owlegrad

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This is not a brand/generic issue. They are trying to get propoxyphene off the market completely because it's dangerous.
Yes, but it's a voluntary withdrawal. What are the chances that every generic manufacturer will also withdraw the drug? Oh, I mean that seriously - when manufacturers of brand named products pull their drugs do generic manufacturers of said drug usually follow suit?

So what do patients who are on propoxyphene get switched to?
 

rph3664

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Lots of people really swear by it. The main toxicity risk is acetaminophen poisoning.

Here's an example. One of my friends, who does not work in health care, was given generic Darvocet after she cut off the end of her finger (slammed into a file cabinet at work) :eek: and she told me that even though she was taking the maximum dose of Darvocet (6 a day), she had some breakthrough pain and was also taking the maximum recommended dose of Tylenol.

We were on the phone, and my response nearly blew out her eardrums. She said, "Was I not supposed to do that?" and I said, "No, you weren't!" She only did it for a few days, and interestingly, her finger grew back although it doesn't look like what she was born with.
 
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Praziquantel86

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Lots of people really swear by it. The main toxicity risk is acetaminophen poisoning.

Here's an example. One of my friends, who does not work in health care, was given generic Darvocet after she cut off the end of her finger (slammed into a file cabinet at work) :eek: and she told me that even though she was taking the maximum dose of Darvocet (6 a day), she had some breakthrough pain and was also taking the maximum recommended dose of Tylenol.

We were on the phone, and my response nearly blew out her eardrums. She said, "Was I not supposed to do that?" and I said, "No, you weren't!" She only did it for a few days, and interestingly, her finger grew back although it doesn't look like what she was born with.
This "voluntary" withdrawal came after a different set of problems. The FDA article mentions a safety study that showed significant EKG changes in a large number of patients taking propoxyphene chronically, even if they were asymptomatic. So now, in addition to being an addictive drug that is no more effective than acetaminophen and has harmful toxic metabolites, it also may lead to the development of serious arrhythmias.

As far as the other generic manufacturers pulling the product off the market, I think they'll follow suit.
 

rph3664

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I do know that it was never intended for long term use. I also wonder if this would be like Serzone, where the brand was withdrawn but the generic could still be sold.
 

npage148

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I would imagine that not pulling the generic would be a liability mine field esp for something as misused and ineffective as darvocet.
 

genesis09

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If the FDA says it is time for "voluntary" withdrawal, generics better withdraw. The FDA can seize the medications. The generic companies know it is better to work with the FDA than against them. Darvocet is no more effective than regular acetaminophen.

Hopefully, this won't be as obnoxious as the oxycontin issues.
 

spacecowgirl

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We have had this out of our hospital for about a year. If people wanted to stay on it, they had to bring in their own from home.

This is going to make some people (and doctors) pretty angry, but I say - good riddance.
 

WVUPharm2007

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Now they just gonna move up to Tramadol..
 

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The withdraw is as voluntary as when a mugger points a 357 at you asks for your money.

I have never in almost 30 years of practice seen a patient with a cardiovascular event tied to propoxyphene. I also know that people will now be taking more tramadol and more hydrocodone and that is also not good.

I'm not saying it should remain on the market. I just don't think is a cause for celebration as the withdraw of this medication will force people to take other medications with their own issues some times more detrimental than propoxyphene.
 

rph3664

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Now they just gonna move up to Tramadol..
Agreed. People who take tramadol seem to be of two camps: either the side effects are so unpleasant, they refuse to take it, or they love the stuff and rapidly become addicted. And I've never heard of anyone who was ordered Stadol nasal spray who didn't get hooked on it. When I graduated in 1994, it wasn't scheduled at all! One of my friends had IV Stadol when she was in labor, and she said it was worse than useless because not only did it not relieve her pain, it made her so dopey, she couldn't verbalize how she was feeling.
 
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Sparda29

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Agreed. People who take tramadol seem to be of two camps: either the side effects are so unpleasant, they refuse to take it, or they love the stuff and rapidly become addicted. And I've never heard of anyone who was ordered Stadol nasal spray who didn't get hooked on it. When I graduated in 1994, it wasn't scheduled at all! One of my friends had IV Stadol when she was in labor, and she said it was worse than useless because not only did it not relieve her pain, it made her so dopey, she couldn't verbalize how she was feeling.
I guess I'm in the 3rd camp. I can use it PRN knee pain.
 
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And I've never heard of anyone who was ordered Stadol nasal spray who didn't get hooked on it.
That nasal spray Stadol is probably the most addictive drug I've dealt with in practice. People that get hooked on that stuff have a major problem.
 

wezvidz

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and more hydrocodone and that is also not good..
What do you see as the big negative switching Darvocet N-100 patients to Vicodin 5/500? More abuse/dependency?

I see it as a logical substitute... more effective with less toxicity. Both are scheduled, both have fall risk with the elderly, etc. I must be missing something.
 

WVUPharm2007

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What do you see as the big negative switching Darvocet N-100 patients to Vicodin 5/500? More abuse/dependency?

I see it as a logical substitute... more effective with less toxicity. Both are scheduled, both have fall risk with the elderly, etc. I must be missing something.
Darvocet is as effective as acetaminophen. Chances are, they don't really need anything stronger for pain relief than 'ol Tylenol. So now they will be asking for something they probably don't need that has a much higher ceiling for addiction and drug seeking behavior.
 

ucrx

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What, tramadol or Stadol? I'm guessing tramadol but please clarify.
Tramadol. The person earlier said that people who take tramadol are in two camps, one that gets side effects and stops the drug and another that becomes addicted.

ETA: Also, how often do you see stadol for joint pain?
 
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Praziquantel86

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The withdraw is as voluntary as when a mugger points a 357 at you asks for your money.

I have never in almost 30 years of practice seen a patient with a cardiovascular event tied to propoxyphene. I also know that people will now be taking more tramadol and more hydrocodone and that is also not good.

I'm not saying it should remain on the market. I just don't think is a cause for celebration as the withdraw of this medication will force people to take other medications with their own issues some times more detrimental than propoxyphene.
That's a good point. I think it's a perfect opportunity for the FDA to send out "Dear Doctor" letters detailing the fact that propoxyphene is no more effective than acetaminophen. Now that physicians are forced to switch to something else, it might finally work.

If it doesn't, then you're right. There will be a lot of little old ladies taking drugs that will do more harm than good.
 

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Stupid question time:

Do pharmacies get reimbursed for returning these meds to the manufacturer during a "voluntary" recall?

/stupid question time
 
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I do know that it was never intended for long term use. I also wonder if this would be like Serzone, where the brand was withdrawn but the generic could still be sold.
There are a number of drugs that indicate "not for long term use". I was made aware of one drug several years ago that is on the top of the abuse chart. Soma - maximum 21 days per product insert. Interesting. If we could only go by this recommendation maybe we could curb it's abuse.
 

MountainPharmD

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I also think Tramadol falls into two categories. Those that think it is completely worthless and those that think it works marginally okay. The group that thinks it works is a very small.

I think the only people who will be upset about propoxyphene going off the market are little old ladies.
 

Its Z

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Stupid question time:

Do pharmacies get reimbursed for returning these meds to the manufacturer during a "voluntary" recall?

/stupid question time
hmmm....good question...

Now I'm going to have to find out.... :thumbup:
 

Its Z

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I also think Tramadol falls into two categories. Those that think it is completely worthless and those that think it works marginally okay. The group that thinks it works is a very small.

I think the only people who will be upset about propoxyphene going off the market are little old ladies.

You don't get paid to think...just count and pour!


:smuggrin:
 

MountainPharmD

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You don't get paid to think...just count and pour!


:smuggrin:
Not me my friend! My techs count and pour. I stare at a computer screen all day, fold labels and put bottles into bags. Oh yeah I also get yelled at by idiot customers, idiot management and occasionally get to go to the bathroom. Oh yeah and do flus shots in between all that. It is a very great and rewarding job that I would run away from screaming if I didn't make 130k plus a year. Pretty silly when you sit down and think about it!
 

Its Z

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Not me my friend! My techs count and pour. I stare at a computer screen all day, fold labels and put bottles into bags. Oh yeah I also get yelled at by idiot customers, idiot management and occasionally get to go to the bathroom. Oh yeah and do flus shots in between all that. It is a very great and rewarding job that I would run away from screaming if I didn't make 130k plus a year. Pretty silly when you sit down and think about it!

I told you not to be doing that..
 

MountainPharmD

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I told you not to be doing that..
I try not to. I slipped a little this morning!

Oh I guess I do count and pour a little. I have to back count the C-IIs after the techs count them. So there ya go!

Its Saturday....get off SDN and go do something! Oh wait you don't care about the weekend because everyday is Saturday for you....I say it only because I am jealous.

I am off to finish staining my fence before the snow comes.
 

Its Z

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Stain the fence? What for.

Don't you have wrought iron fence? What kind of neighborhood do you live in?

Go back to Kansas!
 

Its Z

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Any of you good for nothing boys know how to unscrew a door peephole?

Yes, counter clockwise.

Actually, there should be 2 slots on the perimeter of the peep hole where you can use a wide blade screw driver or a butter knife. You might have to hold the other end (outside the door) also while turning the screw driver (inside )
 

Its Z

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:smuggrin:

What did they do...put the peephole inside out so they can see the inside from outside? Allsome idea!!!

Erin Andrews debacle/]
 

SpirivaSunrise

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Yes, counter clockwise.

Actually, there should be 2 slots on the perimeter of the peep hole where you can use a wide blade screw driver or a butter knife. You might have to hold the other end (outside the door) also while turning the screw driver (inside )
Yeah, the slots are there. But only allows you to grip and tighten clockwise. Nothing to grip counter. Screw it...I'm going with pliers.
 

Its Z

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I'm pushing 5'4" barefoot. They installed it for someone who's at least 6' tall...so I had to go out and buy a digital viewer. :mad:

Step stool would've been much cheaper.
 

Its Z

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Then you hear me set the stool down on the hard tile and that someone's there. Defeats the purpose. I've already had 2 people ring and knock on the door at like 8:30 pm after it's dark this past week...it's creepy.
mmm.. time to move to a safe suburb or get a gun.

Or do both.

Since if power goes out your camera won't work...
 

Its Z

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Get you nice tools.. I've done well with Craftsman stuff...
 

Its Z

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But when you start getting into this kinda stuff, you let me know..

 

Its Z

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you only need high torque makita for your AC/HVAC unit...


What you're looking at is an impact wrench... you'll need it if you're going to work on your red Italian Horse.
 

Sparda29

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What, tramadol or Stadol? I'm guessing tramadol but please clarify.
Tramadol. I have a torn ACL and pretty messed up cartilage so the knee can get pretty painful after a lot of standing or physical activity. I've gone through almost all the NSAID drugs which were either inadequate or too rough on the stomach.

For me, Vicodin is a placebo. Does not do a thing. Percocet results in bad nausea for me. Tramadol so far is the wonder drug. If the knee is hurting a lot, I'll take 50-100 mg, and the pain is gone. I only take it when the knee pain goes beyond a certain threshold.
 

DAW2

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so it's agreed...we take tramadol off the $4 list and make a bucketload of money for the corporate wingwangs
 

MountainPharmD

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So this would be a good time for a slick pharmaceutical comapnay to come up with something like Darvocet N-100 Light. Put like 2mg of propoxyphene in it and the same amount of tylenol in a light pink tablet and charge $700.00 for a 30 day supply. The narcotic twin of Qualaquin. The palcebo effect is real and this would work and not hurt anyone.
 
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