FDA panel votes to eliminate Vicodin, Percocet.

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MountainPharmD

MountainPharmD

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Vicodin in all of its combinations is the number one prescribed drug in the U.S. Are they also going to get rid of Tylenol #3?
Also, the recommendation comes from a FDA panel, and not from the official FDA decision board. It is not for sure if they will eliminate all those drugs for sure. A result of d/c Vicodin will be an increased in C-2s, Vicoprofen, and Tramadol.
 
This is AWESOME news if it works. Watch narcotic prescribing drop through the floor! The shiz is way overused and abused and this is going to make pain med either a legend drug (NSAID) or CII. What the heck is even the point of APAP in the mix? Just go with the straight narcotic. No APAP overdose and easier to titrate. Darvocet will be gone too!!
 
npage148 said:
What the heck is even the point of APAP in the mix? Just go with the straight narcotic. No APAP overdose and easier to titrate.
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Right. Your guess is as good as mine. It makes no sense.
 
LOL, I am waiting for Drugbuyers to explode! Oh, what do I do about my ppppppaaaaaaaaaiiiiiiiiinnnnnnnnn...!
 
npage148 said:
What the heck is even the point of APAP in the mix?
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What if it's there to discourage abuse like the atropine component of Lomotil? But that's insidious and perverse. I suppose it's there to limit the dose of hydrocodone via complementary pathways.
 
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the medical director of the poison center where I did 2 rotations thinks APAP should just be banned. But if we can't do that, he proposed that we eliminate all combination products with APAP.

I bet it would decrease the number of certain overdoses.
 
VancTheTank said:
I have spoken with physicians who use the APAP content as a counseling point for their patients. As in "don't take more that X of these each day or you will destroy your liver." Not sure how effective that logic is on a drug seeking patient, but maybe it helps in some cases.
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The combinations exist for that purpose (how well it works is another story). Both hydrocodone and codeine are C-II when supplied as a pure substance.

The logic of this is beyond me, though. A drug that causes no symptoms until your liver blows up in four days isn't going to deter any average drug seeker fresh off the street.
 
I will bet you all a jelly doughnut that the end result will be:

Any combo with more than 325 mg of Acetaminophen will be withdrawn from the market. Vicodin, Vicodin ES, Vicodin HP all Lortab products Percocet 7.5/500 and Percocet 10/650. This gives them the cover to boot Darvocet-N 100 and generics off the market as well.

The Norcos of the world will remain and the Vicodin & Lortabs will suddenly be re-formulated.....

As for OTC's Tylenol Extra Strength is a goner as will any products containing more than 325mg per dose. They may allow the 650 as a single dose.....
 
Praziquantel86 said:
The combinations exist for that purpose (how well it works is another story). Both hydrocodone and codeine are C-II when supplied as a pure substance.

The logic of this is beyond me, though. A drug that causes no symptoms until your liver blows up in four days isn't going to deter any average drug seeker fresh off the street.
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Please tell us what this purpose is. IT has been shown many times that these combo products work no better than the narcotic alone...and in the case of darvocet it works no better than APAP alone...

These products should espicially not be allowed in hospitals where nurses have five different pain orders (darvocet, norco, tylenol, etc) and give 1 of each at different times even though it always says no more than 4 grams on the pyxis
 
bigpharmD said:
Please tell us what this purpose is. IT has been shown many times that these combo products work no better than the narcotic alone...and in the case of darvocet it works no better than APAP alone...

These products should espicially not be allowed in hospitals where nurses have five different pain orders (darvocet, norco, tylenol, etc) and give 1 of each at different times even though it always says no more than 4 grams on the pyxis
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Because a straight Oxycodone tablet can ground up and injected or snorted and a combo product cant.....
 
Old Timer said:
Because a straight Oxycodone tablet can ground up and injected or snorted and a combo product cant.....
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well it can. And people do it.

the people who shoot up pills aren't exactly worried about purity.
 
bigpharmD said:
Please tell us what this purpose is. IT has been shown many times that these combo products work no better than the narcotic alone...and in the case of darvocet it works no better than APAP alone...</p>
<p>&nbsp;</p>
<p>These products should espicially not be allowed in hospitals where nurses have five different pain orders (darvocet, norco, tylenol, etc) and give 1 of each at different times even though it always says no more than 4 grams on the pyxis
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Sorry, I should have been more clear. I meant that the acetaminophen content is present as a drug abuse deterrent (similar to atropine in Lomotil). When the narcotic component is present in a specific ratio to the acetaminophen (can't remember the value off the top of my head), the combination product can be listed as a C-III.

I agree with you about the therapeutics, at best, they're barely more useful than narcotic alone. At worst, they're an accident waiting to happen.
 
Old Timer said:
Because a straight Oxycodone tablet can ground up and injected or snorted and a combo product cant.....
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I bet people in WV wouldn't mind a line of hydrocodone/acetaminophen....why can the combo not be crushed and snorted?
 
WVUPharm2007 said:
You don't know some of the hillbillies in WV. These dudes would get the opiate isolated in solution, distill, and inject...
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Damn, I honestly didn't see that you had already responded to this before posting above....
 
Old Timer said:
Because a straight Oxycodone tablet can ground up and injected or snorted and a combo product cant.....
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Please consult google about cold water extraction... combinations have not deterred drug addicts for a while
 
Old Timer said:
I will bet you all a jelly doughnut that the end result will be:

Any combo with more than 325 mg of Acetaminophen will be withdrawn from the market. Vicodin, Vicodin ES, Vicodin HP all Lortab products Percocet 7.5/500 and Percocet 10/650. This gives them the cover to boot Darvocet-N 100 and generics off the market as well.

The Norcos of the world will remain and the Vicodin & Lortabs will suddenly be re-formulated.....

As for OTC's Tylenol Extra Strength is a goner as will any products containing more than 325mg per dose. They may allow the 650 as a single dose.....
Click to expand...

Although I see the logic behind the combination products [vicodin...], The only people I see getting an advantage from OTC drugs being reduced would be the drug companies. Even if they remove Tylenol Extra Strength patients will still be in pain and will take 4 or 5 regular strength tylenol to relieve it. That, in essence, isn't going to reduce the liver damage statistics, but make the drug companies more money.
 
I think all of you are getting hysterical over nothing...this is an advisory panel that is recommending this, NOT the FDA. The FDA has the power to do what it wants and the FDA has gone against the panel's recommendations many times in the pass. Believe me, Ortho will do everything they can to keep their product on the market.
 
It makes it mare difficult and too much apap screws with your liver. I didn't say it was fool proof. It just less likely to be abused than straight oxy tabs.
 
Maybe it'd cut down on liver injuries, but it's not going to make the slightest bit of difference WRT drug abuse.
 
67echo said:
I think all of you are getting hysterical over nothing...this is an advisory panel that is recommending this, NOT the FDA. The FDA has the power to do what it wants and the FDA has gone against the panel's recommendations many times in the pass. Believe me, Ortho will do everything they can to keep their product on the market.
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I am pretty sure everyone already knew this was a recommendation by the panel as of now and not a ruling from the FDA. More often than not the FDA follows the panel's recommendations.
 
67echo said:
I think all of you are getting hysterical over nothing...this is an advisory panel that is recommending this, NOT the FDA. The FDA has the power to do what it wants and the FDA has gone against the panel's recommendations many times in the pass. Believe me, Ortho will do everything they can to keep their product on the market.
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it is not many times...
 
67echo said:
I think all of you are getting hysterical over nothing...this is an advisory panel that is recommending this, NOT the FDA. The FDA has the power to do what it wants and the FDA has gone against the panel's recommendations many times in the pass. Believe me, Ortho will do everything they can to keep their product on the market.
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Actually, it is not as often as you claim, but seems to have happened several times recently (bevacizumab in breast cancer, which should not have been approved, whatever). Last time I read a figure, the FDA goes with the recommendations of advisory committees greater than 90% of the time.
 
Priapism321 said:
Actually, it is not as often as you claim, but seems to have happened several times recently (bevacizumab in breast cancer, which should not have been approved, whatever). Last time I read a figure, the FDA goes with the recommendations of advisory committees greater than 90% of the time.
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Based on previous research I did as a student, I would say the FDA goes with the panel findings about 80% of the time. I think 20% is "many" but the word is subjective.
 
Pharmavixen said:
Maybe it'd cut down on liver injuries, but it's not going to make the slightest bit of difference WRT drug abuse.
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You are wrong here. Anything you do to make it more difficult to use will decrease use or shift the usage to another area. All you have to do is look at Paregoric. Before Paregoric, there was Tincture of Opium. This was a wildly popular drug until the junkies figured out instead of swallowing the teaspoonful, you could put a cigarette lighter under it and evaporate away the water and alcohol and leave you with a spoon of powdered opium. Fine for injecting.

Along comes Paregoric (OTC until 1973) which is much less concentrated but also contains camphor. Nobody is evaporating off the liquid to get the opium, because injecting the camphor will kill you.
 
This is an interesting subject. Leaving aside the subject of drug addiction for the time being, let's move to prescribing of these types of medication, specifically Vicodin.

Vicodin is usually prescribed for a variety of different pains, as you all know, I'm sure. The question then becomes....SHOULD it be? Many studies have shown that regular Motrin works better in bone pain (such as for a broken bone) than Vicodin or similar drugs. Yet, instead of sending you home with a prescription for 800 mg Ibuprofin, they send you home with a prescription for a narcotic. When I broke a bone they gave me 200 Vicodin! That's outrageous! Maybe we should change the way these drugs are prescibed, and then drug addiction won't be such an issue as there will be much less of it on the street.
 
Pharmavixen said:
Maybe it'd cut down on liver injuries, but it's not going to make the slightest bit of difference WRT drug abuse.
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agreed👍

kinda sad, but there are lax dr's and lax rph's out there. anyone ever fill a a script for #360 oxycontin 160mg?
 
Carboxide said:
This is an interesting subject. Leaving aside the subject of drug addiction for the time being, let's move to prescribing of these types of medication, specifically Vicodin.

Vicodin is usually prescribed for a variety of different pains, as you all know, I'm sure. The question then becomes....SHOULD it be? Many studies have shown that regular Motrin works better in bone pain (such as for a broken bone) than Vicodin or similar drugs. Yet, instead of sending you home with a prescription for 800 mg Ibuprofin, they send you home with a prescription for a narcotic. When I broke a bone they gave me 200 Vicodin! That's outrageous! Maybe we should change the way these drugs are prescibed, and then drug addiction won't be such an issue as there will be much less of it on the street.
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Wow, I disagree. You act as if Ibuprofen 800mg is without side effects. GI side effects, nephrotoxic effects, raise BP, etc.... I prefer narcotic analgesics any day of the week...
 
Old Timer said:
Wow, I disagree. You act as if Ibuprofen 800mg is without side effects. GI side effects, nephrotoxic effects, raise BP, etc.... I prefer narcotic analgesics any day of the week...
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Oh, it certainly is - but it doesn't have the addiction effects, is what I meant. AND it's more effective.
 
Carboxide said:
Oh, it certainly is - but it doesn't have the addiction effects, is what I meant. AND it's more effective.
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Almost nobody gets addicted from one rx of even 200 Vicodin.....
 
Old Timer said:
Almost nobody gets addicted from one rx of even 200 Vicodin.....
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I see what you're saying, and I hope you can understand that the point I was making is that it's grossly overprescribed, which leads to addiction and accessibility as a street drug.
 
Carboxide said:
I see what you're saying, and I hope you can understand that the point I was making is that it's grossly overprescribed, which leads to addiction and accessibility as a street drug.
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We are in agreement. It is grossly over prescribed......
 
Old Timer said:
I will bet you all a jelly doughnut that the end result will be:

The Norcos of the world will remain and the Vicodin & Lortabs will suddenly be re-formulated.....
Click to expand...

The first thought that went through my head when I heard about this was that the drug industry must have the FDAs ear. I know that they are involved in the committee in some capacity.

Like you mentioned, the result of this will be new dosages on hydrocodone/APAP combos and consequently, newly patented brands.
 
JWells488 said:
The first thought that went through my head when I heard about this was that the drug industry must have the FDAs ear. I know that they are involved in the committee in some capacity.

Like you mentioned, the result of this will be new dosages on hydrocodone/APAP combos and consequently, newly patented brands.
Click to expand...

I wonder, should I try to patent Farmodin 2.5/250? Or maybe 3.75/375?:idea:
🙄
 
Old Timer said:
You are wrong here. Anything you do to make it more difficult to use will decrease use or shift the usage to another area. All you have to do is look at Paregoric. Before Paregoric, there was Tincture of Opium. This was a wildly popular drug until the junkies figured out instead of swallowing the teaspoonful, you could put a cigarette lighter under it and evaporate away the water and alcohol and leave you with a spoon of powdered opium. Fine for injecting.

Along comes Paregoric (OTC until 1973) which is much less concentrated but also contains camphor. Nobody is evaporating off the liquid to get the opium, because injecting the camphor will kill you.
Click to expand...
Interesting stuff. But addictions will be as rampant as ever.

Where I live, Oxycontin has replaced heroin as the #1 opioid of abuse. Thirty years ago, addicts were injecting heroin. Now they're injecting (or chewing) oxys. Six of one, half a dozen of...like that.
 
Kirbypuff said:
agreed👍



kinda sad, but there are lax dr's and lax rph's out there. anyone ever fill a a script for #360 oxycontin 160mg?
Click to expand...

I got one for #420 oxycontin 40mg today
4 tabs 5x/day Ok to fill early pt is going on vacation
 
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