Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: babyjane on August 24, 2016, 10:04:13 AM
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I have been using Vagifem for over 5 years now with no trouble. When I ordered my repeat prescription this week I was informed by our local pharmacist that they cannot fill my prescription because they have given out all their quota for August and will not get any more in until the beginning of September when they receive that month's quota.
I have never heard of this rationing before. Has anyone else encountered this?
thank goodness I order in advance. What would happen if I was about to run out?
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I have not heard of this either BJ.
I'm only allowed 1 box per prescription and been told this has to last me 3 months!!
Janx
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Found this http://www.abpi.org.uk/our-work/news/2012/Pages/230612.aspx
My local pharmacy works to quotas but we have a further two which are really local to me and I just go to one of those if my usual pharmacist has reached their quota.
Taz x
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I have never heard that and worrying as I need to use one everyday.
Janice...why will they only prescribe one box? That is only 2 a week, I couldn't manage on such a low dose.
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Isn't it supposed to be two a week after the initial loading?
Taz x
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I have never managed on two a week, my doctor says many of her ladies need 5 x a week as that is equal to the old 25x 2 dose and is happy to prescribe more. Sadly she has left the practice, so hope I don't encounter problems in the future :-\
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I use one every other day and get 2 x 24 which lasts me three months. I will have to remember to re order at the beginning of the month in this case. So why doesn't this happen with all my repeats then if everything is determined by quotas? I have never encountered it before.
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I know what you mean Tinkerbell it's ridiculous!!
I asked for 2 boxes of vagifem and my doc said the one box is intended for 3 months supply hence 2 a week as instructed on leaflet. I got told off as I was using every other night which was okay for me because of the new LOWER Dose now.
Am I safe using the 2 a week? I now have irregular periods. I'm only asking as i don't want to take progesterone and wanted to know if it's safe to take vagifem without progesterone?
By the way i can't take full Hrt as it doesn't agree with me. But local estrogen is fine though. That's why I'm asking the question.
Janx
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I have used VF alternate nights since it was changed from 25mcg to 10mcg with my doctor's agreement and it is prescribed accordingly.
This schedule works so well for me that I would pay for it if it was necessary.
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Janice....I saw a meno specialist last year and she said it was quite safe to use it every night if necessary. She also wrote to my GP and informed them that even using Vagifem every day was only equivalent to one oral HRT tablet a year.
You do not need a separate progesterone if only using topical HRT.
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Janice....I saw a meno specialist last year and she said it was quite safe to use it every night if necessary. She also wrote to my GP and informed them that even using Vagifem every day was only equivalent to one oral HRT tablet a year.
You do not need a separate progesterone if only using topical HRT.
That's what I thought but no she said I run
the chance of endometrial cancer. The problem I have I can't take full Hrt and I can't stand the progesterone part either.
I get so confused as in professionals saying different things it's unbelievable! At first I did use it everyday then cut it down to every other night and I found it worked well for me and doing well on that then she came out with this very confused!! Help!!
Bless you janx
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That's rubbish, it's a tiny amount and systemic uptake is minute.
Is there someone else you can see at your GP practice?
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Yes i agree it is a small amount estrogen nothing compared to our mega amounts before meno!!!!
Already see another doc now too!!!
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Government deciding again that women can't have their prescriptions filled?
Bugga ……..
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Janice68 was it a doctor that gave you the incorrect information about the systemic effect of Vagifem? If she had looked at this website she would see the official view which is here: "Low dose vaginal estrogen preparations can be used long term without causing any known systemic effect, and without needing any progestogenic protection of the lining of the womb." http://www.menopausematters.co.uk/dryness.php
You will need your doctor's approval for using the higher dose ie more than 2 x per week - and this should then do the trick ie they should prescribe the right amount per prescription ie double. The licensed Estring (local oestrogen vaginal ring) delivers 50 mcg per week whereas the vagifem 2 x 10 mcg deliver 20 mcg - as they say in US "Do the Math" - so doc can't say 20 mcg is too much.
babyjane - I have never come across this before - definitely try a different pharmacy.
Hurdity x
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There is something rather sinister going on with drug supply in the UK, I fear. I had a long conversation a couple of weeks ago with my very good pharmacist who says that drug supply across the board is being affected by the NHS's reluctance to pay the full price that the pharmaceutical companies want, and that other countries are willing to do so, so this means we are no longer seen as a 'priority market'. This is why we are seeing these problems of shortages.
My Dad's partner who lives alone since Dad passed phoned me in tears a few months back after driving all over Northampton and was unable to get her heart drug. She was informed of the same thing by the pharmacist at Boots. Her GP then had to subsequently switch her medication, which neither of them were happy about. Rosemary didn't do well on it, and as she has now been able to source a supply of the drug at last, her GP has switched her back again but she lives in fear that the drug may become unavailable again. It's a worry she doesn't need at her age! >:(
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It's been known for years that the Government of the Day/ won't pay full whack which can restrict the NHS/Pharmacies access to drugs whereas mainland Europe will - of course the Government of the Day don't give a ………… :cuss:
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Hurdity I'm going to try the 2 a week vagifem régime. I think it's me getting confused it dosent take much with my foggy mind but have been told if I take more vagifem I will need to take progesterone and I do not want to take that route again. I have to say I was happy taking Vagifem every other night though for my VA.
Thanks for the info Hurdity!!!
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Who on Earth told you that Janice :bang: :bang: :bang: - it's a vaginal application with local uptake, nowt to do with progesterone surely?
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I was told if I take more than is recommended I need progesterone!! My doc said I might need more vagifem if I was post menopause. My VA bad enough now let alone post meno!!
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As Huridity said the Estring gives a weekly dose of 50mcg with no additional progesterone needed.
So surely 5x10 Vagifem a week if needed is fine....my doctor was quite happy to prescribe that amount and did for whoever couldn't manage on less.
See another doctor if two a week is not enough.
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I was told sometime ago I wld need progesterone even with an estring and that was by a gynae hopefully you will understand how I get confused by it all!
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Been reading this thread with interest as my GP also told me i would need progesterone if i upped my dose of vagifem from twice weekly. I didnt agree with her as I had read on this site that many ladies use more so i rang a local menopause clinic and spoke to a clinical nurse specialist who was so helpful. You CAN use it safely more than twice weekly and she said i should go armed with the NICe guidlines which confirm this fact. Needless to say i have an appointment to see a different Gp next week. None of us want to put ourselves at risk and I actually hate using anything but sometimes needs must for qualityof life.
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Thank you Jc2 for that I thought i was going mad and even asked my OH last night just to make sure I was getting it rite what has been said to me by two docs and gynae who is a bit old school even preferring the premarin hrt route.
Thanks again for info I think I will go back to my every other night. I'm one for quality of life especially when I can't take full Hrt only local!!
Pls let me know what this other gp says to you?
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I have come across the quota thing before...........
I took my prescription in Fri and was told that they had none in, so to come in Saturday when they would have had their delivery.
I went in Saturday and the Pharmacist came out to say that the assistant had been wrong blah blah...., that it did not come with the normal delivery because blah blah....quota....blah and that they had to make an order for it but it would be in on Monday.
To be honest, I did not understand what he was saying, but I get the feeling it is a problem small pharmacists have. I got my vagifem on the Monday, and it hasn't happened again.
My old doctor used to make me put in a paper prescription request every time I wanted a pack in under 12 weeks in spite of prescribing 'one or two twice weekly' and even though I told them I was using 3 a week. This used to take at least 3 days, and a drive to the surgery, then find a pharmacist and needed to be done on a Monday to make sure I got it in the shortest time. So I was using them very sparingly and always on the point of running out especially if things went downhill and I needed a reboost. My new gp gives me 2 boxes and so I can time my prescriptions better and factor in the pharmacy problems. And even better, I can do it paperless, so I just have to specify the pharmacy and pick it up from there. This is much quicker, so if there are any delays, it is not noticeable! Last time, it had been sitting there for me from the date I ordered it (mid-afternoon).
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It is the drop in oestrogen that causes skin thinning = dryness all over the body, inside and out - so replacing oestrogen locally so that the vaginal walls are plumped up and less likely to itch, split etc. is what is recommended. It doesn't say in the leaflet that increased use of Ovestin1m will require progesterone.
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Some time back a gynae told me if I intended staying on Vagifem for life I would need progesterone . She then suggested the Mirena!! Talk about overkill!
There are so many conflicting approaches and no two gynaes tell me the same. Very confusing.
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Some time back a gynae told me if I intended staying on Vagifem for life I would need progesterone . She then suggested the Mirena!! Talk about overkill!
There are so many conflicting approaches and no two gynaes tell me the same. Very confusing.
Thanks linz57 at least I'm not the only one it is very confusing. May I ask how may Vagifem you use a week?
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I'm currently using 2/3 Vagifem alongside half a Femseven Conti patch. If I do eventually leave off the patch I'm sure I'll have to take more Vagifem though.
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Back to the original question. I have, this morning, approached another pharmacy in the town, Lloyds, which is not as big as Boots but neither is it a small independent. The young woman I spoke to could not have been more helpful and she confirmed that they do not have these quotas applied. If something is not in stock they order it and it is there the next day.
I shall be contacting my GP surgery to remove my nominated pharmacy request and will, in future, be taking my prescription to our nearest Lloyds
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I have to say BJ I've never had problems with Lloyd's if they don't have the item they will get it in for me. If there's a problem with the item they will let you know why they can't get it in too.
Janx
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:thankyou:
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I can nominate a pharmacy online now. There are many to choose from on the list - not just the local one - including the Lloyds in the next town. So maybe you can ask to nominate Lloyds at your surgery, then just pick it up from them and save a trip?
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yes dahlia, that was another option but for now I will go back to paper prescriptions so I am not tied to one pharmacy. Once I know they will not let me down I can nominate them
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Our nominating online is just a new thing - I discovered it last month. Before that, you had to sort it with the surgery so it wasn't worth bothering if you were not on frequent meds.
It does mean that you could choose a different pharmacy every time you put in for a prescription online if you wanted.
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Thank you Jc2 for that I thought i was going mad and even asked my OH last night just to make sure I was getting it rite what has been said to me by two docs and gynae who is a bit old school even preferring the premarin hrt route.
Thanks again for info I think I will go back to my every other night. I'm one for quality of life especially when I can't take full Hrt only local!!
Pls let me know what this other gp says to you?
Jan68, I saw the other go today. She is going to refer me to a consultant but she has said I can use vagifem safely every day and she has other ladies who use it on a daily basis. Same practice, two doctors, two very different consultations! So frustrating. Good luck, keep going to get the right solution for you.
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Thank you Jc2 for that I thought i was going mad and even asked my OH last night just to make sure I was getting it rite what has been said to me by two docs and gynae who is a bit old school even preferring the premarin hrt route.
Thanks again for info I think I will go back to my every other night. I'm one for quality of life especially when I can't take full Hrt only local!!
Pls let me know what this other gp says to you?
Jan68, I saw the other go today. She is going to refer me to a consultant but she has said I can use vagifem safely every day and she has other ladies who use it on a daily basis. Same practice, two doctors, two very different consultations! So frustrating. Good luck, keep going to get the right solution for you.
Oh cheers Jc2 for letting me know interesting eh? On what they advise about the amount of vagifem you can take!!
Good luck with the consultant let us know how you get on?
Janx
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I have been given 6 months worth of vagifem at 5 xs aday , I can use it 7 if I want to she has no problem.
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I have fallen foul of that quota business thing again >:( It has taken over a week to get most of the prescription. Thankfully I order well ahead.
Does anyone understand it? It seems only to apply to vagifem and to small pharmacies.
I think that when they go over the amount (quota) delivered each month, they are supposed to be able to order more, but that is not happening. So when they get it delivered, they have a backlog of people waiting, so it all goes, then people come in with a new prescription................
According to the link on the first page, quotas are supposed to be a good thing for patients. ::)
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since I left our local small independent pharmacy and transferred to a Lloyds pharmacy I have not had any trouble.
However I always order all my repeats well in advance :)
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Yes - it is a lesson in doing everything well in advance ;D The last time I left it a bit late with the HRT tablets, I fell foul of the 3 week wait to see someone for my review - and then the pharmacy had to order it in (but that only took the usual day).
I want my local pharmacy to keep going - one of the advantages of changing GP (not that I had any say in it >:( ) was that it is only a short walk away and so is the chemist. Otherwise I have to go to a big superstore, or drive to the next big town. With my last GP, I used to drive there and pick up the prescription and go to the supermarket on the way home and do my shopping. They have also been known to run out of stuff though and it is a pain to have to go back the next day.
From reading online, they should be able to order direct from the manufacturer when the wholesaler will not supply. Maybe they can only do this if they are big? You would have thought they would give them a quota in line with their usual uptake. I live in an area where there is probably above the average number of people in their 60s.
I suppose the other way is to work out when their monthly quota is delivered and time my prescription request with that!!
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I changed pharmacy because it was not only the Vagifem. My endocrinologist is very firm about my having the same brand of thyroid medication and not being given a different brand each time because I react to the slight differences between different brands and it makes my levels unstable.. The small independent chemist couldn't deal with that and I was often given a different brand with them saying they couldn't get my stipulated brand. If the brand is specified on the prescription at the instruction of a consultant then they are duty bound to order it in but they wouldn't do it.
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Sainsbury's have changed to Lloyds, so I may have a go at getting it sent there, and combining it with a shopping trip next time. They used to get things in for the next day if they did not have it, so I may not have to wait the three days.
(No idea why you have to leave it 3 days when they do it electronically - used to be quicker with a piece of paper ::) )