Best pharmacy for seizure meds (U.S.A.)??

[KarenB]

As most of us know, the FDA requires the bio-equivalent in generic drugs to be betweeen 80% to 125% (or something along that line) of the name-brand drug.

Which can be a problem if switching from name-brand to generic, or switching from one generic to another. One can end up getting quite a bit less or more of the active ingredient. So, if using generic, it's important for the pharmacy to stick with the same supplier.

So...this is our dilemma -- we're back in the States now, and need to know which pharmacies are best at NOT switching suppliers.

The pharmacies in our town are:
Rite-Aid
Walgreens
Medicine Shoppe

There's also a Walmart, but I remember having bad experiences with them in the past -- can't remember exactly what, but seemed like something to do with insurance authorization or something.

There's also a Wegman's -- not in our town, but a 20 minute drive away.

FDA regs on bioequivalency:
The statistical methodology for analyzing these bioequivalence studies is called the two one-sided test procedure. Two situations are tested with this statistical methodology. The first of the two one-sided tests determines whether a generic product (test), when substituted for a brand-name product (reference) is significantly less bioavailable. The second of the two one-sided tests determines whether a brand-name product when substituted for a generic product is significantly less bioavailable. Based on the opinions of FDA medical experts, a difference of greater than 20% for each of the above tests was determined to be significant, and therefore, undesirable for all drug products. Numerically, this is expressed as a limit of test-product average/reference-product average of 80% for the first statistical test and a limit of reference-product average/test-product average of 80% for the second statistical test. By convention, all data is expressed as a ratio of the average response (AUC and Cmax) for test/reference, so the limit expressed in the second statistical test is 125% (reciprocal of 80%).

http://www.fda.gov/Drugs/DevelopmentApprovalProcess/ucm079068.htm

 

[chmmr]

Karen, i'm no help with your question but glad to hear you got back to the states safely. How is your son doing? Hugs.

 

[BIGMAN131307]

The pharmacies in our town are:
Rite-Aid
Walgreens
Medicine Shoppe
Walmart
Wegman's

Well I can't help you too much with these.

Medicine Shoppe (never heard of)
Walmart (never tried)
Wegman's (not in my area)

But these I've dealt with for years.

Rite-Aid (used to be my main pharmacy, but over the past few years they have been going downhill fast. The pharmacy department does the bare minimum to help customers.)

Walgreens (the best pharmacy in the area. They will call-in for refills for you, call around to find products in other pharmacy's,etc.)

IMHO: Walgreens is what a real pharmacy should be. My first experience with Walgreens was in a Medical building outlet. I had an Rx for a skin cream that cost about $5. That Walgreens didn't have it in stock. They called around to other Walgreens in my area to find it. The staff in general is pleasant and helpful.

I plan on switching all my Rx's to Walgreens eventually.

 

[KarenB]

Thank you Big Man, for helpful info on pharmacies. I think I remember using Walgreens for a little while, and being pleased with them, but at the time Jon wasn't on seizure meds (just the Keto diet), so we didn't have the issue of switching suppliers..

Actually, our neurologist just sent an email that just settled the question. She prefers Wegmans (a supermarket in NY state that also has a pharmacy) for consistency and also for customer service and especially for working with families on the Ketogenic diet. She believes it's worth the 20 minute drive to the next town. But she's also decided to keep Jon on the name-brand Zonegran just so we don't have any problems with switching to generic.

Chmmr -- thanks for the hugs and asking about Jon. He is doing GREAT seizure wise -- no seizures since late January except for a couple of tiny blips after having anesthesia for an MRI (eyes rolling up in head). He is having some other issues -- a condition called Cavovarus foot which was causing a lot of pain which in turn was triggering a lot of aggression.

The doctors in Thailand thought the foot thing and the aggression thing were two different issues, so they treated him with a whole slew of anti-psychotics and eventually hospitalized him for 8 days, and he was just as mean as ever but a little sleepy. They thought the foot thing was neurological -- some sort of degenerative neuropathy. I kept telling them I thought he was in pain (he's nonverbal, mostly) and they were blowing me off on that. His foot got progressively worse, to the point that he couldn't walk, so we finally hopped a plane and flew to NY where he's being treated at the U of Rochester -- great team there. We had a 3 hour consultation with the team of neurologists (and later a 3 hour consultation with the pediatric team), and they decided that he was indeed in pain, and that the pain was probably causing the aggression. They also think that the foot thing is NOT neurological, but most likely orthopedic. So, after some testing, they decided it's probably plantar fasciitis.

So, he's been resting his foot (in a wheelchair when we leave the house), and wearing this "Wee Boot" and taking pain meds (they weaned him off all the anti-psychotics), and doing remarkably better. His aggression is about 85 to 90% resolved, and his foot is doing better as well. It's still turning in when he walks, but he's not in the obvious pain that he was in before.

 

[jyearta]

For me, I have tried all the chain drug store/pharmist.

In our little town down south we have a family drug store, the owner has helped me a lot.
I have found a compounding drug store in next town that has been great.

 

[chmmr]

I saw your posts about the aggression and the pain and antipsychotics before you left. I'm so glad your trip back got Jon some answers and some relief for both of you.