Cut-price counterfeits are not what the doctor orders

Q: WHILE we were in Indonesia, my husband and I bought some over-the-counter drugs which he takes for his high blood pressure, a prescription that I take for my arthritis and some anti-malarial pills. They were pretty cheap, but now we're concerned that they may be counterfeit medications. Do you think they are safe to take? Dr Rose writes: Buying drugs in countries where there are no regulations, and brand name drugs are freely copied, is not good practice. Western drug companies spend millions of dollars each year developing drugs and conducting extensive research and clinical studies to ensure their efficacy and consumer safety. Companies that bootleg drugs will either substitute a generic drug for a brand name one, dilute a genuine drug, or simply use cheap inert material such as sugar, chalk or saw dust.

According to the World Health Organisation, a wide range of important and useful medications, including tranquillisers, antibiotics, anti-ulcer drugs, anti-inflammatories and heart medications are being counterfeited and sold to unsuspecting consumers. While there have been reported cases of fatalities associated with taking these adulterated drugs, the majority of them are not harmful, just ineffective.

People with serious health conditions should never purchase drugs in a developing country. Always travel with an adequate supply of your required medication. If the drugs appear too cheap to be true, they probably are.

Q: MY legal secretary was just hospitalised with hepatitis. She has no idea how she got the disease. I didn't think hepatitis was such a serious problem. Her doctor said her liver enzyme levels were in the thousands. Will she be able to return to work? Howlong does it usually take to recover? Do the rest of us at the office need to take any special precautions? Dr Rose writes: One of the things that your secretary's doctor will do is check which type of hepatitis your legal secretary contracted.

If she contracted hepatitis at birth or when she was a child, she will usually be asymptotic. It is possible that she may experience flare-ups if she is a chronic carrier. More likely this is an acute infection. With both hepatitis A and B, she will become quite ill, may be jaundiced and experience severe inflammation of the liver, with enzyme levels in the hundreds or thousands. In severe cases, some may even experience blood clotting disorders. This will probably subside on its own and her body will slowly recover over the coming weeks and months.

It may take several months for your secretary's energy level to return to normal. Don't be surprised if she tires easily when she first returns to work.


You do not need to take any precautions to safeguard other workers in an office setting. Hepatitis B is mainly transmitted through sexual contact, or when the blood of an infected person is passed on to someone else by the sharing of needles, razors or other infected instruments. Hepatitis A is potentially damaging only to those who are food handlers. Employees in a legal office setting should not be affected.

Q: IS it safe to have sex in late pregnancy? My husband thinks it is okay but I am very worried. Besides being uncomfortable, I have little desire for sex and feel little arousal. Also, what about oral sex during pregnancy? Dr Rose writes: Yes, it's generally safe to have sex during the last few months of pregnancy, but you will need to find positions which are comfortable. By the third trimester of pregnancy, most women find that the missionary position (man on top) is no longer comfortable. Rear-entry, or the woman on top or on her side may prove to be more comfortable. Ask your partner to avoid deep thrusting as this may irritate your cervix.

Sexual intercourse is not advisable if the woman has experienced vaginal bleeding early in the pregnancy. Women with a history of premature labour or miscarriages should also avoid intercourse or use a condom during sex in the final months of pregnancy, because uterine contractions during orgasm and the prostaglandins in semen can induce labour. There is also a remote risk of an amniotic fluid embolus with uterine contractions during orgasm.

If your pregnancy is high risk due to twins, placenta previa, an incompetent cervix, or other medical conditions, your doctor may advise you to avoid sex.


As long as your partner does not have a sexually transmitted disease and he does not forcefully blow air into the vagina, it is safe to have oral sex during pregnancy.

Interest in sex during pregnancy varies according to the individual woman and the stage of pregnancy. Typically, women experience decreased desire during the first trimester, increased desire during the second trimester and a gradual decline in interest by the third trimester.


Dr Rose Ong is a certified family physician licensed in the United States. She welcomes enquiries but cannot answer them individually. Specific questions should be addressed to your own physician. Additional enquiries: Peak Corporate Health Management, 525-6600, fax 525-8100.