria. All the tick fever cases were in April and ealy May as well. None in mid winter.

Stephen,
I can't see that you'd have a problem with Sullivan/Schein doxycycline. If you have with 100 hydrocodone, that might be different. I travel with a wallet size copy of my state license, but no one has ever asked me to produce it. I pack only personal Rx's for RSA but have a travel medicine chest for more "remote" locations. Some things you might consider that could be handy:

Suture kit with 3-0 and 5-0 silk. There are always sliced fingers to sew up,esp. if fishing.

Marcaine with 25g short needles. Don't stick Lido with 1/100k epi into fingers. The vasoconstriction can shut down the capillary bed.

Antibiotics. Cipro for GI problems. Amoxicillin and/or Clindamycin for puncture wounds or anything else in that realm. #40 of either/each should do it.

Diphenhydramine 1ml of 50mg/ml for IM with a 3 ml 25g syringe as well as the otc tabs. Allergic reactions are common to bites, dust , pollen, and quite a host of new allergens that you or your party may come in contact with.

Scopolamine patch if anyone in your party is prone to motion sickness, especially if deep sea fishing. (saves me)

Epipen

Ibuprofen 800mg

Tylenol III-Not a great pain reliever but very good cough suppressant and antidote for travelers dysentery

Toradol IM-The IM version is an outstanding non-narcotic pain med. If someone in camp breaks an arm/leg etc., it can make their life a whole lot better until you reach proper medical care.

I don't always take all of this to RSA, but do take these and a few more on trips to Cameroon, Zambia, and Tanzania. I have left anything unused at local health clinics, where it is greatly appreciated. I've never had a problem with customs in any country. Guns are more interesting than pills. However, I understand that some frisky Customs Agent could make an issue of it here, but I just don't see it for these meds.

Hatari: Before my trips to africa, I always went to my flight surgeon and he prepared a "kit" for me that had a lot of the things you mention including some prescription pain killers and stuff like that. The PH I hunt with John Sharp has a HUGE medical kit in his Land Cruiser. It's so elaborate, I'm sure one of you guys could dosurgery on the hood of the darned thing if you had to! I still had MEDEVAC insurance though jorge

Yea, Toradol (Ketoralac) is a non-narcotic NSAID that is a hyper- magnum ibuprofen . I use it IV in my practice but it is also available in oral form. It would be a good prescription pain reliever to take if you needed something stronger than motrin/ibuprofen. It avoids the usual narcotic side-effects of nausea, constipation, drowsiness or euphoria and is non-addictive. The downside may be if taken frequently or once in that certain rare individual, stomach ulcers, and can make your platelets "slippery" so that you bleed a little easier. It's a short term answer to mod to severe pain.

Gdv

Ketoralac suffers badly from the first pass effect, which is why the IM/IV dose is so much more effective. the oral form is the bomb to cure brain tumors that are the result of too much time with John Barleycorn, or so I've been told! Can be bad on the stomach if one has GI issues or if it is used for more than 10-14 days. I really think it is an under used med.

I agree. Having been the recipient once (IV) when I had a soft palate cellulitis - and had to continue working!- I can speak to its great pain-relieving abilities.

Gdv

I took doxy on one trip and the sun sensitivity was enough to make me discontinue it.

I much prefer malarone. Also Africans have access to European sourced prophalaxis that you could take in place of the doxy.

jim

I have several 3-0 Nylon sutures on Keith needles so one doesn't need a needle driver. I appreciate the reminder about Ketrolac, IM, as I fear it's effect on bleeding, particularly after a tonsillectomy keeps me from appreciating it's use. I think before I head off on the sheep hunt I'll round up some Marcaine (plain....good point about the fingers), syringes, 25ga needles, and Ketrolac.
Good thread,
Don

docdb-

I used to give Toradol at the end of a tonsillectomy when hemostasis was assured (and still do with many other procedures). I never had a problem with it. And the patients were very comfortable. Then, as with other things, I have with advancing age become more and more conservative and decided to discontinue its use in that setting. Anecdotally, though, I've never seen a bleeding "problem" that could be definitively attributed to the drug.
It's a good drug and the 25 ga. needles and some .25% Marcaine are a good idea too.


Gdv

Hatari
Toradol for 10-14 days! Man I hope you got good insurance, lots of blood and extra kidneys.

Goodnews
I've yet to see bleeding problems from toradol that were not GI related. In fact, we use toradol and lovenox on almost every trauma patient we have.

Now, GI bleeds, yes, and after only one days use.

I took Doxycycline while in RSA the first trip and was very sun sensitive, even with sun block. The second trip I just took it with me in case I developed tick bite fever which was very unlikely or I had travelers symptoms which is always likely in a foreign country. As far as the suture, I never went that extreme in South Africa. Just dressings, bandaids and steristrips, alcohol pads. I did however bring some dermabond this trip for minor wounds.

Most of what I bring are drugs. I bring Zofran(The disolving type), Decadron(IM of course.), Promethazine(Again IM), Benadryl, Imodium, Celebrex or Vioxx(I know it is off the market.), Antibiotic ointments, Sonata or Lunesta(Depends on what the reps bring us.), Aciphex(Proton pump inhibitor of choice),Tylenol, Sudaphed, Ibuprofen, Laxitives and I am sure several others. I know it is like a pharmacy in my bag. But I never have problems when I travel to Africa of needing a drug and not having it.

Remember, I stated "IF" used more than 10-14 days. Actually studies I read 10 years ago or so didn't report a high incidence of GI bleeding or other problems if used within this window. It is such an effective pain reliever without narcotic side effects that patients with pain loved it. It simply took their pain away. They demanded it for more chronic conditions, and payed the price when used more than 14 days. It got to such a point that Syntex changed the recommendations for oral use to be administered only after an IM or IV dosage, which killed it for routine usage. Now the oral recommendations are not to exceed 5 days. I can go with that. I rarely prescribe it anymore, but probably should reconsider. Only problem is that many pharmacies do not routinely stock it, which makes it a pain for the patients. I also have no idea where insurance stands on this product. Such is the world we live it.

Say you're in a remote area, and you severely sprain or break an ankle, 40-60 mg IM can really save you some misery.

I am not nearly so familiar with the efficacy when ketoralc is used P.O. as I use the IV/IM approach. For our major bowel cases, I use cont. lumbar/thoracic epidurals for pain management for 3-5 days post-op. The drug of choice barring contraindications to cover or supplementation is ketoralac 30 mg IV q 6 hrs prn x 12 doses. This is reduced starting at age 60 and again at age 70 taking into account their "used" plumbing.
Very good recoveries with this regimen as I've stated earllier have never seen to this point in time a problem attributable to the drug. I would see it as the analgesic of choice for Africa in the parenteal form.
There may even be some statistical evidence that bowel anastamoses heal better with this regimen. Perhaps better perfusion at the site.

Gdv

Hatari
I was thinking more of your malpractice insurance. A drug that the manufacturer and FDA have clearly labeled with black box warnings not to be used for more than 5 continuous days carries a huge liability if used for 10-14 days. Now it may be perfectly fine in most individuals, but any bad outcome, whether the fault of torodal or not, is going to come back to the physician who prescribed it and the pharmacist who filled it. An attorney can produce every reference book you have in your office before a jury and they'll all say no more than 5 days and the jury will blame the drug, right or wrong.

Some retail pharmacies don't carry the po drug because they're tired of fighting with the docs who insist on prescribing more than 20 tabs at a time.

I agree its a great drug. One of the best things to have around if you get a kidney stone out in the middle of nowhere. One of the best things ever for post op recovery. Just not one for general use.

Come on guys it's Ketorolac. Even us uneducated RNs know that.

Sorry, I work with Army docs.