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Unread 06-01-2011, 06:15 AM   #1
gotoffmdone
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Default TEVA's vs Roxane's 2mg Generic Subutex..what I learned today

Sometime back, I recall a thread that spoke about someone who had switched from brandname Suboxone to the generic form of Subutex only to find that it did not work as well for him. If I am not mistaken the post also started referring to the different generic companies and the writer was convinced that one generic brand was much better than another. I can't recall if this particular poster was takinn the 2mg Sub tablets or the 8mgs Sub tablets.

It seems as though I do recall one the generic makers of Subutex was a company that went by the name of TEVA and one byt he name of Roxane. This comversation I am speaking of may have occured somwhere in that post or another, I'm just bot sure.

I did peak my interest a bit because I, too, thought I noticed somewhat of a difference when I started taking the generic Subutex 8mgs. It wasn't that much of a difference at that doseage, so I really never talked about it. For the past six months or more, I tired twice to reduce my dose in an attempt to ween off Subutex for good. When that process started, I was switched to the 2mg Subutex generics made by Roxane. So for the past six months, each and everytime I have filled a script for generic Subutex, the pills were the tiny round white ones mfg by Roxane. I never really had anything to compare them too, as the Roxane brand was what I had been given each and every time for six months.

Weening off that drug, even after getting my dose down to .5 mgs every day then jumping was just as bad for me when I stopped at 8mgs then 4mgs a second time. It felt as though once I got down to 2mgs or less, I was essentailly not taken anything. I still did not figure into it that the mfg of the generic 2mg Subutex had anything to do with any of that.

Now that umpiring is upon me and my back is getting worse by the month, by Sub Dr decided two visits ago that I should take 2mgs three times a day. I go into Walgreens and usually I get a partial script. The script is written for 90 2mg tabs. The pills have cost the same and looked the same every time, that is until today. Normally 30 of the pills I had been getting were around 45 dollars. Then when I would go back and get the remaining 60 I had put on hold, the cost me 80 some dollars.

Well today the pharmacy tech priced me for half of my script which would have been 45 2mg Subutex. His price today for 45 was more expensive than the 60 I got last time. The pharmacy tech could not figure out what could have gone wrong and why I was being charged so much more when I had just gotten them a couple weeks earlier at the same price I had always paid. My comment was well they probably went up in cost, which I really didin't believe in that theory wholeheartedly.

I noticed when I got home, the 2mg Subutex pills were not round like they had always been, in all the time I had gotten them. They were shaped like the brandname Subutex 8mgs. They were a smaller oval. That's when I looked the bottle a little closer and saw the letters, "mfg TEVA". In the six months I have been getting Subutex 2mgs in generic form, thaat is the first I have seen of the TEVA brand. That appears where the cost differential lay between the price I paid today and what I had been paying for the exact same amount of medication for the past 6 months. TEVA's 2mg generics are slightly higher than Roxane's 2mg generics.

But that was just the beginning. Having it the back of my mind whereby I had read a post started by someone here who swore that the TEVA brand of generic 2mgs outperformed the Roxane's generic brand handsdown. Today, unexpectedly, was the very first time I got to put that hypothesis to test for myself. My methadology, while not scientific, consisted of taking the TEVA brand and waited.

The conclusion I have drawn based on my own experience, is the hypothesis stands on its own merits and TEVA's generic 2mgs Subutex blows Roxane's out of the water. It appears I got as much in the way of bioavailabity of Bupe from those 3mgs of TEVA's generic Subutex, as I had been getting from all 6mgs of the Roxane brand.

These results I did not expect. I had an open mind despite what I had read on this board sometime ago, because I really could not locate the writing. So, I wasn't at all influenced by what someone else had claimed to be the case. I took the TEVA brand with absolutely no preconceived notions before trying. If anything I took the TEVA brand generic thinking I would NOT feel any difference.

But I did, so whoever said that the TEVA brand of 2mgs Subutex works better than what Roxane throws togehter made a believer out of me. I hope my Walgreens can keep the TEVA brand in stock but my first, ever, time seeing it was today. What few dollars more I spent buying the TEVA, I made up for in cutting my dose in half.

wayne
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Unread 06-01-2011, 06:32 AM   #2
NancyB
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Hi Wayne, that is interesting that you notice the difference between the Roxane and TEVA also. There have been a couple of other people who noticed it, and a few who didn't notice any difference. I think this is the thread you might be referring to?
http://www.addictionsurvivors.org/vb...ad.php?t=26289

But Positivetj just posted the other day that he doesn't think it was the generic causing the problems he was having.
http://www.addictionsurvivors.org/vb...5&postcount=41

In that first thread, I found the ingredients for the TEVA, Roxane and the brandname. Do you see anything in the Roxane that might cause for less absorption?
http://www.addictionsurvivors.org/vb...0&postcount=22

One last thing, are you using a prescription discount card to help with the cost? There are a bunch in this thread and they can be used for any prescription - not just bupe.

Any word on getting disability so you can get that darn operation?

Nancy
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Unread 06-01-2011, 09:08 AM   #3
gotoffmdone
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Libbye has to turn in some paperwork to continue getting her extra help(from the state) with her Medicare part B and part D premiums. I have to fill out an application they sent us then take it to DHS in time for a pre scheduled phone interview. At that time I am going to ask those folks whay my options may be. I know in order to get back on TnCare I would have to be deemed disabled. I am going to get the paperwork, fill it out, and see if I could qualify for temp disability just to to get coverage long enough to get my back taken care of.

I have no real explanation for why the TEVA brand works so much better. I was surprised. It was by pure coincidence that I was given them yesterday. Like I said, I had no preconceptions or baises on way or another. But there is something different about them. The mechanism of dissolving seems to be easier to control with the oval shape than the tiny round pills. Other than that I don't know. I thought it could be psychosomatic because of going back to where you started if you took Subutec as I did. By that, that I mean just the shape alone could have a placebo effect. But IMO there's no doubt there is a tangeable difference.

wayne
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Unread 06-02-2011, 11:03 AM   #4
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Wayne I was the one along with another user swearing that the Roxanne pills are inferior I do take the 8mg. In my area I have not been able to get any TEVA do to heavy back order however I bought the NAME BRAND to compare and the name brand work outstanding compared to whatever Roxanne is claiming is their version of subutex. If you are interested I am getting together a petition to send to the FDA to make Roxanne prove their ingredients to the FDA I was told to do that by a pharmacist himself!! He said it has been done many times in the past and the company winds up getting pulled off the shelfs by the government for having less amounts of the active ingredient in thre generics. I just lost my Mom two days ago very unexpectedly so I haven't been on here but it was great to see your post this morning. Like I told my doc and two other pharamcist ITS NOT IN "MY HEAD" the ROXANNE do not work very well at all!!! Ill post here in the near future with a form we will be sending the government offices we need to contact to complain against Roxanne Labs. Sincerely , Champ
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Unread 06-02-2011, 01:35 PM   #5
gotoffmdone
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Absoloutely, this Roxane being inferior in not in your head. Like I said I had never had anything but the Roxane generic but from the get go I felt as if I was taking less medication. I can take 1/2 the amount of the Teva brand and get more for my money than the Roxane brand. Personally I wish I had not been given the Teva brand because now I will dread seeing those tiny round tabs again.

I didn't request the Teva brand or anything. It was just given to me and THERE IS A DIFFERENCE. At first I was curious as to how this could be then I regained my senses and realized we are talking about the pharmaceutical industry.

I have heard of cases re: other meds, even non narcotic meds, where Drs insist on their patients taking the brandname over the generic. One in particular kind that comes to mind was a heart medication my mom was taking.

wayne
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Unread 06-02-2011, 07:42 PM   #6
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I take the Roxane subutex and it works great for me. I actually take less of the medication. Saying they don't work and are somehow inferior is not true. For whatever reason, if they do not work for one person does not mean they don't work for everybody. I am sure the DEA would like to know about this. I would think Roxane would have discontinued the med. by now if it did not work. Steve
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Unread 06-02-2011, 11:51 PM   #7
gotoffmdone
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Roxane has worked for me as well, for months now. Never said they didn't. Its all I had ever taken until the other day. Just said the Teva seems to be a little more potent and I can get by taking less of it than the Roxane brand. The only reason I posted about the change was because I was truly surprised by the difference. I can't explain it but, to me, the difference is real. But you are correct that just because one person has problems with something or perceives things differently doesn't mean everyone has and does. I didn't mean to imply that to be the case. Heck Sub, itself, is not for everybody even though some people think it is the answer to everyone who is abusing opiates. My experience is just that, one person's opinion. Not a scientific study be any means.

wayne
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Unread 06-03-2011, 01:34 AM   #8
alanw
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This sounds identical to Pills VS Strip.

Some people are more sensitive to change.... Or here say.
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Unread 06-03-2011, 05:16 AM   #9
gotoffmdone
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Some people have problems with the naloxone thats in Suboxone, even though when using it as directed the amount of naloxone that one gets into their system is supposed to be negligable. Most people report no problems with it.

wayne
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Unread 06-03-2011, 04:43 PM   #10
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The Naloxone cannot be taken SUBLIGUALLY it is a med you take orally with a glass of water,so as the suboxone melts in your mouth the buprenorphine starts to work but the naloxone does nothing because it must be swallowed with a glass of water like most meds in order to have any effect whatsoever. It is only a blocker if you try to "shoot up" the suboxone it blocks the buprenorphine from working. So to ever think maybe suboxone is stronger or whatever than subutex because it has a 2nd drug mixed with it ...It's impossible. That's what my Doctor and my pharmacist both stressed to me when I thought Suboxne was better than Subutex and said maybe because the naloxone...
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Unread 06-03-2011, 07:56 PM   #11
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Hi Champ, my condolences to you on the loss of your mother.

I just wanted to clear one thing up. Naloxone (narcan) is what is injected to reverse opiate overdoses. So it has very poor bioavailability sublingually and in the GI tract.
http://www.drugs.com/mtm/naloxone.html
"Naloxone is given as an injection under the skin, into a muscle, or into a vein. Your doctor, nurse, or other healthcare provider will give you this injection. You may be shown how to inject your medicine at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes."

In the Suboxone, the naloxone is 'clinically insignificant' because of the poor bioavailability. But if injected, it can cause a rapid onset of withdrawals.

More on the naloxone:
http://www.naabt.org/faq_answers.cfm?ID=64
People sometimes confuse naltrexone with naloxone. Naltrexone is also an opioid agonist, but it comes most commonly in pill form, and the newer formulation is a once-a-month time release injection called Vivitrol.

I hope that helps.

Once again, my sympathies to you.

Nancy
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Unread 06-03-2011, 08:29 PM   #12
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Champ,

Please accept my condolences on the loss of your mother, you have my deepest sympathy.
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Unread 06-03-2011, 10:14 PM   #13
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I had never heard before that Suboxone may be stronger than Subutex because it had a second drug in it, as in a synergistic effect. My impression was that they are the same except that the non-naloxone formulation, Subutex, has more potential for abuse and, therefore, if anything, could make Subutex potentially the more potent of the two because of the different routes it could be administered.

wayne

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Unread 06-15-2011, 08:16 PM   #14
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Hi Wayne, and everyone else,

I'm the man you're referring to in those other posts. I haven't been here in a long time because of this issue, and a few others, caused me to leave. I just happened to drop in today. I'm glad I did. I'm glad you are lending me some credibility to what I have known since Roxane first hit the market, over a year ago. Roxane Bupe was one reason I abandoned Bupe almost 2 years ago. But to be honest, severe back pain was also an issue. But ever since I came back to Bupe, this past March, I found the same problem with Roxane Bupe. However, I never did get to try the 2 mg tabs. Everything I said was in relation to the 8 mg tabs of Teva. But I did try both the 2 and 8 mg Roxane, and both were equally bad for my system.

Now I will admit and say this is how these brands effect me. BUT, and this is a big but. If indeed the drug was being manufactured correctly then it shouldn't matter who takes it. The drug should effect us all pretty much the same. Unless someone is just allergic to Buprenorphine, in which case no generic brand, nor even the name brand, should effect that person right. But I'm fine with both the Name Brand and the Teva brand, but the Roxane brand made me very sick feeling. I had no pain relief at all. I had a ton of anxiety from them, and needed Ativan every night to knock down the anxiety. And they didn't really stop the cravings. I kept feeling like I needed to take more and more and more Roxane Bupe. No matter how much I took, I never felt at ease. That was when I took some Ativan, and finally felt the shakiness stop.

I was supposed to get the 2 mg tabs this past month, but my insurance co. played a dirty trick on me and my doc. I'm very sensitive to Bupe. If I take even 1 mg too much at the same time I get very drowsy and can't function for several hours. My doc knows all about this. So I'm supposed to take the doses as .5 mg to 2 mg max at a time. This means some creative cutting on my part. Since I'm never too certain of the exact size of a piece, I think I take 12 mg a day. So my doc wanted me to switch to the 2 mg tabs so we could be certain as to what I'm taking. Not that there's a problem, this was to make it convenient for me. So we asked for 6 pills a day, of the 2 mg tabs. Currently the insurance is giving me 2 pills a day of the 8 mg tabs. Well guess what? The insurance co. wouldn't give us 6 pills a day. They'd only pay for 4 pills a day. But that's not enough. So I had to go back to the doc for a script for the 8 mg tabs, and I had to pay another office fee. He made it a reduced fee, but I still feel cheated. But it's no biggie.

Luckily for me, I have long since stabilized on the Bupe and I am doing very well. The Teva is working on pain, my depression, a little mental energy (btw, it's mental energy, not physical energy) and of course I have no cravings for any other drugs at all.

I want to add 1 more thing. While Teva is better than Roxane, the Name Brand is better than Teva. I find even the Teva wears off faster than Buprenorphine should. And I think that's true whether it's taken as Tex or Suboxone. Years ago when I was on name brand Tex I never needed a large dose at night to hold me until morning. But this year I find I need about 4 mg before bed or I wake up with a runny nose and some feelings of withdrawal. I never had that with the name brand. I'm hoping this might change as time goes on. I seem to remember that it took almost 1 full year for my body to become fully acclimated to Bupe. But right now I'm comparing how I was 6 months ago when I was taking Roxicodone and MSContin for the pain. Except for the pain, I am so much better on Bupe. I have often found that after 6 - 8 months on pain killing opiates they start to make a real mess out of my mind and emotions. That's the condition I was in last December. I am soooo much better now. I just wish I didn't have this pain. I hope it doesn't get worse again.

So thank you Wayne for reporting this. Maybe now I can come here again and even be shown a little respect. I wasn't lying, nor was I trying to make trouble. I was just reporting my experiences, and I figured someone else was bound to have similar problems. I only wanted to help others.

Jack
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Unread 06-15-2011, 10:17 PM   #15
gotoffmdone
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Jack

I had no idea something like this caused you to feel uncomfortable in coming back to the site. That;s terrible IMO

I must admit I never really kept up with your original post about this subject. The TEVA vs Roxane thing hit me out of the blue. First of all, I wasn't expecting to notice a difference because I had been getting the same Roxane generic from the git go. The first difference I noticed was how much more expensive the Teva brand was than the Roxane. Neither myself or the pharmacy tech could understand why this one time I had to pay a little more for the same amount of 2mg pills. He never could figure it out and just asumed a price increase had ocurred in the past week and a half. It wasn't until I got in the car and opened the bottle that I noticed a huge difference in the shape of the pills. The Roxane brand of generic is tiny and round. When I opened the Teva brand I noticed they looked a lot like the brandname verson of Subutex. They were white with an oval shape. Being that was my first time seeing them I was surprised, as I had no idea that there were more than msker of generic Bupe. Even despite you earlier post, Jack, I never gave much thought to getting the Teva brand as it had never ocurred in the 8 months I had been taking the 2mg generics.

I went back in and spoke with the pharmacy and we came up with the plausible explanation why I might now be paying more for my generic 2mg Subutex. Someone must think there is a difference somwhere between Teva and Roxane because one is more costly than the other. Not saying it is ingredient related, or lack thereof. Could be in the manufacturing process such as cost of raw materials or labor. Stock holders could be the reason. I have never said where the differnce lay, just that I noticed a difference.

All I can say is this has been my first go around with the Teva generic. Until now ALL I had ever taken was Roxane so I had never had anything to compare it too. I have found that the extra money I have to pay for the Teva brand is well worth it. Starting on day two with the Teva brand, I was able to reduce my dose from 4mg to 2mgs. I don't pretend to know the reason I just accept it.

Jack, one thing that bothered me was when I read about the way in which you felt treated or maligned when you started your post concerning this topic. If you were made to feel as though you were being less than honest and were chastized for expressing your opinion based on YOUR experience then, IMO, that is shameful. There is no room, rhyme or reason why that would take place here. We are all different people with some very serious issues in common. At no time will any or all of us ever see eye to eye on any topic. But express your opinion ang go on. Don't denegrate someone because they disagree with the masses or they tend to march to the beat of their own drum.

I have been to group therapy, I have been to rehab after rehab and all their aftercare programs. I have been to N/A. I have been to A/A.

Within a couple of months I would, either, relapse or be heading in that direction had I kept listening to some of the same old tiring bullsh**. Private, one on one therapy and/or group therapy helps many, but not aeveryone. Same can be said for Rehabs with an aftercare program. A/A and N/A, the Gold standard of treatment are not for everybody.

My point is I have always NOT stuck with one source long enough to call that place home and feel comfortable speaking my mind. I take part of the balme for that. But folks would invariably know that once I had stopped showing up that wasn't usually a good sign. Finding support on the internet has been made simpler for some to grab onto because of the anonymity they can find in their room behind the keyboard of a computer. That's hasn't been why I have stuck with NAABT so long. By my count this post will somewhere over the 2500 mark. That represents a lot of stick to-it-of-ness. I started posting here just before I inducted back in September of 2006. And unlike all those other support formats I am still here. But it has mainly been due to the non judgemental attitude of this group as a whole.

Jack that's why I was bothered by the reason you gave for no longer wanting to ne a part of this forum or to speak about that particular subject matter. If it does get to the point to where we cannot freely express our views and opinions on here, or ask a question, without feeling ridiculed, belittled(not taken seriously) or talked down too, I would be the first to go. To where I have no idea.

But come back and join us, Jack. No matter what anyone says or thinks, me thinks you were on to something, whatever that something may be. Teva, Teva, Teva.......

wayne
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Unread 06-15-2011, 10:18 PM   #16
Champ
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My MOM died on May 31st leaving me totally parentless since dad went last year from Cancer. That I believe I have taken maybe "1/2" 8MG Roxanne every three days or even four just totally forgetting about them and I haven't had a craving ,a physical pain or anything because I have been hurting mentally and calling utility companies and Banks and lawyers etc etc Maybe ALL this stuff is in our heads I feel great other missing her severely ! Weird isn't it ?

Last edited by Champ; 06-15-2011 at 10:22 PM..
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Unread 06-15-2011, 10:29 PM   #17
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In fact I haven't taken any at all in 4 straight days now looking at the calendar...4 days ago a half of and 8mg so I have had only 4MG in all this time and never felt better wheres these withdraws and cravings and anything Geeze it's amazing what something as strong as sudden death can do for your mental state. I really believe maybe not for all but definetly for me if you dont think about it your mind isnt telling you what you want to hear like I NEED ANOTHER or OH I'M DRUG SICK (withdraws) And I know what withdraws are when I kicked my 3 80mg oxy snorts a day for over two years or so...hmmmm The MIND is a powerful thing.
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Unread 06-16-2011, 09:46 AM   #18
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Hi Champ, again my sympathies on the passing of your mom.

That is great that it's been four days since taking since taking anything. The mind sure is a powerful thing! Congratulations! Please keep us posted on how you're doing.

Nancy
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Unread 06-16-2011, 05:15 PM   #19
gotoffmdone
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Champ
I really hate you have so much to contend with but you may be correct. You may find you are not having time to think of dosing or that Sub has fallen way down on your list of priorities. Maybe this is a sign showing that you may not need the drug afterall. If it keeps going this way you may find that you can conclude one day that enough time has past for the acute wds from Sub to have subsided, yet you haven't taken any. Would be nice if you could lose your dependence on Sub. And still not have cravings. With the right frame of mind it just may be possible. I wish you the best.

wayne
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Unread 06-20-2011, 02:45 PM   #20
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Hi Champ & Wayne,

I'm sorry to hear about your Mother. I lost my Mother to cancer 10 years ago and it was a very difficult time. What made it so hard for me was that I have no siblings, wives nor kids. She was the only immediate family I had. But death is always hard to deal with no matter how you look at it. And I don't know why neither, but the death of a loved one can change how a drug is effecting us. In my case the change wasn't so good. About 1.5 years before she passed away a new pdoc had decided to try Wellbutrin on me. I was highly skeptical because no other AD med ever did me any good whatsoever. I don't know if this pdoc is just brilliant, or he was taking another crap shot. I like to think he's brilliant. He urged me to just try the Wellbutrin, even if it was only a few days. He said it's a very different drug from all other ad meds, and works completely different. Well Wow, he was right. From day 1 Wellbutrin made me feel good. I felt so good, people who knew me thought I was high. They knew I didn't get high, but based on how I was behaving, they figured I did something. I was in this great mood and I had everyone around me laughing and feeling good too. It seemed that Wellbutrin was what I needed my whole life. And then my Mother died. That was the end of Wellbutrin making me feel better. Of course that also made my depression go from being a clinical depression, to a situational depression. But even years later, Wellbutrin never worked again. I try taking some every few months just to see if the effectiveness comes back, and it doesn't. Nowadays the only things that are helping are the Bupe, and I think Provigil helps too. I'm not so sure about Provigil. If I'm feeling down and I take a Provigil and sit there waiting for it to work, it doesn't. But if I get up and take 1 to help me have some energy, and if nothing goes extra wrong that day, then it seems to help. So yes the mind is a powerful thing, but by the same logic, the brain is an incredibly complex and complicated organ.

Btw, I wonder if anyone has had experience with this. My doc ran a Testosterone blood test and my Testosterone is so low he became alarmed. So he wants me on Testosterone replacement therapy. I asked him why I need extra Testosterone, seeing as how I'm not married? He then went into a very long list of symptoms that can be caused by Testosterone that's too low. These included depression, anxiety, lack of energy, low self esteem, feeling sick often, even when there's nothing seriously wrong. But he then included a low immunity response so low Testosterone can also cause a man to get sick for real. Although this isn't happening to me. But almost everything else he said is. So I'm supposed to start using Androgel this week. I was gung ho and ready to try it, and then I read on the Internet that people who smoke shouldn't be on Hormone Replacement Therapy. Now I'm scared. I thought he knew I smoke. I'm supposed to see him Friday again, so maybe I'll wait until Friday. But from what I have read some doc's ignore the smoking and Hormones warnings and others don't. Anyone have any knowledge or opinions on this.

Not to beat a dead horse here, but I felt a negative difference in Roxane Bupe from day 1, over a year ago, when they 1st came out. And I kept trying them, and they were just lacking something, but I wasn't sure what. Then I was off Bupe 1.3 years. When I came back on Bupe, last March, my insurance wouldn't cover the script without prior authorization. Since I had been in and out of wds for 2.5 months my pharmacy gave me 1 Bupe tab to hold me until the next day. It was 1 pill, and I had no idea what brand it was, all I knew was that it was generic, and it was oval. I didn't even look at it because I expected it to be terrible. I expected this because the year before I had bad results with generic Bupe. And like you Wayne, I didn't know more than 1 generic co. made Bupe tabs. So I took some, and to my relief, it worked almost as well as I remember the Name Brand to work. That was very good. The next day I picked up the rest of the script, and I expected the same thing. But it wasn't the same thing at all. And the more I took of the other pills, the worse I felt. So I agree the mind is a powerful thing. But this is not my imagination. I wish it was.

I too hope you never need another Sub Champ. And again, my condolences.

Jack
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Unread 06-20-2011, 06:39 PM   #21
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Does Teva make 8mg Subutex?

I took Suboxone til Generic came out from Roxanne. I immediately noticed the duration of the generic was considerably shorter, and once a day no longer worked. Most people, including here, said it was my imagination.

Consider the fact that there is no generic Suboxone, only Subutex. So obviously making Suboxone is not just a matter of throwing in Naloxone.

It also seems odd that Teva is more than Roxane. Since Teva is the later entrant in the market, you'd think they'd undercut Roxane to gain market share.

I take Roxane Subutex now, but if TEVA could be more effective with pain or depression, I'd like to switch.
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Unread 06-20-2011, 07:01 PM   #22
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Hi Jack, here's a link that might be of interest to you on testosterone. Opioids can decrease the testosterone level - it doesn't matter if you're sexually active or not, it's a hormone that can cause problems if out of balance. One of which is depression.
http://www.addictionsurvivors.org/vb...ad.php?t=22923

This one might be of interest also, Brett talks about a problem he ran into with the injections.
http://www.addictionsurvivors.org/vb...ad.php?t=23697
But other guys in that thread are talking about the improvements in depression and energy they get from testosterone. This might be just what your system is missing.

OhioMike has done testosterone replacement and he smokes. Brett used snuff and didn't have any adverse effects.

I just have one question about the wellbutrin. Did you ever give it a chance to work? You said "I try taking some every few months just to see if the effectiveness comes back, and it doesn't." You also said "I seem to remember that it took almost 1 full year for my body to become fully acclimated to Bupe." Have you thought about giving the Wellbutrin a longer amount of time to see if it does work again? Just a thought. But maybe the low testosterone is the root of a lot of how you're feeling and you won't need to bother.

edited to add: "It may take 4 weeks or longer before you feel the full benefit of bupropion. Continue to take bupropion even if you feel well. Do not stop taking bupropion without talking to your doctor. Your doctor will probably decrease your dose gradually."
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000970/

Nancy
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Unread 06-20-2011, 07:03 PM   #23
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Quote:
Originally Posted by jasel View Post
Does Teva make 8mg Subutex?

I took Suboxone til Generic came out from Roxanne. I immediately noticed the duration of the generic was considerably shorter, and once a day no longer worked. Most people, including here, said it was my imagination.

Consider the fact that there is no generic Suboxone, only Subutex. So obviously making Suboxone is not just a matter of throwing in Naloxone.

It also seems odd that Teva is more than Roxane. Since Teva is the later entrant in the market, you'd think they'd undercut Roxane to gain market share.

I take Roxane Subutex now, but if TEVA could be more effective with pain or depression, I'd like to switch.
Hi James, yes, TEVA makes both 8mg and 2mg generic -tex. It is interesting how some people don't notice any difference between the generics, and others do. I still wonder if it has something to do with the way it's absorbed, because of different fillers and it effects some people but not others.

Nancy
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Unread 06-20-2011, 10:39 PM   #24
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I would guess there's probably a vast difference in people's anatomy that makes degree of absorption into the blood stream vary considerably. Add to that things like dry mouth, caffeine consumption, etc. and it becomes more varied.

I haven't tried the TEVA, but I noticed a difference between the brand name Suboxone vs Roxane Subutex. With the brand I could take 4mgs in the morning and I was good for the day. With the generic I take 2mgs in the A.M. and another 2 around 5 or 6. Which actually helps, having smaller more frequent doses.

That's also why I'm interested in the patch. If I could just put a patch on once a week, and not have to worry about finding Sub doctors, or the stigma, yes there is one, of taking what most people consider solely an addiction treatment. My concern is if the low dose will also serve to defray WDS. I'm less concerned about things like cravings, because when I crave a drug, it's marijuana.

There also is a belief that if you skip a day and don't notice it the next day, that you won't notice it at all. I've had situations where I've missed a dose or skipped one, and two days later I feel the effects. Don't care if it sounds scientifically impossible, it happens. It's all in my head, but it's NOT all in my head... if you see my point.

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Unread 06-21-2011, 12:23 AM   #25
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Be sure to learn about the patches. They are to be used for seven days from what i understand and they come in mcg doses not mg doses. I think 20mcg dose is the highest they make and I beleive it was Tim that told me the a 20mcg patch delivered the quivilent of about 1mg of Bupe to the body per every 24 hours.

If that is the case, I could see the Bupe pain patches working well for those perons with zero history of opiate use and, for sure, no opiate abuse history. But for those of us wo have been using the bupe tablets or have taken full agonist for pain, I doubt very serioulsy that 1mg of Bupe per day would ease moderate to severe chronic pain.

That is one of my biggest pet peeves with regard to Bupe in patch form being the only FDA approved route od adminstration. If there is ANY doubt in anyone's mind that MONEY is the driving force behind anything to do with Bupe this should puts those doubts to rest.

Either Bupe is good for chronic pain or its not. If it is determined that Bupe is good as a chronic pain reliever then whatever route of adminstration that works best for a given patient is the one that should be used. One mg per day may not suffice in relieving their pain. Rather than having to stick two or three or four 20mcg patches to your chest every day, a person and his/her Dr should have the option to use the much cheaper generic Subutex pills and take whatever amount may work best. Some days they may not need any due to the halflife of Bupe still doing an adequate job.

If the FDA has determined that the opioid, Bupe, is adequate and has given its approval for it to be used a a pain reliever, could someone please tell me what could possibly be the reason, IF THE REASON IS NOT MONEY DRIVEN, why the only way it can be used to relieve pain is as a seven day, time relase, patch at a maximim dose of 1mg per patch per day. I recall trying to use Fentanyl patches. It was hard enough for me to get those patches to stay put for their required three days. I can't imagine trying to maintain one patch anywhere on my skin for a total of seven days.

I just don't see why the FDA did not approve Bupe to be used for pain, in any and all of its many forms. Why just the patch, if not for money's sake.

Sorry for the rant but whether we are talking pain relief of treating addiction to opiates, it just bothers me that the system is such that so many people cannot access such treatment for purely monetary reasons. It is so easy at times to see right though what the bureaucrat's motivations are that one can only conclude they could care less what we think. This is a market aimed at the well to do or those with insurance. The rest of us just have to go along and get along as best we can.
wayne

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Unread 06-22-2011, 07:09 PM   #26
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"Sorry for the rant but whether we are talking pain relief of treating addiction to opiates, it just bothers me that the system is such that so many people cannot access such treatment for purely monetary reasons. It is so easy at times to see right though what the bureaucrat's motivations are that one can only conclude they could care less what we think. This is a market aimed at the well to do or those with insurance. The rest of us just have to go along and get along as best we can."
wayne


Right on, Wayne! Makes you fume, don't it?
Are they serious about these bupe patches? 1mg p/ day? And the patch is supposed to stay on for a whole week? Heck, I couldn't even make a nicotine patch stay on me for an hour!!! I find that bupe, for me, is just an adequate pain reliever. I compare it to those big white 800mg Ibuprophens. I still take Sub for;Depression, minor aches, and most importantly, cravings. And believe it or not, cravings for alcohol also. I was a full blown alcoholic(and opiate addict) for 34yrs. I haven't been drunk for at least 5 years now.
It bothers me also, that there are so many suffering addicts still out there wanting some help, but just can't afford the money. AA/NA works miracles for some,(w/ no cost attached) but some just can't or won't 'get it'...
I recall writing to Reckitt a few times and letting them 'have it', w/ both barrels as to why the price for Sub was so high. I metioned the suffering heroin addicts in the gutter, that could use some help, to no avail, ofcourse. It is all about the money. Sad, but true....
I feel grateful that I'm able to afford it, and I try to show my gratitude whenever I can.
In one of the above posts, was it you Wayne, that metioned the price difference in the 2 Labs prices for generic 'Tex? I was wondering how much more the Teva lab's prices were? Ballpark, every part of the country seems different....Thanks,,,,
Scott...
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Unread 06-22-2011, 09:42 PM   #27
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I get my generic 2mg Tex at Walgreens. In the almost year that I have taken the Roxane generic I have paid the same price. This last time was the first time I got the Teva brand and even the pharm tech was confused as to why there was a price difference within the past two weeks. We both assumed that the drug co has just raised their prices. Then when I got home and noticed the tablets were oval shaped and not round that's when i noticed I had been given the TEVA generic. Thats also when I recalled a post from someone speaking to the TEVA brand working much better.

When I took the first ever TEVA tablet, I noticed the difference right away. Until then I had just dismissed out of hand the comment that there was a difference between to two generics. But I am definitely a believer now.

As far as the difference in price it comes to about $30- $40 per every 90 tabs. If memoery serves me right.

wayne
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Unread 06-22-2011, 10:52 PM   #28
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Hello, Just a thought on the bupe patches. Guess it would depend on the clinical studies done with the patches, but overall, bupe works best for pain in small doses. Perhaps it has been shown that a steady supply of bupe, administered by a patch, relieves pain. There again, the clinical studies would have to be looked at to see just what they show.

It always makes me uneasy when I hear how so many things seem to be done because there is money to be made-like that is a bad thing. We wouldn't have any of these medications if the companies could not have made money on them. In addition many companies do offer discounts and help to individuals who have difficulty coming up with the cost. Lots of people with many different diseases have difficulty paying for their meds-not just the disease of addiction. That is why so many folks keep looking for ways to get assistance and finding ways to get the medications they need. It is not always easy, but I am glad that modern medicine has come up with these new medications that can help so many live-and they sure wouldn't have done it if they couldn't make money doing it.

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Unread 06-23-2011, 12:45 AM   #29
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nan

I see what you are saying but why is it do you think that the cheapest form of bupe, i.e. the 2mg Subs could not be cut in half and taken once a day. I agree that there is nothing wrong with the patches being produced and used but why not allow the Drs and their patients to determine if another form of Bupe works best. The main problem I have is if Bupe is good for pain WHY limit Drs who can prescribe it for pain without having to have the waiver to only the patches.

And what happens if one mg per day by way of the patches is not adequate to control pain. The only alternative would be full agonists. And if the pills could be used for pain I imagine the makers of the generic form could make any strength. The could make .5 mg pills. I'll bet you a Wendy's burger that people will report problems with having to keep a patch secured to their body for an entire week.

That way people could get Sub by going to the PCP who takes their insurance without having to go to Drs who charge them more for writing a script for Sub than they do for other patients who gets an extensive physical. And from my experience, a Dr who has not taken the course knows as much about Sub and addiction as some of these Drs who have taken the course to get that all important x number.

If you went thru what I had to go thru just to get my Dr to switch me over to the generic Subutex you would understand my emphasis on the money aspect of this drug. My DR was getting ALL of his info regarding Sub from the Suboxone drug rep. He had the Dr scared to death that if he wrote for Subutex he would be highly scrutinized by the DEA because Bupe without the naloxone was being highly abused. And for that reason the DEA kept their eye on Sub Drs who prescribed Subutex. The drug rep told my Dr that if he started rxing Subutex his patients would be subject to more pill counts and drug screens. This guy knew that money would be taken out of the makers of Suboxone's pockets, if people started buying the generic form of Subutex.

It wasn't until Nancy kindly contacted my Drs office mgr with a different perspective. She alleviated their DEA fears and the Dr started giving me the generic Subutex. Why else would a drug rep engage in that kind of fear mongering if not for reasons financial.

If a person has good insurance or a sizeable bank account this is a non issue. Too many of us don't have such luxury.

wayne

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Unread 06-23-2011, 11:49 AM   #30
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Quote:
Originally Posted by gotoffmdone View Post
...If the FDA has determined that the opioid, Bupe, is adequate and has given its approval for it to be used a a pain reliever, could someone please tell me what could possibly be the reason, IF THE REASON IS NOT MONEY DRIVEN, why the only way it can be used to relieve pain is as a seven day, time relase, patch at a maximim dose of 1mg per patch per day........I just don't see why the FDA did not approve Bupe to be used for pain, in any and all of its many forms. Why just the patch, if not for money's sake.
It’s about 2 things money and government. First, the FDA doesn’t approve chemicals on a general basis they approve/ unapproved specific drugs. So Suboxone is approved for opioid addiction and not pain and BruTrans is approved for pain and not opioid addiction, although both are buprenorphine products. For a drug to get FDA approval for a specific indication the manufacturer is required to do extensive and expensive clinical trials to show that that specific drug is effective for that indication. This can cost 10s of millions of dollars. Companies cannot secure this level of financing unless they have a way to recoup it plus a profit. For that they need patent protection to prevent generics from competing at price levels that would make it impossible to recoup the initial investment. Normally, patents for drugs last 20 years. In the case of buprenorphine, the patent expired in 1989. To make Suboxone possible NIDA gave it “orphan drug status” which in short allows marketing protecting like a patent but for only 9 years, that expired in 2009. Drugs with an indication for pain won’t qualify for orphan drug status, so with no chance to recoup the high costs of FDA approval Suboxone will never be indicated for pain. For more buprenorphine based products indicated for pain, there needs to be some kind of patent protection associated with it like a patented patch or implant.

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Unread 06-23-2011, 12:13 PM   #31
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The laws surrounding addiction, opioids and buprenorphine are ridiculous and heavily influenced by ignorance of the disease, stigma and fear. Actual evidence has been ignored or didn’t exist at the time the laws were passed. Even worse, the laws that do exist have been misinterpreted. For example the 1914 law that has resulted in it being illegal for doctors to prescribe opioid-based medications to treat opioid addiction, actually has an exemption in it for doctors using the medication in the course of good medical practice. But this last part is ignored. In 1919 the Supreme court was presented with this question:
3. 'If a practicing and registered physician issues an order for morphine to an habitual user thereof, the order not being issued by him in the course of professional treatment in the attempted cure of the habit, but being issued for the purpose of providing the user with morphine sufficient to keep him comfortable by maintaining his customary use, is such order a physician's prescription under exception (b) of section 2?'
Here was the answer:
As to question three-to call such an order for the use of morphine a physician's prescription would be so plain a perversion of meaning that [249 U.S. 96, 100] no discussion of the subject is required. That question should be answered in the negative.
After this it was determined that it was illegal for doctors to prescribe any opioid to treat opioid addiction. Even now when we have lifesaving medications that are clearly administered in the course of professional treatment, other Congresses and regulation writers still hold to this outdated belief and general misinterpretation of what was actually ruled upon. There have been exemptions that have allowed methadone clinics and physicians to become certified to prescribe buprenorphine, but none of that is necessary or legal with a proper interpretation of the law. - IMO.


Tim

for more about the laws see: http://www.naabt.org/laws.cfm
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Unread 06-23-2011, 04:57 PM   #32
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The link below is why I don't trust some of the motives of the FDA. My wife took the generic form of colchicine for gout for years now, and there is no more generic and only one company has given the patent for the exact same drug but only in brandname. It seems the FDA has approved the use of a non approved drug for decades. It seemed to work well and I doubt they have ever had a larger sample population on which this drug has been used.

I would have thought that since Bupe has been approved for pain in the injectible form it would not be that big of a leap to use Subutex. I can see where Bupe+Naloxone could be reserved for addiction.

But we all have our opinion and we can agree to disagree.

wayne


http://www.medpagetoday.com/Rheumato...matology/22600

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Unread 06-23-2011, 05:33 PM   #33
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"Whereas the unapproved products cost around 10 cents a pill, Colcrys comes with a sticker price of nearly $5 a pill, Kesselheim and Solomon wrote".

This was a direct quote from the article about the gout drug that was taken off the market after decades of use.

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