Prescription drugs in Brazil

12/01/24 Welcome, PKristinaCampoH.  It's difficult to generalize, in part because in Brazil as in Mexico, many drugs that require a prescription in the United States are sold over the counter here.  So it's quite possible that you could fill at least some of your prescriptions here.  Brazil has very active generic drug program, so generics are also widely available here. 

Chuy may have been mentioned in reference to Brazil because of your interest in Uruguay.  Chuy, Uruguay has a Brazilian twin city, Chuí, Rio Grande do Sul State, Brazil's southernmost city (but not quite southernmost point).  The two form a unified urban agglomeration with unrestricted passage across the avenue between them, so it would be an easy place to compare prices and availability between Uruguayan and Brazilian pharmacies.

@PKristinaCampoH So the whole Mexico adventure sounds strange. I would definitely stay away from that.

I have however received a prescription without physically being with a doctor here in Brazil. A few months ago, I had a severe case of The Shingles. At the time none of the doctors diagnosed it. My wife arranged a video (I Phone) conversation with a skin doctor. She immediately identified it and prescribed the medicine that eventually cured me.

All other times I have had a physical visit with the doctor.

Roddie in Retirement🕵

My wife says be careful with generic prescriptions in Brazil as they're not as potent or reliable and could have fillers.. She's a nurse. But who knows. Just passing the message. Do your own research.

12/02/24 The Brazilian pharmaceutical industry is regulated by Anvisa (Agência Nacional de Vigilância Sanitária), the Brazilian equivalent of the FDA in the US, which conforms to international standards.  Most generic medications in my medicine cabinet are produced by the Brazilian subsidiaries of major European and Israeli pharmaceutical companies, not by independent local labs.  I trust Brazilian industrial formulations of anything on the WHO Essential Medicines List, some of which are not approved for use in the United States but are here.  More recent compounds and reformulations, especially if they're still under patent, are imported and available, usually at high prices.

Compounding pharmacies ("Farmácias de Manipulacão" in Portuguese) are practically extinct in the United States but very common in Brazil, at least in the North where I live.  In these establishments the pharmacists mix custom prescriptions to the physician's specification from their own supplies of bulk ingredients.  I would have less confidence in their internal controls than in those of the manufacturers, particularly for anything meant to be taken internally.

My wife comes from the medical profession in Brasil, and I have no issue with any Anvisa cerified drugs. In regards to the practice of compounding, well, this would most likely be done with the aforesaid Anvisa certified products, so, no worries there either.

FWIW Anvisa has a very good reputation and is viewed very highly by Brasilian society, unlike the FDA.

12/03/24 @kolyaS122HSU.  I agree on the quality of the ingredients as delivered to the compounding pharmacy, and on Anvisa's overall reliability.  My concern would be with the pharmacy's storage and compounding practices.  That was the contamination route for the last compounding pharmacy scandal in the US that caused deaths.

My husband uses skin products from a compounding pharmacy near our home and is happy with them.  Since they're for external use, that doesn't worry me much.

12/03/24 @kolyaS122HSU. I agree on the quality of the ingredients as delivered to the compounding pharmacy, and on Anvisa's overall reliability. My concern would be with the pharmacy's storage and compounding practices. That was the contamination route for the last compounding pharmacy scandal in the US that caused deaths.
- @abthree

@abthree, how do you make sure that you are getting the right product?  I understand that medication can be delivered based on strength (i.e. 10mg, 20 mg, etc...), do you recommend to start with a small dose first for a week and then increase to the prescribed dosage?  Is this something that the pharmacist can provide in a consultation?

The idea here is if you are getting something that is unexpected, you will not be affected as much with a smaller dosage... hopefully....

12/03/24 @abthree, how do you make sure that you are getting the right product? I understand that medication can be delivered based on strength (i.e. 10mg, 20 mg, etc...), do you recommend to start with a small dose first for a week and then increase to the prescribed dosage? Is this something that the pharmacist can provide in a consultation?
The idea here is if you are getting something that is unexpected, you will not be affected as much with a smaller dosage... hopefully.... - @Pablo888

I'd discuss that with the doctor before starting a dosing plan of my own; a pharmacist might also be able to provide useful guidance.  It could well be harmless, but if the treatment plan is to disrupt a disease process with a sudden large dose,  a gradual approach could foil it. 

I always take a quick look at the package insert ("bula") before I put anything in my mouth as a reminder of what I might expect, even if the doctor already told me.  The inserts follow a standard design, and I focus on contraindications, precautions, interactions, adverse reactions/side effects, and maximum daily dose.