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Generic Versions of Lamictal?


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#301 In_Remission_madcap

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Posted 04 June 2009 - 08:09 PM

I contracted SJS a month after switching to Dr. Reddy's from brand. I had been on GSK's version for five years with Zyprexa but without episodes. I was so upset I cried in the pNP's office. Of course, I was on prednisolone to get rid of the rash, and I didn't know it threw emotions for a loop. She informed me that only four other people in her practice had contracted SJS after being on Lamictal for a protracted amount of time.

I did notice, however, that the Dr. Reddy's seemed to fight with Zyprexa for hunger cravings, i.e., LTG caused me to not be hungry after the AM dose, but Zyprexa caused me to be hungry, as normal, in the PM dose.

Lithium seems to be working in place of the Lamictal/LTG, and is cheaper.

Boo, Dr. Reddy's POS.




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#302 quiet storm

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Posted 06 June 2009 - 10:57 AM

Any experience with the zydus generic brand? I've been rolling with the teva generic for a while at 200mg. Just got my new mail order prescription today and its zydus instead of teva. A white round tablet instead of the blue diamond shape the teva brand has

Edited by quiet storm, 07 June 2009 - 08:20 PM.

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#303 cherries

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Posted 16 June 2009 - 07:41 PM

pdoc just started me on it and he refuses to prescribe Teva. I called Walgreen and they carry another generic of it called Tora or Tara, I believe. They ordered it for me. Pdoc just says teva does not work.

Edited by cherries, 27 June 2009 - 10:41 AM.

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#304 Jerod Poore

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Posted 17 June 2009 - 02:49 PM

I contracted SJS a month after switching to Dr. Reddy's from brand. I had been on GSK's version for five years with Zyprexa but without episodes.

[...]

Boo, Dr. Reddy's POS.


As much as I hate Dr. Reddy's myself I doubt if it had anything to do with SJS. Sometimes SJS will strike out of the blue after taking Lamictal for five years or longer. Unless you had to increase your dosage because of the switch, you would have been getting less lamotrigine, not more. If you did increase your dosage, then it could have been just enough to trigger SJS, as would an increase in brand Lamictal have done if you needed it.
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#305 cherries

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Posted 17 July 2009 - 07:42 AM

My pdoc office gave me a card that saves me $25 I think on each script so I only pay $20 for the brand Lamictil, at least for the next 6 months. maybe they will have another card after that .
I have had to lower my dose on the lamictil b/c I am just bizarre manic, I was yelling at my pdoc. he gave me topamax and keppa. I can try both, one at a time to see which works. I have to find something to calm me down, I am ready to do some truly bizarre stuff.

Edited by cherries, 17 July 2009 - 10:17 AM.

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#306 funkycrayon

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Posted 29 July 2009 - 07:11 PM

tell me if i'm crazy...

i'm on my second time with lamictal. the first time was on 200mgs of the name brand. the hair loss was really bad even at lower doses, and i ended up actually going off of it. a few months back, pdoc convinced me to try it again, this time to complement the lithium i was already on. i've been taking 100mgs of the generic up to one week ago, with no problems at ALL with hair loss. weird, i know.

so it gets weirder. i forgot i had some 200mg tablets left over from before, so instead of getting a refill i started cutting those in half exactly one week ago. now my freaking hair is starting to fall out again! is this even possible, that i wouldn't have this s/e with the generic but i do with brand? or maybe the 200 mgs tablets are different than 100s? i suppose i could be imagining it, but i don't think so. since my brush with baldness, i fall just short of actually counting how many strands of hair are in the shower drain every morning.

should i throw away these 200mg brand name pills? or is it a coincidence that i'm noticing this now? i can't think of anything else that has changed in the last couple of weeks.

thanks...
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#307 Brooke

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Posted 30 July 2009 - 09:53 AM

generic medications in whatever form are made of exactly the same ingrediants as the
non generic version its just that they are cheaper as there made by different pharmacuetical
companys.they have to be the same ingrediants or they wouldnt work.


well something is different or people wouldn't be reacting so badly, myself included. pdoc said legally they can be 15% less than the brand.
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#308 Brooke

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Posted 30 July 2009 - 10:16 AM

Since I had to go back to brand Lamictal due to HORRIBLE fatigue and sleepiness, my doctor told me the pharm rep visited him this week and said there is a new kind of Lamictal for people who can't swallow or something like that - I missed those details, but it melts in your mouth. So maybe a way to get brand w/o paying the high price - since there is no generic equivalent - yet.
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#309 notfred

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Posted 30 July 2009 - 02:03 PM

SmithKlein Beechum is making Lamictal XR, a time release formulation and Lamictal ODT, an orally dispersing tablet.

nf
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Dx: Major Depressive Disorder, Attention Deficit Disorder PI, Refractory Insomnia, CSA, Temporal Lobe Epilepsy, Dyspraxia, Tremor
Psyc meds: Aplenzin 522 mg, Abilify 15 mg, Vyvanse 70 mg, Lunesta 6 mg, Levetiracetam 2000 mg, Propranolol ER 60 mg
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I am in full remission (296.36) from Depression. ADD, insomnia, Epilepsy, and the Pseudoparkinsonian tremor are well controlled.

 

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#310 Brooke

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Posted 31 July 2009 - 06:35 AM

SmithKlein Beechum is making Lamictal XR, a time release formulation and Lamictal ODT, an orally dispersing tablet.

nf


Oh, I thought it would be GSK. But it won't be like a generic will it? It will be as good as GSK's Lamictal? Sorry, I don't understand the pharmaceutical business.
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#311 notfred

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Posted 31 July 2009 - 08:06 AM

http://www.accessdat.../ob/default.cfm
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Dx: Major Depressive Disorder, Attention Deficit Disorder PI, Refractory Insomnia, CSA, Temporal Lobe Epilepsy, Dyspraxia, Tremor
Psyc meds: Aplenzin 522 mg, Abilify 15 mg, Vyvanse 70 mg, Lunesta 6 mg, Levetiracetam 2000 mg, Propranolol ER 60 mg
Other: Fenofibrate, Atorvastatin, Lisinopril, Hctz, Asprin, Metformin, Januvia, Ranitidine, Cetirizine, Nasalide, Montelukast
PRN's: Lorazepam, Alprazolam, Dextroamphetamine, Propranolol, Cyproheptadine, Patanol, Prednisone, Ipratropium, Ondansetron, Hydrocodone, Doxepin
Supplements: Fish Oil 6 g, Multi-vitamin/mineral, vitamin D 1,500 IU

I am in full remission (296.36) from Depression. ADD, insomnia, Epilepsy, and the Pseudoparkinsonian tremor are well controlled.

 

J'ai seul la clef de cette parade sauvage.
Arthur Rimbaud, Les Illuminations, Parade

"I think you are on enough medications." --my pdoc
 

Dr. Frankenstein: You know, I'm a rather brilliant surgeon. Perhaps I can help you with that hump.

Igor: What hump?

 


#312 Jerod Poore

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Posted 31 July 2009 - 11:52 AM

SmithKlein Beechum is making Lamictal XR, a time release formulation and Lamictal ODT, an orally dispersing tablet.

nf


Oh, I thought it would be GSK. But it won't be like a generic will it?


They're both GSK brand Lamictal. SmithKlein Beechum is a pre-merger entity.

This has got to be either the best-laid patent-extension strategy in the history of pharmaceuticals, or the most brilliant idea someone at GSK's R&D department ever had. Think about it: GSK produces a medication in a shape that is really, really difficult to swallow. Then as soon as it goes generic they come out with a version that disintegrates. I bet if you put 25mg in your mouth and let them melt they'd be 100% bioequivalent to swallowing them, because those suckers disintegrate on me all the time and I've never had a problem. The blackcurrant-flavored wafers have been around since forever. So they've just been waiting.

Here it is, from the updated PI sheet:

LAMICTAL ODT Orally Disintegrating Tablets are formulated using technologies (Microcaps®* and AdvaTab®*) designed to mask the bitter taste of lamotrigine and achieve a rapid dissolution profile. Tablet characteristics including flavor, mouth-feel, after-taste, and ease of use were rated as favorable in a study of 108 healthy volunteers.


That's what they were working on, something to deal with the taste that everyone was bitching about! Looks like they started late 2007, early 2008. The AdvaTab stuff wasn't used for anything until around 2006. OK, GSK wasn't holding out on anyone. They may have had the idea sooner, and even had some failures, but couldn't go anywhere with the stuff they're using now it until recently.

As for the XR version, it has to have its own PI sheet.

LAMICTAL XR Extended-Release Tablets contain a modified-release eroding formulation as the core. The tablets are coated with a clear enteric coat and have an aperture drilled through the coats on both faces of the tablet (DiffCORE™*) to enable a controlled release of drug in the acidic environment of the stomach. The combination of this and the modified­release core are designed to control the dissolution rate of lamotrigine over a period of approximately 12 to 15 hours, leading to a gradual increase in serum lamotrigine levels.


Just like the old version of Tegretol XR. I'm too out of it to want to read how a cross-taper with Depakote or Tegretol is going to work with Lamictal XR.
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Current meds: lamotrigine 300mg, topiramate 325mg, buspirone 60mg, protriptyline 60mg, EPA 600mg, methylphenidate 5-10mg, lorazepam 1mg PRN
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#313 SoLongThanksForAllTheFish

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Posted 31 July 2009 - 03:01 PM

I started out on Teva's lamotrigine. I liked the initial effects but as I titrated up I found it worked better some days and not others. At first I attributed this to cycling.

I entered the blackest depression late in February, and couldn't figure out the cause. With my wife's help I realized it started the day I filled my last lamotrigine prescription, and theorized there might be quality issues with the generic e.g. inconsistent effectiveness even among pills in the same lot.

pdoc wrote a brand-name lamictal prescription which stabilized my mood in a couple of days. I haven't had trouble since switching to the brand name. pdoc went so far as to file a report on my experience (had me get the manufacturer, lot #, etc.)

I haven't had trouble with Teva's other generics (gabapentin. mirtazapine) but I'm not impressed with the lamotrigine.
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#314 SoLongThanksForAllTheFish

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Posted 31 July 2009 - 04:05 PM

I posted on my experience with lamotrigine in the brand vs. generic forum, but to summarize the generic didn't help my bipolar depression, irritibility, etc. and I had to switch to Lamictal brand.

I find the Lamictal somewhat activating; I can see where it would cause some people to become hypomanic or manic.
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#315 Brooke

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Posted 05 August 2009 - 01:23 PM

Hello again... sorry for all the questions... I've had such a time with the switch from brand to generic and back to brand!!

To try to make it as short as possible, I switched to generic b/c of cost. Started feeling extreme fatigue and sleepiness. Stayed on generic for 3 weeks. I even tried taking it before bed to see if it would help with the daytime sleepiness, but it didn't. I switched back to brand to see if it was the generic making me so tired. Within one day of switching back to the brand, I wasn't tired anymore. BUT what I am experiencing is problems with my mood. I'm irritable and depressed again. It's not extreme, but not good either. Could all this switching have messed me up? It is so frustrating. If Lamictal is that sensitive... !?!?

I don't know if this will make any difference, but the first time I took Lamictal, I took it after having my first child - PPD. It worked great, and I only took 50 mg. I stopped taking it when I got pregnant with my 2nd child, and when I started again, 50 mg was not enough. Now I am on 75 and was feeling good until all the switching around.

:mad: !!!!!!!!!!!!

Oh, I also wondered if Lamictal stays in your system, working all the time or if it works best right after you take it, then wears off till you take it the next time.

If this doesn't have to do with the switching around generic/brand, is it normal to have to increase the dosage after taking it for a while? I've been on it since the end of March.

Edited by Brooke, 05 August 2009 - 01:39 PM.

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#316 Brooke

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Posted 05 August 2009 - 01:36 PM

SmithKlein Beechum is making Lamictal XR, a time release formulation and Lamictal ODT, an orally dispersing tablet.

nf


Oh, I thought it would be GSK. But it won't be like a generic will it?


They're both GSK brand Lamictal. SmithKlein Beechum is a pre-merger entity.

This has got to be either the best-laid patent-extension strategy in the history of pharmaceuticals, or the most brilliant idea someone at GSK's R&D department ever had. Think about it: GSK produces a medication in a shape that is really, really difficult to swallow. Then as soon as it goes generic they come out with a version that disintegrates. I bet if you put 25mg in your mouth and let them melt they'd be 100% bioequivalent to swallowing them, because those suckers disintegrate on me all the time and I've never had a problem. The blackcurrant-flavored wafers have been around since forever. So they've just been waiting.

Here it is, from the updated PI sheet:

LAMICTAL ODT Orally Disintegrating Tablets are formulated using technologies (Microcaps®* and AdvaTab®*) designed to mask the bitter taste of lamotrigine and achieve a rapid dissolution profile. Tablet characteristics including flavor, mouth-feel, after-taste, and ease of use were rated as favorable in a study of 108 healthy volunteers.


That's what they were working on, something to deal with the taste that everyone was bitching about! Looks like they started late 2007, early 2008. The AdvaTab stuff wasn't used for anything until around 2006. OK, GSK wasn't holding out on anyone. They may have had the idea sooner, and even had some failures, but couldn't go anywhere with the stuff they're using now it until recently.

As for the XR version, it has to have its own PI sheet.

LAMICTAL XR Extended-Release Tablets contain a modified-release eroding formulation as the core. The tablets are coated with a clear enteric coat and have an aperture drilled through the coats on both faces of the tablet (DiffCORE™*) to enable a controlled release of drug in the acidic environment of the stomach. The combination of this and the modified­release core are designed to control the dissolution rate of lamotrigine over a period of approximately 12 to 15 hours, leading to a gradual increase in serum lamotrigine levels.


Just like the old version of Tegretol XR. I'm too out of it to want to read how a cross-taper with Depakote or Tegretol is going to work with Lamictal XR.


Great info. Thanks so much. Am I understanding right - there are 2 new formulas of Lamictal - ODT and XR?

GSK is definitely doing well for itself with this - I'd think lots of people would go on the new one. I will just to get around insurance, and I'm sure I'm not the only one!

Really appreciate you taking the time to explain it to me.
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#317 mj1127

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Posted 05 August 2009 - 01:53 PM

Those blackcurrant flavored orally dispersable ones are available as generic, so the insurance companies might not see it as as a "brand without generic equivalent". I got the Dr. Reddy's ones by mistake once.
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#318 notfred

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Posted 05 August 2009 - 02:31 PM

I doubt insurance will pay for either of these new formulations.


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Dx: Major Depressive Disorder, Attention Deficit Disorder PI, Refractory Insomnia, CSA, Temporal Lobe Epilepsy, Dyspraxia, Tremor
Psyc meds: Aplenzin 522 mg, Abilify 15 mg, Vyvanse 70 mg, Lunesta 6 mg, Levetiracetam 2000 mg, Propranolol ER 60 mg
Other: Fenofibrate, Atorvastatin, Lisinopril, Hctz, Asprin, Metformin, Januvia, Ranitidine, Cetirizine, Nasalide, Montelukast
PRN's: Lorazepam, Alprazolam, Dextroamphetamine, Propranolol, Cyproheptadine, Patanol, Prednisone, Ipratropium, Ondansetron, Hydrocodone, Doxepin
Supplements: Fish Oil 6 g, Multi-vitamin/mineral, vitamin D 1,500 IU

I am in full remission (296.36) from Depression. ADD, insomnia, Epilepsy, and the Pseudoparkinsonian tremor are well controlled.

 

J'ai seul la clef de cette parade sauvage.
Arthur Rimbaud, Les Illuminations, Parade

"I think you are on enough medications." --my pdoc
 

Dr. Frankenstein: You know, I'm a rather brilliant surgeon. Perhaps I can help you with that hump.

Igor: What hump?

 


#319 Anna

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Posted 05 August 2009 - 08:05 PM

Lamictal is pretty sensitive, so yes, the switching could have messed you up. I'd give it a few weeks to see if everything evens out again.

Anna
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#320 SoLongThanksForAllTheFish

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Posted 06 August 2009 - 04:56 AM

I had trouble with the generic. I had to switch to the brand name. I found it much more effective.

Switching back and forth could cause mood instability. If you stick with the brand name for a while things might straighten out.

75 mg is still a low dosage and you may need to increase. I didn't get a complete effect until around 175-200 mg.

I also found there was a "wearing off" effect. I ended up splitting the Lamictal into 2 dosages, once around 6AM when I woke up, and another around 2pm. I also found it was more effective to take it an hour away from meals (either before or after).

Edited by Bones, 06 August 2009 - 06:31 AM.

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#321 Brooke

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Posted 06 August 2009 - 10:48 AM

I had trouble with the generic. I had to switch to the brand name. I found it much more effective.

Switching back and forth could cause mood instability. If you stick with the brand name for a while things might straighten out.

75 mg is still a low dosage and you may need to increase. I didn't get a complete effect until around 175-200 mg.

I also found there was a "wearing off" effect. I ended up splitting the Lamictal into 2 dosages, once around 6AM when I woke up, and another around 2pm. I also found it was more effective to take it an hour away from meals (either before or after).


Thank you. If things don't get better, I will ask pdoc if I should increase or maybe split the dosage. I'm back to taking it at my regular time (as well as yesterday). I'm feeling better. So strange how it is with psycho drugs! :mad:
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#322 Brooke

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Posted 06 August 2009 - 10:49 AM

Lamictal is pretty sensitive, so yes, the switching could have messed you up. I'd give it a few weeks to see if everything evens out again.

Anna


Thanks. :mad:
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#323 Jerod Poore

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Posted 06 August 2009 - 12:18 PM

Great info. Thanks so much. Am I understanding right - there are 2 new formulas of Lamictal - ODT and XR?


Correct.
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Keep up with Crazymeds and my slow descent into irreparable madness boring life via your preferred social media:

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Current meds: lamotrigine 300mg, topiramate 325mg, buspirone 60mg, protriptyline 60mg, EPA 600mg, methylphenidate 5-10mg, lorazepam 1mg PRN
Past meds (likely incomplete): Abilify, clonazepam, desipramine, diazepam, Gabitril, lithium, Neurontin, Paxil, prochlorperazine, Provigil, Prozac, Risperdal, Seroquel, Serzone, Strattera, Trileptal, Zyprexa

#324 Jerod Poore

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Posted 06 August 2009 - 12:21 PM

I doubt insurance will pay for either of these new formulations.


That's all a matter of insurance company / HMO politics, pharm rep salesmanship and the consumer's luck.
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Current meds: lamotrigine 300mg, topiramate 325mg, buspirone 60mg, protriptyline 60mg, EPA 600mg, methylphenidate 5-10mg, lorazepam 1mg PRN
Past meds (likely incomplete): Abilify, clonazepam, desipramine, diazepam, Gabitril, lithium, Neurontin, Paxil, prochlorperazine, Provigil, Prozac, Risperdal, Seroquel, Serzone, Strattera, Trileptal, Zyprexa

#325 Jerod Poore

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  • Location:Saint Regis Montana

Posted 06 August 2009 - 12:28 PM

Those blackcurrant flavored orally dispersable ones are available as generic, so the insurance companies might not see it as as a "brand without generic equivalent".


Those are normally for pediatric use. they come in 2mg, 5mg and 25mg only. The only adult application 2mg and 5mg wafers have are for a retrial after SJS.
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Current meds: lamotrigine 300mg, topiramate 325mg, buspirone 60mg, protriptyline 60mg, EPA 600mg, methylphenidate 5-10mg, lorazepam 1mg PRN
Past meds (likely incomplete): Abilify, clonazepam, desipramine, diazepam, Gabitril, lithium, Neurontin, Paxil, prochlorperazine, Provigil, Prozac, Risperdal, Seroquel, Serzone, Strattera, Trileptal, Zyprexa

#326 Brooke

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Posted 07 August 2009 - 08:51 AM

I doubt insurance will pay for either of these new formulations.


That's all a matter of insurance company / HMO politics, pharm rep salesmanship and the consumer's luck.


I talked to my insurance today, and they approve a copay for Lamictal XR and Lamictal ODT (For regular Lamictal I pay the copay + the difference in cost b/w the generic and brand which = $120). When I talked to my doctor, he just mentioned the ODT, not the XR. I take 75 mg, once a day. I don't have an issue with swallowing, but I just wondered if there was any concern with the inactive ingredients in the XR or ODT. Do you know if one is better than the other? I had such a bad experience with the generic, and now my mood is unstable on brand Lamictal when before it was fine. I just don't want to mess things up any more.

Also do you know if there is a certain length of time that a patent lasts? Being able to pay a copay is going to save me a lot of money.

Thanks!
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#327 notfred

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Posted 07 August 2009 - 09:32 AM

Also do you know if there is a certain length of time that a patent lasts? Being able to pay a copay is going to save me a lot of money.

Thanks!



The Orange Book says they do not have exclusivity on either XR or ODT so anyone is free to make their own versions.
The patent on Lamictal has already expired. So far my insurance is denying coverage for XR or ODT.

nf
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Dx: Major Depressive Disorder, Attention Deficit Disorder PI, Refractory Insomnia, CSA, Temporal Lobe Epilepsy, Dyspraxia, Tremor
Psyc meds: Aplenzin 522 mg, Abilify 15 mg, Vyvanse 70 mg, Lunesta 6 mg, Levetiracetam 2000 mg, Propranolol ER 60 mg
Other: Fenofibrate, Atorvastatin, Lisinopril, Hctz, Asprin, Metformin, Januvia, Ranitidine, Cetirizine, Nasalide, Montelukast
PRN's: Lorazepam, Alprazolam, Dextroamphetamine, Propranolol, Cyproheptadine, Patanol, Prednisone, Ipratropium, Ondansetron, Hydrocodone, Doxepin
Supplements: Fish Oil 6 g, Multi-vitamin/mineral, vitamin D 1,500 IU

I am in full remission (296.36) from Depression. ADD, insomnia, Epilepsy, and the Pseudoparkinsonian tremor are well controlled.

 

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#328 quiet storm

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Posted 08 August 2009 - 03:53 PM

Lamictal XR? Is there really a need for this for a medication that has a half life of 25 hours? Smells like patent extender to me.
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#329 notfred

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Posted 08 August 2009 - 04:41 PM

Lamictal XR? Is there really a need for this for a medication that has a half life of 25 hours? Smells like patent extender to me.




For the indication of seizures the dosing is twice a day, according to the PI. I suspect the XR would be once a day.

nf
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Dx: Major Depressive Disorder, Attention Deficit Disorder PI, Refractory Insomnia, CSA, Temporal Lobe Epilepsy, Dyspraxia, Tremor
Psyc meds: Aplenzin 522 mg, Abilify 15 mg, Vyvanse 70 mg, Lunesta 6 mg, Levetiracetam 2000 mg, Propranolol ER 60 mg
Other: Fenofibrate, Atorvastatin, Lisinopril, Hctz, Asprin, Metformin, Januvia, Ranitidine, Cetirizine, Nasalide, Montelukast
PRN's: Lorazepam, Alprazolam, Dextroamphetamine, Propranolol, Cyproheptadine, Patanol, Prednisone, Ipratropium, Ondansetron, Hydrocodone, Doxepin
Supplements: Fish Oil 6 g, Multi-vitamin/mineral, vitamin D 1,500 IU

I am in full remission (296.36) from Depression. ADD, insomnia, Epilepsy, and the Pseudoparkinsonian tremor are well controlled.

 

J'ai seul la clef de cette parade sauvage.
Arthur Rimbaud, Les Illuminations, Parade

"I think you are on enough medications." --my pdoc
 

Dr. Frankenstein: You know, I'm a rather brilliant surgeon. Perhaps I can help you with that hump.

Igor: What hump?

 


#330 quiet storm

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Posted 08 August 2009 - 06:37 PM

True. I could see it helping with med compliance and convenience.

Edited by quiet storm, 08 August 2009 - 06:38 PM.

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