Exalgo (Sustained Release Hydromorphone)

[Disciple]

Got a mailing for this yesterday. QD dosing.

Anybody heard about this? Reps been coming by yet?

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Members don't see this ad.

 

[lobelsteve]

I miss Palladone. Glad to hear it's back in an ETOH stable form.
I wonder if I can crush, chew, snort, smoke it?
Just another option in LAO's.

 

[PMR 4 MSK]

Got a mailing for this yesterday. QD dosing.

Anybody heard about this? Reps been coming by yet?

None yet but I look forward to disappointing them. I'm sure the rheumatologists I work with will be giddy for another LAO. Especially if the rep is cute.

 

[jsaul]

I miss Palladone. Glad to hear it's back in an ETOH stable form.
I wonder if I can crush, chew, snort, smoke it?
Just another option in LAO's.

palladone-- yeah that was good one

The rep was like the energerizer bunny with that one while it was on the market and then suddenly she stopped coming.

 

[Disciple]

Anyone know if there's an immediate release component to it?


If not, if may be worth a try for the "Doctor, they gave me an injection of Dilaudid in the ER and it worked well, can I have some?" patients.

 

[lobelsteve]

I love Dilaudid. It scares the crap out of me.
My dad was dying from cancer 2 years ago, colorectal 5 surgeries, infections, mets to liver and lung.
His onco was giving him MSIR 5, than 15's. My dad was a smoker, but never drank, no illicits.
I call the onc and ask him to be put on Avinza (I was a lecturer for them a few years back). He gets on 60mg and is doing well. He calls 2 month later to tell me about this new medication for his BT cancer pain. He says, "It's delightful." Talking about Dilaudid. I'm thinking my dad is now an addict by saying something like that. He died a few months later, but not in pain.

I have no problem telling patients the story and Rx'ing. I know local guys who refuse to prescribe because they say it is only for cancer pain. UDS, SOAPP-R, records, imaging- pick the patient carefully. and it's all fair game. Miss you dad, he'd appreciate the mention in this thread.

 

[Aether2000]

It has no short or intermediate acting component. It is a 24 hour drug that reaches its Cmax in around 6 hours, then gradually falls to around 3/4 of the peak value. It is not affected by food. It can be crushed and snorted. Alcohol does not affect the absorption or the tablet in any way. Expensive! Tier 3 on most insurances. No cute rep in my area....perhaps I need to move.

 

[Disciple]

Expensive! Tier 3 on most insurances. No cute rep in my area....perhaps I need to move.

That's too bad, sounds like a pretty good product.

I'm expecting those copay discount cards for them to be able to compete.

 

[Mister Mxyzptlk]

I'm a late adopter because IMHO these preparations do not confer any major advantages and they are hideously expensive. I only use the new proprietary stuff if the old inexpensive standbys don't work. Still waiting for my first Opana patient and have prescribed Kadian only once because the patient was already on it.

hydrocodone -> MSC / patch / MTD -> pump.

 

[PMR 4 MSK]

I'm a late adopter because IMHO these preparations do not confer any major advantages and they are hideously expensive. I only use the new proprietary stuff if the old inexpensive standbys don't work. Still waiting for my first Opana patient and have prescribed Kadian only once because the patient was already on it.

hydrocodone -> MSC / patch / MTD -> pump.

Shame on you for not jumping on the Bandwagon!

Those drug reps need help paying for all those lunches they bring, "experts" (read - guy from outta town) they pay to come give a canned lecture at some swanky restaurant, the makeup and all the nice clothes they wear. The least you could do is write a few thousand dollars worth of their drugs per day (just 1-2 prescriptions). Sheesh...

You know, the cost of marketing these knew drugs is very high, especially the direct-to-consumer advertising. Do you have any idea how much a 30-second spot costs during prime-time these days? Add in the costs of marketing to doctors and they have no choice but to charge insane amounts of money for the drug "to recoup research and development costs."

 

[Tenesma]

i like dilaudid too --- however the street value is CRAZY high in this area ---