I take Ambien to sleep. When I first started taking it, the generic form caused me to sleep walk. So the doctor changed my prescription to Ambien CR (which is timed released). The timed release doesn't have a generic so I have been paying big bucks for it.
This time, when I got my prescription filled, the pharmacy sent me the generic of the timed release that has just come out. I called them and they explained that the new generic was on the market. Well I tried it and it doesn't work. It will cause me to fall asleep, but I wake up after about 4 hours.
The have changed my order back to the Ambien CR, but they said they would not refund the cost of the generic. Their position was that because I did not specify name brand that they were in the right sending the generic. I would have been fine with that had the drug worked, but it doesn't. I have left a message for the person at Emory that writes my prescriptions, but still awaiting his call. I expect to get a refund as the generic doesn't work.
I will have to see what the prescription guy says, but regardless of what he says, I am going to dispute the charges with my credit card company. The generic version was over 100 bucks.
That depends on how the actual prescription being filled was written--if it allowed for the substitution w/o confirmation, they're in the clear. If it was for the branded version specifically and didn't note that the generic could be substituted, then I'd venture you've got basis (other than that you apparently used some of the product instead of rejecting the order at delivery--that's a somewhat different issue as well I'd guess).
What rules are in your state for return of a prescription also would be a factor perhaps; can't imagine that it would be allowed for the pharmacy to restock anything that has left their possession.
Metspitzer wrote in news: snipped-for-privacy@4ax.com:
Three things about Ambien: The timed release version is better than the "regular version". The generic version didn't work for either, just like the OP. After having used it for a fairly long time, discontinuing the timed release version of Ambien was a horror for me. Just because they say it isn't addicitive, doesn't mean your body doesn't get dependent on it. Lckily, it was only 2 or 3 nights with hardly any sleep, and I was off it.
Try benadryl as a cheap alternative. 100 of them for a few dollars at walmart.
As the other poster noted they can no trestock anything that left their possesion. No matter if it got used or not. If the script allowed subs then you're just out of luck.
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.
Depends on the medicine. For example, most antidepressants you are talking 4-6 weeks before you even think about it increasing dose let alone taking someone off. Same with many kinds of high blood pressure. There are all sorts of things from stress, to how much caffeine, to heat in the room that cause sleep problems. If you tried just once or twice, I wouldn't think that was a good test as opposed to a week (or more). The precribing information for Ambien (wasn't that what you were talking about) says specifically re-evaluation should come if not resolved in
Careful about over-the-web prescribing, even for an over-the-counter medication!
Benadryl (diphenhydramine) is an anti-histamine, which is an entirely different class of chemical than is Ambien. Benadryl has an atropine-like action and, therefore, should be used with caution in patients with a history of bronchial asthma, increased intraocular pressure (e.g., pre-glaucoma or glaucoma), hyperthyroidism, cardiovascular disease or hypertension. It must be used with caution in patients with lower respiratory disease including asthma.
It takes longer to be broken down in the body than does Ambien, even Ambien CR. and is more likely to build up in the system, leading to a "hangover" effect with persistent drowsiness, slowed reflexes, etc. after the normal time of awakening.
If Benadryl, at a MUCH lower price, had a similar effect on the body as Ambien, Ambien would not be as popular as it is. One of the main attractions of Ambien is that it does not produce hangover nearly as much as many other sleeping meds.
This is not to minimize the potential side effects of Ambien. Just saying that it would not be wise to tell anyone to take a medication, even if available over-the-counter, without suggesting that the patient consult first with their doc.
Without counting the pills, I would say I have been taking it two weeks. Three nights I found myself wide awake before dawn and I took another one. One thing that aggravates my situation is that I have the strong urge to urinate about once an hour.
My bottom line is that the replacement doesn't work as well. I realize they can't reuse the pills, but I also have 90 day supply of pills I can't use either.
Your message gave me a thought. Because I have to order meds 90 days at a time, the pharmacy should send an evaluation script when making a change before committing to 90 days. My insurance pays 75%. I am stuck with 2 months of bad product.
I know "they" say generic is the same thing, but it most certainly is not.
Peter wrote in news:il3ch0$80s$ snipped-for-privacy@news.albasani.net:
Points well taken. In fact (I am too lazy to go and look it up) antihistamine/anti-motionsickness type medications are in over the counter "sleepaids".
About the only thing the FDA makes generic prove is "bioequivalency". They can take as few as 10 or 20 healthy volunteers, give them the meds, take their blood and as long as blood levels are roughly equivalent to the original, they are good to do. THey do have a fairly wide equivalent window, don't remember what it is any more. There have been some problems documented with generics. One medication the stuff making up the pill was different from the original and interfered somehow with the pill's usefulness. It is not unheard of for the bioequivalency window to be wider than the therapuetic one so you might not get enough or even OD depending on the particular batch.
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
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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 been reported".
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:
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NEWS Man Found Innocent Who Blamed Murder On Halcion October 22, 1993
NEWS Sleep aids' labels will warn of risk for odd behavior
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.
LIFESTYLE The Link Between Grapefruit Juice, Drugs
Chuckle. Had my quack change my BP scrip to allow generic, since the pharmacist said there was now a generic available at the same dosage level at a much lower cost. Picked it up, looked at it, and asked pharmacist if he had made a mistake. It was the exact same brand-name med I had been taking, at 1/3 the price. The company now also sells it as a generic, to discourage the other companies from poaching. Same pill, same color, same control number and brand name printed right on it. But unless the patient thinks to ask, or their pharmacist tells them (kudos to my local RiteAid), they and their insurance company will go on paying for the full-price version. I can see why the drug company does it- the marginal cost of each pill is trivial for them- rather than lose the sale entirely, better to sell it at a discount and still make SOME profit on it.
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.
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