Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Isithotinhere on March 12, 2013, 01:44:10 AM
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I popped into Boots today with my prescription only to be told there is some problem with the distribution of Vagifem and they don't know when they'll get new stocks!!! I was told to go back to the docs and get something else instead. Like what??
Has anyone heard about this and got any info? I have 2 left for this week then I am knackered!!
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I can't find anything about online but your best bet is to take the prescription to another pharmacy. Phone around a few to see who still has stocks. Which dosage is your prescription for?
Taz x
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I'm not sure Taz. I've left the prescription with them and they're going to ring me when they get some. I suppose that means I will have to start from the beginning again with a 2 week dose?
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Really? That's interesting because they have been short on them before (which made me think they maybe didn't have call for them very often)and have had to post them out yet yesterday the assistant told me they were very popular! We don't really have anywhere else round here but I think I'll ring around other Boots stores to see if they have any cos I really don't want to start from scratch again.
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That's terrible! Never had a problem getting mine.
Hope you get some ASAP.
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A couple of years ago there was a huge problem with Ovestin and Oestrogel which lasted for months and I was very worried-I was having to try to pick it up in large chemists in London- it turned out there was a problem with both manufacturing and also distribution- a small amount going to most countries. This info was available online- it was mainly info for pharmacies- I had to shop around for ages along with half the population of my town it seemed- and eventually found a small independent chemist who managed to get some. I still don't allow myself to run out- usually request a prescription when I have at least one full tube/container left in case there are problems again. Boots I have to say was helpful, but they said their supply was erratic and there was nothing they could do about it.
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Vagifem 25 has been discontinued now I think, I got 10 when I picked my prescription up, but bizarrely the instructions are still the same, so twice weekly still. Will need to see GP if things start to play up again!
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Isithotinhere - are you on Vagifem 25 on 10? If 25 then as Minnie says it has been discontinued. Maybe Boots are useless on this and haven't caught up with this fact? They should know they will issue 10's to any prescription 25's. Actually my doc surgery wrote me a letter to this effect in early Feb. If you are on 10's then they (Boots) are really useless!
I wonder how many women will find that 10 mcg twice a week doesn't work?
Hurdity x
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I've just had my repeat prescription for 25mcg returned to me by the pharmacy as they say they can only supply 10mcg now and that I need to get my prescription altered by my doctor.
I was using 25mcg twice a week - I'm wondering if my new prescription will say 4 times a week or just 2 :-\
ariadne xx
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I'm ashamed to say I don't know if I'm on 10 or 25 (Boots has my prescription). I'll ring them tomorrow and see what I can find out. Thanks everyone for your help :)
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araidne - I expect that's why I got a letter from the doc - but they must have done this in my surgery automatically for all women on 25's. Bet the new script will say twice a week. That was the rationale behind discontinuing I think - based on some research showing that for the women in the study - 10 mcg was as effective. A bit absurd when the leaflet on 10 mcg used to say" A switch to the higher dose product Vagifem 25 micrograms should be considered if the response after three months is insufficient for satisfactory symptom relief." There was a thread on this recently somewhere.
isithotinhere - nothing to be ashamed of!! I mean it's only when things go worng that we start to question and it will be on your prescription - which you haven't got! Hope you get it sorted
Hurdity x
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I was put on 25's last year for three months but asked to go on 10's as I had read the 25's had been discontinued in the USA and assumed we would likely follow suit. The information online suggests the reason 25's were discontinued is that the 10's give exactly the same effect and no benefit could be found for using 25's.
My prescription is due in a few weeks so I hope there are no problems with shortages but it DOES sound like boots are the issue!!
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Yes, think this has been discussed before. It is definite, so my doctor says, that the 25 mcg has been discontinued and only 10mcg now available. I have one box of 25 left and then will have to switch to 10 mcg. the only thing I'm worried about is if 2 a week aren't enough then since the dr. has only prescribed the same number of 10's as 25's it will be even more expensive. Prescription charges I think are also going up in April again. Deep joy >:(
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This gives details of the trials carried out after the FDA in America wanted Norvodisk to produce the lowest dose possible. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234898/
Taz x
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My first time using your forum, here goes.
I had no problem obtaining Vagifem at my small Boots chemist and was told that the manufacturers had discontinued 25mg. Apparently 10mg "gives the same benefit". I haven't found this is true for me and I'm considering using 10mg every other day until I feel comfortable. Luckily I don't pay for prescriptions but wonder when GP will notice the fast rate I'll be using them!
Does anyone know of a good vaginal lubricant without nasty buildup?
Thanks
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Hi vanilla slice :welcomemm:
I expect there will quite a few women who find that vagifem 10's won't be enough for them, me being one of them. I started off with 10's and was using 3xweek but they didn't help enough so gp gave me 25's. Luckily I have a stock of them which will last me a few months - but what I will do after that? ::)
As far as lubes are concerned all I do is insert a vitamin E capsule and find that very soothing, so can't help with that one.
Katy x
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I'm not sure Taz. I've left the prescription with them and they're going to ring me when they get some. I suppose that means I will have to start from the beginning again with a 2 week dose?
NO go back to chemist and ask for your script back they can not keep it
Ring around as was said every Chemist and see if you can find them in another chemist
If they all have same problem see which one is getting them in soonest
I looked ive heard or read nothing aboiut Vagifem being short
It could be that oyur chemist doesnt keep many pks in and has simply run out
My chemist is always running out of my Lexoton as Im the only person in his shop that uses it
If you run out and are with out them say for a fortnight or so a dose every 3rd night might be enough longer
Well id do it every other night for a couple of weeks Month or so then id do 10 day reboot xxx get your script back
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My first time using your forum, here goes.
I had no problem obtaining Vagifem at my small Boots chemist and was told that the manufacturers had discontinued 25mg. Apparently 10mg "gives the same benefit". I haven't found this is true for me and I'm considering using 10mg every other day until I feel comfortable. Luckily I don't pay for prescriptions but wonder when GP will notice the fast rate I'll be using them!
Does anyone know of a good vaginal lubricant without nasty buildup?
Thanks
Your not alone and GPs know this to go from 50 to 20 a week is pathetic
Just do what feels right for you
Thens ee GP tell him /her your taking it every 3rd night end of
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I don't know if you can get a script back- can you? What if you have already paid for it?
I know that sometimes they have one product available but not all and I don't leave the script- but try somewhere else. I;d always assumed that once they had it that was it- I know they can't give it back if you have taken one item but not all of them.
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I know they can't give it back if you have taken one item because that happened to me when there was a problem getting ovestin cream and in the end couldn't get it for me but they couldn't give the script back as I had taken the rest of the items. That's when I went back to gp and she gave me vagifem. I think they can give it back if you haven't taken anything.
Katy x
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You can definitely get the prescription back. I've even had them back when I've had one item dispensed. They just tick off what you've had. I pre pay for prescriptions. If you have more than one item a month it works out cheaper. I think I pay something like £10.55 a month.
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Boots actually rang me yesterday morning about the prescription. He confirmed that the 25s had indeed been discontinued so I'd have to get a new one from my GP for 10s. So...I have ONE 25 left for tonight then I am down to 10s and have no idea if they will be enough for me but somehow I doubt it. I think I'll probably end up using twice as many :-( I'd be very interested to know how everyone else is tackling this?
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I think I mentioned before that our medical practice sent a letter to all Vagifem 25 users at the end of January - so they must have done a search on their system. I did not have to ask for it but would need to go and get the new prescription when I run out ( which I haven't done yet).
The letter said:
"We have been advised that Vagifem 25 mcg pessaries have been discontinued. The best option for change in your case would be Vagifem 10 mcg pessaries. We would suggest continuing to use them twice weekly. However, given that this is a lower dose, if you should experience any recurrence of symptoms we would be grateful if you would contact us for further advice"
What I would suggest to anyone is maybe try the 10 mcg twice a week for a trial period. If symptoms do recur go back to the GP and ask for twice the amount of Vagifem for the same prescription price because it is not controlling your symptoms. So - if you got 3 months of 25s on one prescription ask them for 6 months of 10s or say you need twice as many.
Then how about continuing the twice weekly regime but put in two at once? Can't imagine having to do 4 a week - especially those who still have a nice healthy libido ;) . It is a terrible waste of plastic and bad for the environment but seems like would be the best thing to do rather than suffer unneccessarily.
Will be unpopular with the NHS but appalling that the decision was made to discontinue.
I am still looking at that link Taz which is a very interesting review and will have more to say on this at some point!
Hurdity x
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Thanks a lot Hurdity, I'll take your advice... with fingers crossed :-\
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It seems as if the decision was driven by the FDA but, to my mind, it happened after the advice changed from having to have a break from Vagifem every so many months to being advised that it can be used continually. Higher dose with a break or lower dose without a break.
Taz x
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They did that with the pill and so many unwanted or should I say unplanned babies happened
If its so dangerous discontinue it 10m 2x7 is a hell of a drop from 50 a week
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It has not been shown to be dangerous - so no-one needs to worry
Hurdity x
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Trying not to be cross about this...but really! WHY mess with something that works?
Think it's time to do my Deepak Meditation
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It doesn't seem to be a Norvodisk decision but something they were asked to do by the FDA. When their trials "seemed" to show that there was no difference in the effectiveness of the two doses then they had no reason not to comply with the FDA's guidelines that the smallest amount of oestrogen to give relief should be used. In order to keep their license I believe they had to discontinue the higher dose.
Taz x
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I like the way you said "seemed" because that just about sums it up!
As always scientific trials are open to interpretation.
For me the crucial statement in the paper that Taz linked to a few posts back was that in a trial with (only) 230 women (not from the same area), a comparison between 10 and 25 mcg Vagifem showed both gave significant improvements (in various measures connected to vaginal health) but that "These improvements were greater with the 25 mcg than with the 10 mcg which was to be expected."
That says it all.
It's all done on percentages and statistical significance - but what if you are one of the individuals for whom there is insufficient difference using 10 mcg? That's the problem, which is why a higher dose, of course is needed.
As I said before, for anyone for whom the 10 mcg twice a week does not work, I would persuade your doc to prescribe twice the amount on the same prescription and use 2 at once.
Hurdity x
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I KNIOW IM SHOUTING AND I KOW IVE SAID IT BEFORE BUT ITS ALL MONEY
WE BABY BOOMERS AND POSTBABY BOOMERS(ME) WE ARE A CASH COW FOR THEM
IF IT WAS DANG WHYVE THEY BEEN FLOGGING IT FOR OVER 10 YEARS
NOPE MONEY MONEY MONEY SORRY XXXXXXXXXXXXXXX
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Suzi- what is "DANG"? I don't understand your post. Do you mean Doing Any Good???
It's clear why women have to use it all the time- just like you use moisturiser on your face or foot cream on your dry heels! They work, but they don't make a permanent change happen! Women's bodies are not suddenly going to start producing oestrogen in their 50 and 60s and older- so it has to be put back if you have VA.
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I think it's short for "dangerous" Gig.
Taz x
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Aaaaaaaaaaaah! Thanks.
Ignore comments then Suzi. Sorry.
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Suzi I'm not sure what you are saying?
All HRT involves products which cost money - and yes make money for drug companies - but if we want it then someone has to pay. Even if it is free to use on the NHS - the NHS pays the drug companies.
As far as I understand the drive for withdrawing the 25 mcg Vagifem was mainly due to the mantra - now outdated since the review of the WHI study (as I understand) - to use as low a dose as possible for the shortest possible time, and that this drive came from US - possibly from the FDA rather than the company.
The company is not saying use double the amount - it is saying that the lower amount is effective as shown by trials. However as I said below in my previous post the trials are not definitive and cannot possibly apply to all women.
Someone somewhere should be putting pressure on Novonordisk about this but I imagine the big Menopause Societies (such as the British, North American or International Menopause Societies) would be the only organisations with the remotest chance of being listened to.
From what I can see there also definitely needs to be more work done (long term trials) but sadly if they have withdrawn the 25 mcg are they going to conduct any more of these?
Hurdity x
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Its my opinion and only mine and like everyone else Im entitled to it
They have been flogging Vagifem for over 10 years now and women havent been dropping like flys
The price has almost doubled for 175m less in a pkt
Women who used 25x2 to drop to not even the amount of 1x25m a week is a huge drop
They could have brought it down to 20 even 15 and maybe with time see whast happens
They ahd the 25 for 10 years if Vagifems not safe then we shouldnt be using it
Wonder if the ladies on HRT were told weve all decided now ladies that HRT pills are going to be cut back
Sorry ladies but you will have you will have to manage We will only make the lowest possible dosage of HRT in furture
Yes you may probably get the screaming abdabs back the flushes the headaches depression but its safer for you
Weve decided HRT pills are high risk so all doses will be lowered by at least a 1/2 there would be an OUT CRY I bet
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They think it is safe but there have been no long-term trials conducted as to how long it is safe to use it so maybe that is another reason why they have lowered the dose. When it was first produced the manufacturers did put a time limit on it's use and advised a break every so many months. Over time lots of women (me included) wanted to use it non-stop and, I think, due to pressure the company revised it's advice and said that it was suitable for continuous use. Maybe this caused them to rethink and the decision was made that for continuous use then the lowest dose should be used? http://www.dslrf.org/mwh/content.asp?L2=1&L3=7&SID=130&CID=2061&PID=42&CATID=0
Taz x
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Suzi- I don't really understand what your point is.
Is it that now the product available is weaker we have to buy more? If that is so, then drs could surely prescribe the doubled amount on one script? The cost of NHS prescriptions is not something that bothers the manufacturers i imagine.
If the manufacturers are responding to pressure from medics for a weaker product that is one thing- but TBH I doubt it. It's more likely to be a commercial decision. But without knowing more, I can't say.
There is still a lot of ignorance amongst GPs as to what is safe re. local HRT. I have heard of women not being given more than a few months' supply whereas my gynae is happy for long term use ( which is what the latest research shows) with the caveat that some women who do not use any progestins should possibly be scanned every couple of years just to check there is no uterine lining build up.
I pay for my prescriptions anyway as they are private. Sometimes the cost is less than the NHS, sometimes it is more. It's never a break-the-bank amount and the difference is usually no more than a couple of pounds. If cost is an issue then it's worth checking the cost of a private script which sometimes is cheaper than the standard NHS charge.
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Do NHS doctors issue private prescriptions ?
I think Suzis point may be that the drug companies can make more money by supplying a weaker product.
Honeyb
X
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yes! My old GP usd to offer my husband a private script for all kinds of things that were cheaper to buy privately. Sometimes they cost nowehre near the £7. 60 ish of a standard script.
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Fortunately we don't have that problem in Scotland......for the moment all prescriptions are free no matter what you get.
I have never been offered a private prescription from anyone other than a private doctor.
Honeyb
X
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Well there's no need to offer is there is you get them all free.
Lucky Scots is all I can say!
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Its such a shame that drs are so blind at times. The instructions on my Ovestin say use as required ( manf. advice is once or twice a week) - I use 2 times a week but sometimes more. My dr doesn't count how much I use as long as it's reasonable.
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The recommendation to review or break the treatment once a year was to assess the need for continued use of Vagifem - and for doctors to discuss with women any issues of concern - because long term trials have not been carried out for longer than a year, as I understand. (Please post links to refs if you know of any longer!).
In reality because for most women symptoms return on cessation of treatment, specialists advocated long term indefinite use, even though this could not be supported by trials.
Some experts recommended an annual progestogen challenge (taking a progestogen) to determine whether there is any endometrial build-up ( ie womb lining thickening). If there was any bleeding then this means there is some systemic absorption. Most docs do not do this.
However as we know it is licensed for continuous use without the need for progestogen.
As always - we are all different and all women should take note of any unusual spotting or bleeding especially post-menopause, because it is the extremely unlikely event of cancer is the only concern.
I mean most of us on HRT take/use HRT quite happily and there is likely to be more instance of endo build-up through conventional HRT than with Vagifem.
janm - I think you should insist on being prescribed double the amount on the same prescription if your symptoms return when you reduce to 10 mcg - or even now since you have tried before.
All they need to do is to make sure you are reviewed annually by your doc and discuss any symptoms of concern. I imagine you would go for a scan if you had any bleeding, spotting or unusual uterine pain.
if you wanted to you could even suggest an annual progesterone challenge - which would do the above.
When I've got time (not sure when) I will summarise all the result from that paper which will show that 10 mcg is effective in some trials on very few women - but not effective on 100% of women in the trial. I bet the GPs won't have read it....
Hurdity x
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Maybe they are right maybe you are right and Im wrong only time will tell
I still think HRT is far far worse has far more sides you only have to read on here to see that
BUT kowone is suggesting that HRT be down graded
Yes maybe there have been longer term trial and not the same for Vagifem Ovestin Ortho gynest?
I do tihnk it is mostly money but thats just my opinion it doesnt make me right just the way I see it xxxxxx
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Suzi - I agree with what you say re HRT not being downgraded - at least for some formulations. I don't understand why for example, as soon as the WHI results were first published, they did not ban all the horse oestrogens ie the Prempak and Premique ones? - since these are the ones that were the subject of the study. However since even these data have been re-evaluated 10 years later it is still not clear. But that is odd (lack of removal of these from the lists) because it actually was as a result of trials, and there really hasn't been anything definitive on Vagifem 25/10 long term as far as I can make out. The more work (ie long term studies) there is done on bio-identical/transdermal formulations of HRT, including vaginal preparations, the better it will be for all of us. Throw in some long-term testosterone trials for women and it will be even better!
Hurdity x
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Just adding my experience here.... I picked up my repeat prescription from the pharmacy for Vagifem 25 and was advised that they were now discontinued and that my pharmacist could no longer get them.
The new prescription was for 10mcg, still at twice weekly.
I have decided to try them for a month when I will review it with my GP - as long as I can last that long that is! So far I have already had to add an extra one after a return of a bladder flare up.
I am devastated as I was doing so well!!!
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But was that on the GPS script 25 or 10?
If its 25 not 10 then give it a week or so if symptoms start to come back adjust dose yourself
Next time you go you can then tell him no longer 25s see what he says but dont let it get hold again xxx
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The surgery had rejected my request for the 25mcg and re-issued prescription for Vagifem but for 10mcg. That has also happened to some friends of mine. It is so frustrating.
I know that I have posted on several topics, but this really is bugging me.
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My prescription was returned to me by the pharmacy so that I could get it changed by the GP. Did the pharmacy itself change yours scriv?
ariadne xx
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Picked up my last batch of 25mg yesterday. I already use 3 per week to keep soreness at bay. I'll be using the 10mg daily :(
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I order repeat prescriptions via the GP website, delivered to the pharmacy. The surgery rejected my request and sent the new dosage prescription to the pharmacy. I noticed it and commented... and was told that they can't get them anymore. :'(
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All of you with problems do what I did go back see GP
They must5 be made to understand OK xxxxxx
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Yes Boss! Will do! lol ;) Seriously though, thanks a lot for your support Suzi Q!
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your very welcome
Knowne should be in pain
OH and keep out of the bath soaking fanny NOOOOOOOOO
No soap just under arms etc no where near Fanny ok
Find find Goats milk soap or Olive Oil soap both really good you can even wash lightly down there it wont irritate