Ouch. Happened to my Dad, too. Very nasty. You have my sympathy. As Kurt
Vonnegut once wrote: "I knew getting old was going to be bad - I just didn't
know it was going to be THIS bad!"
Good grief! You don't take sleepers because your bladder/prostate is
keeping you awake....that's kind of like turning up the AC when the
house is on fire.
The generic should be exactly the same, chemically, as the brand name.
Could your worry about everything be doing tricks? Taking sleeping
pills for years and years is a bad idea...one almost always develops
tolerance to sedatives, and withdrawal can be worse than original problem.
A hazard of many medications, including Ambien, is a "rebound"
effect..actually making the problem worse. As with alcohol, the sleep
induced is not "normal" sleep - may sleep more soundly but wake sooner.
There are lots of things to try before taking meds long-term.
I don't want to get into discussing of personal matters, but wonder if
the doc does blood work now and then to check liver function (to make
sure your body clears the chemical as it should).
I'd have either done as you (apparently) did and taken the chance't (but
wouldn't have expected anything, either), or if was really concerned
about either the cost and/or the possible efficacy I'd have consulted
the prescribing physician about a trial length and smaller initial
prescription to go with same and/or perhaps even the generic might have
a samples program...
Either way, if I took the subject prescription at the pharmacy knowing
it was the generic I'd certainly not think it was their responsibility
for anything other than having filled it correctly.
Doctors script was probably marked to give generic if available.
I don't think pharmacies are allowed to accept drugs back. Beef should
be with the generic company although FDA normally screens generics
carefully before allowing them.
Maybe you could talk doctor into giving you samples he has on hand to
make up for it.
If the script (which most people don't keep copies of but should - I learned
the hard way) said DAW (Dispense as Written) you MAY have a case depending
on your state, but I would doubt it. IIRC, a lot of state pharmacy boards
allow for generic substitution unless clearly stated otherwise.
On the other hand, the pharmacy laws probably prohibit them from accepting
any returned drugs, so you're probably stuck between a rock and a hard
place. Find out who makes the generic from your pharmacist - they will
usually have an 800 number, but some don't.
I'll bet the maker of the drug would be *very* helpful to you in getting
some sort of credit rather than having you file an adverse reaction report.
The maker of the "real" Ambien would also be interested in hearing about
your troubles since they have an obvious dislike of generic suppliers.
The FDA collects incident reports such as your concerning medication that
are occasionally helpful in identifying a problem drug. Not sure what their
hit rate is with underperforming generics, but you owe it to the rest of us
to share your experience with them. The "real" maker could certainly use
enough reports/testimonials like yours to pressure the FDA to do their own
testing of the generic for efficacy. The FDA is actually making some big
pushes in removing drugs from the market of late. Adverse reaction reports
helped removed poison Chinese blood thinner and other contaminated products
from the market.
Be aware, too that time-release meds are well-known for absorption maladies.
They rely on all sorts of tricks, from slower dissolving salts to plastic
matrix contraptions. Any change in intestinal motility can drastically
change the rate at which the medicine hits your bloodstream. The generic
formula probably uses a different timed (controlled) release mechanism than
the patented med does.
FWIW, I have found the same thing with generics - potency seems to vary
wildly as do shape and size. How would anyone really know if they were
getting a counterfeit generic when every few months the pharmacy stocks a
different generic, probably made in China or India or places unknown?
If your sleeping walking returned with the new med, I think the FDA might
pay even more attention.
FDA Adverse Reaction Reporting
I've had a problem resolved simply by faxing over forms to complete to the
pharmacy district supervisor but in my case I was also backed up by having
the magic letters DAW on the prescription (which I scan into my PC ever
since CVS lost a prescription for CII meds). But if you're on any kind of
a co-pay system, you may have already consented to generic substitution
whenever available. You poor pharmacist might have thought he was doing you
a favor . . .
I'm no doctor or lawyer, but OT to your question, what I think is
interesting is the first report I heard of sleep walking from this.
It was Patrick Kennedy, a son of Bobby I think, a Congressman from
Rhode Island, who was found iirc driving around the Capitol in the
middle of the night. He said it must because of the Ambien, but I'm
sure a lot of people though, Oh, yeah, sure, he was probably drunk.
Of course no one would be the first to blame Ambien if it didn't
really do it, because no one would believe him, since there had never
been afaik a drug that caused sleep walking, or driving (Scarey!).
Since then I've heard quite a a couple other stories, plus yours,
about it, and of course they warn about this in their commercials,
while not admitting to it. "Cases of [activity while asleep] have
Sleepwalking was the least of it. When the parent drug of Ambien (Halcion)
came out, people committed murder without remembering it. I, too, didn't
believe such stories until my wife started taking it - she would get up in
the middle of the night, wash the dishes, scrub the sink, etc. and not
realize she was doing it until I woke her out of her trance when she started
to run the vacuum cleaner. It was a real, looking-but-not-seeing sort of
daze that you only see in zombie movies.
It was pretty scary in some ways, funny in others. It got the nickname
"blue bomber" because it induced such a powerful hypnotic state in people.
The newer compounds are not quite as powerful. She finally stopped taking
it and moved to Lunesta, which seems not to bring out the midnight
housecleaner in her. Hopefully it also is less likely to make her stab me
to death while she's sleepwalking. It did have one very strong advantage
over barbiturates - I believe the LD50 is something like 1000 tablets while
barbiturates can kill you if you take just a few extra and a drink or two.
Doctors loved getting hold of a far less-lethal sleep aid than Seconal or
Nembutal. I've always thought state prisons should issue new prisoners 100
seconals and a fifth of grain alcohol upon admittance in exchange for them
signing an organ donor card.
Halcion's initial studies were tainted by a doctor who took money from the
manufacturer to administer the drug to his patients but he instead phonied
up the entire report using names he had gathered from a trip to the local
cemetery. Still, the FDA approved the drug even though the legitimate test
population was quite small. It wasn't until it got out "in the wild" did
the reports of serious sleepwalking begin to arrive at the FDA. I believe
the Brits have already banned Halcion - not sure of its current US status -
a Utah woman killed her mother while on Halcion and sued the manufacturer.
Upjohn settled the case out of court, all the while denying that the drug
was to blame for the murder. There are plenty of other interesting reports
of Halcion-induced homicides and other bad behavior on the net:
Man Found Innocent Who Blamed Murder On Halcion
October 22, 1993
<<A man who said the sleeping pill Halcion drove him to shoot his wife to
death was found innocent by reason of insanity. John Caulley admitted
donning a mask and ambushing his estranged wife, Kathleen, outside their
Troy home in 1988. The 44-year-old former stockbroker had started taking the
prescription drug three months earlier. Critics have said Halcion can cause
serious side effects, including short-term memory loss, violent behavior and
hallucinations. The federal Food and Drug Administration concluded in 1992
it was safe and effective when used as directed.>>
Sleep aids' labels will warn of risk for odd behavior
<<By Jonathan D. Rockoff the (Baltimore) Sun, March 15, 2007
WASHINGTON -- Under pressure from the federal government, drug makers are
revising labels on Ambien, Lunesta and other popular sleep aids to warn that
the pills may result in driving, eating and even having sex while sleeping,
health officials said Wednesday. The manufacturers of the 13 popular
medications are also preparing information bulletins for users that will
highlight the possibility of bizarre nighttime side effects. The Food and
Drug Administration requested the action to discourage patients from taking
higher-than-recommended doses or combining use with alcohol consumption.>>
Here's something more for Metspitzer from the same site relating to how what
you eat when you take a med can seriously affect absorption into the
bloodstream, especially with sleep aids like Halcion and Ambien.
The Link Between Grapefruit Juice, Drugs
<<By Bob Condor, Chicago Tribune, May 23, 1996
A grapefruit diet is unlikely to help you lose weight and keep the pounds
off, but researchers are finding it can most definitely affect absorption of
certain drugs.Researchers at the University of Michigan reported that
grapefruit juice enhances the body's ability to move active ingredients of
some medications more swiftly into the bloodstream. The most prominent drug
categories include calcium channel blockers, a group of short-acting
sedatives (including Halcion) and Seldane, a sinus medication.>>
I worked as a nurse, night shift, in a hospital. Patients on Halcion
would regularly go nuts, especially elderly folks. Occasionally,
younger people on Halcion would be very difficult to rouse during the
night. A number of times elderly patients who were perfectly alert and
normal during the day would become agitated and/or disoriented during
the night when put on Halcion. Only sleep med I've ever taken was
Seconal, when in hosp. for childbirth, and it only made me feel drunk.
Yes, by all accounts I was lucky that the worst I saw was my wife's midnight
compulsive cleaning behavior. We still have a nearly full bottle left. To
me, it's like Red Kryptonite - you never know exactly what you're going to
get. I'll probably chuck it soon. The worst side effects I have are muscle
spasms (from the rebound) and a god-awful quick temper when I first wake up.
What you've written mirrors what I know about Halcion - it's a "spin the
wheel" sort of drug with some people almost immune to it and others going
shi+ stomping insane. I'm sure you're one of the people that now believes
people can commit murder on Halcion and not remember it. But it takes
seemingly normal people turning into creatures from a horror film right
before their eyes to convince people that it's a drug that's best left
alone. Its great advantage when it first came out was that is was virtually
impossible to OD on it without stockpiling it for months. What a great
advertising gimmick: You won't be able to kill yourself but you WILL be
able to kill your spouse and not even remember!
I take Prograf so I was already told NOT to have grapefruit. Finally
they cut out something I already disliked. :)
It was cutting out the stuff I did like that was tough. I never had
any GOOD habits :)
--------From the web-----------
Do not consume grapefruit or grapefruit juice during treatment with
Prograf unless your doctor has told you do. Prograf can have a
dangerous interaction with grapefruit or grapefruit juice. Avoid
exposure to sunlight or artificial UV rays (sunlamps or tanning beds).
Prograf may increase the risk of skin cancer. Use a sunscreen (minimum
SPF 15) and wear protective clothing if you must be out in the sun.
That's good news. Getting sick usually means giving up things you like.
There are actually loads of really specific drug/food/drink prohibitions. I
know about the ones for thyroid problems like cabbage, kale, milk, soybean
and things with kelp products (more than you could ever dream - powdered
kelp is everything and when the big fish all die out, kelp will be our new
Prograf is serious stuff. Are you a transplant recipient? (Feel free to
ignore that question if it's too personal - for all I know it's also used to
treat hangnails, but I know of it because I was going to have donor tendon
transplant surgery until my surgeon got himself killed in a car crash
driving on black ice.)
Diabetes is murder on people with a sweet tooth. It might also be murder on
Medicare if the actuaries are wrong about their projections. It's a disease
that reflects our culture in many ways. I'm still not sure that corn syrup
is the same as cane sugar. Even less so now that the corn syrup industry is
running ads that say they are exactly equal. (-: When someone has to tell
you "I am not a crook" you should start worrying.
Yes. I had a liver transplant almost 9 years ago. Everyone has noted
that the side effects of Ambien are bad. They should read about
Prograf's side effects.
Did your tendon problem heal without having a transplant? That sounds
like a serious injury. (Bad luck for your doctor too) Doctors don't
get snow days.
I also was recently diagnosed with diabetes and put on insulin.
Diabetes is on the list of possible sides from Prograf. Another thing
that could have contributed to my diabetes was a large dose of
steroids I had to take for a short period. But, right now, I have
stopped taking insulin and am controlling my diabetes with exercise
and by staying away from sugar.
Ouch. That's serious business. When I was read the riot act about how even
a tendon transplant would change my life I got very hinky about doing it.
My surgeon, who pioneered the only technique that had more than a 50%
success, sealed the deal by getting killed. I'm glad to hear you've done so
well. The new immunosuppresants are miracle drugs, but they are also very
powerful drugs with lots of caveats and tradeoffs. Since a tendon problem
is usually not threatening, I was not in the same place you were in.
Yes, he was responding to a life threatening injury of one his patients in a
car crash when he got into one himself. Very sad. All I can say about the
tendon problem is that it's stable but progressively getting worse. I am at
stage 3. Some MDs have recommended amputation. )-: Not ready to go that
route but maybe when I get to stage 4. There are also some interesting
experiments going on with artificial and animal tendons, but that still
leads to anti-rejection drugs and their boatload of side effects. The
tendon problem came about, FWIW, as a side effect of taking Cipro as an
anthrax prophylactic. In some people and in combination with other drugs it
makes tendon tissues inelastic like old rubber bands left in the sunlight.
Surgery success rates are very low in such cases because of the systemic
Good for you. Controlling your diet is almost as hard as "keeping kosher."
There's sugar stuffed into everything these days. If I were to invest in a
business, it would be sugarless *edible* versions of all the popular sweets.
The Pepsi Generation is going to soon turn into the Diabetes Type II
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