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Anxious Americans flock to Mexico for cheap Cipro

CIUDAD JUAREZ, MEXICO — CIUDAD JUAREZ, Mexico - With panic on their faces and dollars in their pockets, Americans are streaming into this shabby border town to buy cheap fixes of ciprofloxacin, the now-famous antibiotic also known as Cipro, which has become the latest fad in the United States since the public learned it can successfully treat anthrax.

Though ciprofloxacin can cost hundreds of dollars a bottle in the United States and is in limited supply, Mexican ciprofloxacino is abundant in pharmacies near the border and sells for a fraction of the price.

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Ciudad Juarez, just a quick walk over the Paso del Norte Bridge from El Paso, Texas, is filled with dozens of farmacias that for years have been dominated by signs reading "VIAGRA" and "PROZAC." Now, many have new postings that say "WE HAVE CIPRO" or simply "CIPRO."

No prescriptions are needed to purchase antibiotics and some other classes of drugs in Mexican pharmacies, which are generally well stocked with generic brands of popular American medicines. Many customers who are drawn to the drugstores are stockpiling in the belief that ciprofloxacin will save their lives.

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"I heard they're not selling it in the U.S., and that to me is scary," said Tania Laycock, who was visiting El Paso from Arkansas and walked across the bridge to buy a $16 bottle of ciprofloxacin. "I bought it because I want to be safe. I want my children to be safe."

She ended up buying 10 bottles for a total of $160. If Laycock had bought the same thing - 36 pills with 500 milligram strength - just a few miles north in El Paso, it would have cost her $1,850, or $185 a bottle. If she had traveled to New York, the price would increase to about $2,100, or $210 a bottle.

Internet sites such as www.2-buy-cipro.com sell six pills for $45, but when you add shipping and the consult fee, the total climbs to $120.

Laycock, 46, said she bought so many bottles because she feared she would be unable to get Cipro in the States in the case of a mass anthrax outbreak. And then there's the fear of multiple exposures. "It's not like chickenpox where you never get it again," she said. "It could be very costly if you get it a few times." The store clerk told her she would have no problem carrying back as much of the drug as she liked.

However, the U.S. Customs Service in El Paso said U.S. citizens must have a prescription from an American doctor to carry antibiotics from Mexico to the United States, and then, only a three-month supply is allowed. They declined to comment on the heavy importation of ciprofloxacino or whether they have confiscated any at the border.

American citizens appeared to pass freely across the border, carrying the drug in their bags.

Cipro demand has skyrocketed across the country in the past two weeks after letters containing anthrax were sent to media outlets and the Capitol Hill office of Senate Majority Leader Tom Daschle, claiming one life. At NBC, anchor Tom Brokaw, whose assistant was infected, held up a prescription bottle during a newscast and declared, "In Cipro we trust."

Among those taking it as a precaution are Maryland Sens. Barbara A. Mikulski and Paul S. Sarbanes, whose offices are in the same building as Daschle's. Some doctors are prescribing it to people who have not been exposed to anthrax, even though health officials have implored them not to.

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"The inappropriate use of antibiotics is of real concern to the American Medical Association," said Timothy Flaherty, chairman of the board of trustees for the association. "You don't take things you don't have to take. The potential of drug resistance is a real problem. It's been an issue with us for some time." Also, he said, snatching up bottles for safekeeping is a bad idea. "My concern with the stockpiling mentality is that if someone has it in their medicine chest and get the sniffles, they may take it," he said. "There is no justification for stockpiling."

But people aren't listening. And neither are the Mexican pharmacies. Califarma Pharmacy in Juarez, one of dozens of pharmacies on the main drag next to the international bridge, just dropped its price of 36 tablets of ciprofloxacino from $38 to $16 so the drug would be more accessible, said sales clerk Angeles Payan. She and several other pharmacies in Juarez reported a bustling business.

"We dropped our prices because of solidarity with the United States," Payan said. "We know you can't get it over there and we don't want to take advantage of that."

Mexico has at least seven brands of ciprofloxacin on pharmacy shelves, including Kenzoflex, Ciproflox, Ciprofur and Ciproxina. All are made in Mexico.

In the United States, one company, Bayer, has the patent on Cipro, which means there are no cheaper, generic brands. Bayer also sells in Mexico under the name Ciproxina, which is the most expensive brand in the country, going for about $50 for 14 pills.

Though Bayer's U.S. patent expires in 2003, some politicians are pressing the government to permit the sale of cheaper, generic forms of the antibiotic. The American Medical Association has announced that other drugs, such as amoxicillin, can also be used to treat anthrax. Because of demand, Bayer has announced plans to triple its usual production, enabling it to supply 200 million Cipro tablets over the next three months.

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Cipro was approved as an anthrax treatment in August 2000. It originally received approval from the Food and Drug Administration in 1987 to treat a variety of infections, including those of the urinary tract and sinusitis.

In Juarez, some pharmacists tell customers that they can use ciprofloxacino for other infections besides anthrax. Some also warn customers not to take the drug unless they have been exposed to anthrax or have symptoms of another illness, said Carlos Aguilera, manager of Zipp Farmacia. "People come in and they're anxious, and they want to buy it for themselves and to send to family in other areas," Aguilera said. "I tell them to be careful because it's dangerous if you take it and don't have anthrax. I tell them they'll have a bad reaction. I don't remember what, but something bad."


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