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Old 07-28-2009, 07:48 PM   #1
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Hi, can you help me with a question regarding Generics (switch) and nausea (again)

Hi, it's been some time.
In March or April 09, my doc switched me from Percocet 10/325 (30 mg daily) to OxyIR 15, 3 times daily (45 mg). I posted at that time about serious nausea I was experiencing and received some great advice about plasma levels, etc.

I adjusted to the Qualitest brand - it took a few weeks but they worked great, provided a good deal of pain relief, etc. I use one pharmacy. I put in my refill today and received Mallincrockdt brand. I've been sick all day. Just when things were going along pretty good...............

I tried Pepto Bismal (which helped during the switch from Percocet to Oxy IR) but I can't even keep that down.

I'm drinking water and may nibble a cracker - I feel like crap. I assume I will adjust to this new brand in a week or so, right? I don't want to change pharmacies - I would have to call my insurance company, etc. but I will have no choice if this carries on. Edited to add - I'm not sure I am allowed to name pharmacies (or names of Generics)...............do you think I could ask the pharmacy to order X brand for me (I don't think they'll do it as they are a national chain and the preferred pharmacy for my insurance).
Thanks in advance.
Tara

Last edited by kim46; 07-28-2009 at 07:53 PM.

 
Old 07-28-2009, 08:19 PM   #2
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Re: Hi, can you help me with a question regarding Generics (switch) and nausea (again

Oh no not someone else that got switched to the Mallin(crap) generic brand of pain meds These are notorious for being the worst generic medication out there especially for pain medications. I tried taking the Mallicradt brand of Vicodin once and ended up in minor withdrawal and they made me have nausea too. Needless to say, I don't get my Vicodin filled at CVS anymore. Most of the chain pharmacies (CVS, Walgreens, Krogers, Walmart, etc) are going to carry the absolute cheapest generic medications and there #1 favorite hands down is Mallicradt generic.

PLEASE DO NOT FILL THEM WITH THAT PHARMACY AGAIN. Find an indepent pharmacy because they usually carry better, higher quality medications even with the generics. I don't know if you are going to be able to deal with this for a whole month but don't stay on the Mallincradt brand and if you stay in withdrawal then call your doctor and tell them what is happening. keep us psted

brian

 
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Old 07-28-2009, 08:26 PM   #3
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Re: Hi, can you help me with a question regarding Generics (switch) and nausea (again

Quote:
Originally Posted by tarajb View Post
do you think I could ask the pharmacy to order X brand for me (I don't think they'll do it as they are a national chain and the preferred pharmacy for my insurance).
Absolutely.....Especially if you use an independent. They will order specific meds for you and even put your name on a bottle...Mine does.

Some large chains may not because they are often stuck with whatever their big distribution center carries. However, as you may know from reading many of my posts, I'm a very big advocate of independent pharmacies....The service level is usually much, much higher. This is just one of the areas where they will often come through for you.

From reading your post, it sounds as if you aren't responding well to one of the inactive ingredients....Some type of filler. I'd try to switch back ASAP. I fact, depending on the relationship you have with your pain Doc, you might call and ask if you can bring in your current script to exchange for a new script...And have them destroy your current meds. Then, you could take the script to be filled at a pharmacy that carries your preferred brand. PMs will allow a patient to change pharmacies when there is a problem with a med....Just have to let them know upfront first.

Hope this helps.

Take care,

Ex

 
Old 07-28-2009, 08:30 PM   #4
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Re: Hi, can you help me with a question regarding Generics (switch) and nausea (again

Thanks Brian. Gee, this is all so confusing - I did research some threads about generics and the 20% thing and all.............some say there is no difference, some say it's perceived, I just know that I am ill, much sicker than I felt when I switched to OxyIR.

I'm glad you said CVS because, yes, it is CVS. I so want to find an independent pharmacy but I have an extensive list of prescribed meds (one being a very expensive antibiotic) - the thought of starting up a new relationship with a new pharmacist makes me sick!

Do you think I can return them and ask them to call around to other CVS' for the Qualitest brand. I am not kidding you - I wouldn't be posting this if I wasn't concerned about how sick I've been today when I was fine 2 days ago. It is so strange, I just don't get it at all!
My doctor is out until next Tuesday. I will have to make do if I have to wait until I have to call him. The idea of being sick for the next couple of days is not good - I have too many commitments to attend to, ack. I should be working right now but I don't feel well enough and have instead been trying to educate myself on why I feel so different (is it all in my head? - that said, I am not well-versed enough to even know that 2 generics can be so different)............so it can't be in my head, right?
Thank you!
Tara

 
Old 07-28-2009, 08:33 PM   #5
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Re: Hi, can you help me with a question regarding Generics (switch) and nausea (again

Quote:
Originally Posted by tarajb View Post
Do you think I can return them and ask them to call around to other CVS' for the Qualitest brand.
Federal laws prohibit the return of any controlled meds. However, I would try what I suggested in my previous post about contacting the Dr...Not sure if you saw that or not.

Best of luck to you and I'm sorry you're going through this.

BTW, the 20% thing is real.

Regards,

Ex

 
Old 07-28-2009, 08:34 PM   #6
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Re: Hi, can you help me with a question regarding Generics (switch) and nausea (again

Thanks Ex, we were posting at the same time. I would have to wait until next Tuesday. Perhaps I can call the pharmacy and deal directly with them, do you think? Any chance I could go to an indy and ask them to destroy and refill - I doubt it because CVS has been paid, this sucks, I'll have to call my insurance company to see what they say or my GP - do you think my GP can negate the original script - perhaps write me up for Oxy30mg, which I can slit in half or something and then destroy these and then I can update my PM doctor when he's back next Tuesday? There is no covering doctor for PM.
Arrrghhh.
Tara

 
Old 07-28-2009, 08:38 PM   #7
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Re: Hi, can you help me with a question regarding Generics (switch) and nausea (again

Thanks Ex, I just typed this long reply and it's gone.

In a nutshell - since my PM doctor is not available for a week and there is no covering doctor, I can call my GP, ask for what? Perhaps I can get by percocet 10 for the week. Or Vicodin - I am really confused as to what to do because PM doctor is unavailable for 7 days.
Thanks.
Tara

PS: I've read so many differing views on the 20%. I am going to stick with your extensive experience and agree that it is real then.

That said, I think the problem is the fillers or something because I've adjusted to my new Oxy IR dose. I hope I am making sense.
Tara

 
Old 07-28-2009, 08:44 PM   #8
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Re: Hi, can you help me with a question regarding Generics (switch) and nausea (again

Given how serious you are describing things, I would either try to get in touch with your PM or your GP and inquire about an exchange and destroy type thing....You bring in your meds for them to destroy and they give you a new script in return. I guess the big issue for you is how your PM will perceive this since he is out of town and I'm guessing is the originator of your script.

Once you get your new script, you could either ask CVS to get the other brand, or go to an indy...Or another chain for that matter. I would call CVS ahead of time and ask to speak to the PIC (pharmacist in charge) and see if they can get your preferred brand in ASAP. If so, then it would be a much easier process since you already use them. If other stores of theirs carry it and it's stocked at their MDC, then they should be able to get it in 24 hours or less. Or it's also very possible that another CVS within driving distance already has it.

As far as your insurance goes, they may not pay for the second script since according to their records, you will still have a number of days supply left. They probably won't care about your reaction thing...They will say you shouldn't have such a thing and that their system shows the med as compatible and approved by the FDA. A bunch of bunk, but it will be their way out. However, you could pay cash for it, and given that it's a generic, it can't be that expensive. Just because insurance denies it, doesn't mean you can't pay cash. Because there is a ton of competition in the oxycodone line, prices are very cheap.

Last thing....When you go to get this new script filled, you might want to take a note with you from the Doc explaining what is going on.....Because when they run the script through and if denied, it will pop us as just being filled, and the pharmacist may deny it thinking you just got another script filled. Taking a short note with you, or having the Doc call, will prevent this from happening.

Hope this helps, and again, I'm sorry.

My best,

Ex

Last edited by Executor; 07-28-2009 at 08:48 PM.

 
Old 07-28-2009, 08:55 PM   #9
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Re: Hi, can you help me with a question regarding Generics (switch) and nausea (again

Oh Dear, thanks Ex, I now have a major headache, I'm not kidding. How can I have such a serious adverse reaction so quickly? I will call my GP first thing tomorrow - he is my doctor of choice and coordinates all of my medications. He prefers that I get the Pain Meds from a certified pain med doctor. In this case, he will help me out, I'm sure. He'll figure out what to do for the week. I may have to ask him to cover me for the month because my pain management doctor is a bit difficult to deal with (he's older and has a heavy foreign accent, though highly qualified per his certifications, I get frustrated with him often (quietly) because it's hard to have a conversation with him at times). I do have an outstanding relationship with his office manager though and I can call the Chiropractor at the PM office as well.

Thanks. At least I know it's not in my head - I don't think I'm in withdrawals - I could be and also be having a bad reaction to the brand entirely.
I had better try to get some rest - thank you both for your prompt and quick replies because I am feeling very nervous on top of everything.
Thank you.
Tara

 
Old 07-28-2009, 09:16 PM   #10
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Re: Hi, can you help me with a question regarding Generics (switch) and nausea (again

Quote:
Originally Posted by tarajb View Post
Oh Dear, thanks Ex, I now have a major headache, I'm not kidding. How can I have such a serious adverse reaction so quickly?
It's hard to say without knowing more detail...Could be WD. Or, it could the opposite....Could be too much. Remember, generics can be +/- 20%....A 20% increase, or something along those lines, could make you have an upset stomach, headache and etc. Doesn't take much of an increase, or decrease, to foul things up. I would have to know more detail in order to provide a specific answer.

I think at this point, it's best to contact your Doctor and figure out a plan until your PM gets back. Probably not best to continue on like this for a week or more. Your Doc will know best.

Lastly, I know you've got a lot going on and you say your head is spinning....Please remember that whatever you do, to either clear it with your PM, or have a good feeling that it won't be a problem. Obviously, you know your Docs best, but keep all the lines of communication open and document.

Best of luck to you and I hope you feel better.....SOON.

Regards,

Ex

 
Old 07-28-2009, 09:32 PM   #11
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Re: Hi, can you help me with a question regarding Generics (switch) and nausea (again

Thanks Ex, I do have a good relationship with PM doctor - he will have no problem with me seeing the GP.

This whole mess started with my insurance company when I asked for Brand Percocet in April 08. The PM doctor ordered brand, I had no issues with the pharmacy and brand but my insurance company balked and demanded to know why I couldn't have a generic so I caved on the percocet and agreed to fill it generically - it was so embarrasing - they wrote a letter to all of my doctors (OB, GP, PM) and listed all of my meds in their insistence to get me on generics. I take brand Valium (and have for many years for anxiety) and my doctor refused to change to generic (strange! it just hit me that he wouldn't change the valium). Everything else is generic except for the antibiotic I have just been prescribed for another condition (which is so expensive, I am shocked). I think my insurance company pays upwards of $1K per month for valium and antibiotic and I had to involve high level insurance managers to straighten the mess out - it was humiliating. Luckily for me the insurance manager's wife suffered from the exact same issues I deal with and made life much easier for me - my treatments have not been denied, etc., etc.

Talk about jumping through hoops. There could be a problem with the new Oxy and the Antibiotic, but I've been on the Antibiotic for 2 months now, and had NO problems with it and the Qualitest.
Thanks again, good night, I will post an update.
Tara.

 
Old 07-28-2009, 10:30 PM   #12
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Re: Hi, can you help me with a question regarding Generics (switch) and nausea (again

Quote:
Originally Posted by tarajb View Post

Thanks again, good night, I will post an update.
No problem....Glad to help. Keep me posted.

Regards,

Ex

 
Old 07-29-2009, 12:18 PM   #13
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Re: Hi, can you help me with a question regarding Generics (switch) and nausea (again

I would suggest asking your doctor for low dose Percocet because at least it would help out with the lower dosage. Just think if that Mallicradt brand has 20% less active ingredient you could possibly be dropping from 45mg/day to 36mg/day and that would definitely put you into withdrawal. However, if you were to supplement with say 2 Percocet, it would bump things back up to normal hopefully. I highly, highly doubt that CVS is going to order a different generic medication. I am sure that ALL of the CVS stores in your area are probably being switched to the Mallicradt generic for this. I can tell you that they use the same generic brand for their Vicodin too. I switched to an indepent pharmacy for that and get the Watson generic (SO much better).

brian
p.s. I went to pick up my Duragesic patches last night from CVS and they had filled them with the generic MYLAN brand. I absolutely refused those and told them to fill with the Duragesic brand (I had even given them the coupon for Duragesic and my doctor had written Duragesic on the script this time) - freekin idiots!!!!!!!!!

 
Old 07-29-2009, 12:27 PM   #14
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Re: Hi, can you help me with a question regarding Generics (switch) and nausea (again

Quote:
Originally Posted by brianpain33 View Post

I went to pick up my Duragesic patches last night from CVS and they had filled them with the generic MYLAN brand. I absolutely refused those and told them to fill with the Duragesic brand (I had even given them the coupon for Duragesic and my doctor had written Duragesic on the script this time) - freekin idiots!!!!!!!!!
Wow...That would be a big difference! Good thing you caught it as controlled med aren't returnable.

Ex

 
Old 07-29-2009, 02:07 PM   #15
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Re: Hi, can you help me with a question regarding Generics (switch) and nausea (again

I don't know if you have Hy-Vee stores in your area, but if you do and an independant isn't available you might try them. I had excellent service from them before I moved, and the new one I changed to after my pharmacy nightmare has been working out well.

I hope you are able to get everything straightened out today.

Tigg.

 
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