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Medical Forum / Diseases and Disorders / Arthritis / May 2005

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MTX Availability

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roby - 25 May 2005 17:52 GMT
I switched from methotrexate tablets to injectable by mouth about three
years ago: three months worth of injectable is $8.75 vs $30.00 for tabs
from Medco.  Late last year, the (lpp) injectable became unavailable.
Today, I learned that Medco still can't get injectable ... and I was
amazed to hear that they don't have generic MTX tablets either!  My
latest refill will be Trexall ($60).

Sooooo, my MTX cost jumped from $35 to $240.

They had no words about why the generic was not available, or whether
this was a temporary situation.

Anybody know more?

Roby
Harvey R. Stone - 25 May 2005 18:37 GMT
My  latest refill will be Trexall ($60).
> Sooooo, my MTX cost jumped from $35 to $240.
> They had no words about why the generic was not available, or whether
> this was a temporary situation.
> Anybody know more?
>
> Roby

Hi Roby,,,,  I wish I did know more.   I have my questions about this
shortage.    Someone,,,Anyone should look into THE LOSS OF A CHEEP DMARD
which can only be subbbbed with a way more expensive DMARD.....  These
shortages smell fishy to me.   IF and I say if today's cancer treatment is
being done with newer drugs and Methx is no longer needed,,,  I might
understand it
  As everyone here knows that I believe in the free market   BUTTT  this is
starting to smell.
Harv
Nanny - 29 May 2005 20:22 GMT
I haven't been taking oral MTX for a long time, but with insurance, I am
paying $10 for a 30-day supply.  Shhh...don't tell anyone - I want it to
continue.  Nanny

> My  latest refill will be Trexall ($60).
>> Sooooo, my MTX cost jumped from $35 to $240.
[quoted text clipped - 13 lines]
> is starting to smell.
> Harv
Ron Stewart - 25 May 2005 19:14 GMT
What does "injectable by mouth" mean?
I have never had a problem buying generic MTX  injectable at the local
drugstore. I get a 6 month supply for $22 and a 2 year supply(100) of
syringes for $20. Our insurance company uses Medco but the preapproval
process is such a hassle I just pay out of pocket since it is so cheap.

Signature

Ron Stewart
Santa Rosa, Calif.

>I switched from methotrexate tablets to injectable by mouth about three
>years ago: three months worth of injectable is $8.75 vs $30.00 for tabs
[quoted text clipped - 11 lines]
>
> Roby
Harvey R. Stone - 25 May 2005 21:38 GMT
> What does "injectable by mouth" mean?

What they meant to say is pill taken by mouth.   You are very lucky to not
have had your supply interrupted.

Harv
roby - 25 May 2005 23:02 GMT
> What does "injectable by mouth" mean?
> I have never had a problem buying generic MTX  injectable at the local
> drugstore. I get a 6 month supply for $22 and a 2 year supply(100) of
> syringes for $20. Our insurance company uses Medco but the preapproval
> process is such a hassle I just pay out of pocket since it is so cheap.

I draw the dose into a syringe and "inject" it into a glass of orange
juice.  Well, those were the good old days.

You are fortunate to have access to generic MTX in either form.

Roby
Lyn - 26 May 2005 02:30 GMT
I just ordered a refill on mtx from Medco on Sunday, (pills), just got
the shipment verification notice, will be here in 2 - 5 business days.  
3mth supply $20.

Lyn

> I switched from methotrexate tablets to injectable by mouth about
> three years ago: three months worth of injectable is $8.75 vs $30.00
[quoted text clipped - 11 lines]
>
> Roby
Nanny - 29 May 2005 20:23 GMT
>I just ordered a refill on mtx from Medco on Sunday, (pills), just got the
>shipment verification notice, will be here in 2 - 5 business days.  3mth
[quoted text clipped - 17 lines]
>>
>> Roby
Nann Bell - 26 May 2005 05:00 GMT
> I switched from methotrexate tablets to injectable by mouth about three
> years ago: three months worth of injectable is $8.75 vs $30.00 for tabs
[quoted text clipped - 11 lines]
>
> Roby

they *should* have the generic pills, but your tale goes along with other
horror stories I've heard about Medco.  Depending on what your out-of-pocket
costs are, it might be worth it to you to get the pills from a local pharmacy
rather than through the mail.  You'd be able to get the generic from them.  
Or sic your insurance company on Medco if your policy is cornering you into
using them.  The insurers can't be happy with covering a brand name rather
tahn a generic.  

Anyway, I got mine filled, locally, just a couple of days ago without any
trouble.  And this at a small-town pharmacy that keeps limited supplies on
hand (I always make sure I give them plenty of notice on refills!)  Oh, I
should say that was generic tablets - I handle the pills well and we never
switched me to the injectable.

Signature

Nann
remove the Gator cheer to email me
Simply the thing I am shall make me live --- William Shakespeare

janers - 26 May 2005 14:22 GMT
The MTX pills are available.

It is the injections that are hard to get.  I also use Merck Medco and they
have not been able to get the injections, nor has any pharmacy near me or
for that matter FAR from me.'

The company that manufactures MTX, and I called them, will be back in
business by mid JUNE they said.
Plus Bedford labs will also have it.

Please hang in there for the injections.  WE hope they keep their word and
are on their way. But I agree with others, this is damn stupid to not have
the drug in the first place.

janers
Walt Hanks - 26 May 2005 15:45 GMT
And again, my pharmacy has an ample supply.  I really think these
"shortages" are being made worse, in part, by lazy/uninformed/whatever,
distributors who just don't take the time.

Walt

> The MTX pills are available.
>
[quoted text clipped - 12 lines]
>
> janers
Karen - 26 May 2005 20:35 GMT
> The MTX pills are available.
>
[quoted text clipped - 11 lines]
>
> janers

My Dr. told me 2 weeks ago that the companies are changing MTX and
putting a preservative in it, and you'll only be able to get your
injections at the Dr.'s office.  I did find two bottles that will keep
me going for a while.  (only taking .3 a week)

I wonder if the mfg getting back in business by mid June, it will be the
"new kind"?
janers - 27 May 2005 01:28 GMT
Was told just the injection type of MTX.

I also use the preservative type and this is the one that apparently out.
I got vials 4 of them right now from a older smaller pharmacy.  It is a
vial with 50mg in it.  If you use .3 cc then that is what I use and that
equals 7 1/2 mgs.   Enough for about 7 shots or month a half.
You do not have to get that at a doc office.  If you know how to inject
yourself and are given instructions on dosage there is no problem.
the vials that have no preservative are much more expensive too, that is
what I hear.

And my doc and myself contacted 12 local pharmacies and each pharm guy told
the same story. Not available.  Plus is you go to available drugs on line
or ones that are being back ordered?  There is the MTX right there saying
it is out of stock ...so someone has them somewhere in a back storage room
Note on all vials has the expiration date and last longer in storage than
the NO preservative.
Plus once you break a vial of No preservative, you are suppose to throw
away the rest if you do not use it right away.  Does anyone do that???
Fess up now LOL

keep the faith, the MTX hopefully will be there soon

janers
Walt Hanks - 27 May 2005 11:26 GMT
> Plus once you break a vial of No preservative, you are suppose to throw
> away the rest if you do not use it right away.  Does anyone do that???
[quoted text clipped - 3 lines]
>
> janers

Actually, Bedford is recommending that the preservative free MTX be stored
in syringes to maximize storage life and get multiple doses from a vial.  I
take 20 mg/week; that's 0.8 cc.  So when I open a vial, I draw two full
syringes and a half a dose.  I recap one of the full syringes and the half
dose and put them in a bag, then take the other dose.  Two weeks later I
inject the half dose into a new vial, then draw three complete doses.  This
way I get 5 doses from two vials.

Again, this is per manufacturer's guidelines.

As to the preservative vs. non-preservative, I believe the story is that the
two manufacturers that were shut down by the FDA (which is what caused the
shortage) have only been certified to produce MTX with preservative.
Bedford will continue to produce the preservative-free variant, which those
of us who are sensitive to the preservative will need.

Also, Bedford announces the release of each batch in advance and pharmacies
are instructed to call and order what they need on the release day - not
before.  Following these instructions, my pharmacist has always been able to
get what she asks for.  But other pharmacists in the area, who don't follow
instructions, don't get any.

Finally, if someone is taking injectable MTX orally, they might consider
switching to the IV solution instead.  It can also be taken orally and has
not been in as short a supply.

Walt
janers - 27 May 2005 17:19 GMT
Hey there,
do you known what the preservative does to some people?  side effects?

I have not heard nor read much about that, so if you have links or the
who's, why's or wherefore's then fill me in here.  Love the info.

thanks bunch for your informative information

janers
Walt Hanks - 30 May 2005 01:54 GMT
Hi there.  Just got back from my Sister's wedding in San Diego.  Sorry I
didn't reply sooner.

For me, the problem is a strong injection site reaction (redness, pain,
etc.)  Others can have an allergic reaction.

Hope that helps!

Walt

> Hey there,
> do you known what the preservative does to some people?  side effects?
[quoted text clipped - 5 lines]
>
> janers
RoseB - 30 May 2005 02:05 GMT
>Hi there.  Just got back from my Sister's wedding in San Diego.  Sorry I
>didn't reply sooner.
[quoted text clipped - 5 lines]
>
>Walt

hmm.  Interesting. I have used the injectable for ten years without
problems, but was recently noticing an  increase in pain following the
injection. Now though I have had an injection site reaction where
there is a fairly large bright red area that is very itchy and hard.
It is not terribly painful, but perhaps just past the liminal level of
pain. I have also had smaller pinpoint red marks from other recent
injections. I had not thought that it could be a reaction to the
preserving agent.

    Rose   @}>->--
    Being educated means that rather than fearing the unknown, one seeks to understand it. RB

    Please remove "Ima" to reply.
 
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