I had to look up what this is! Tacrolimus.
There are other makes:
One think I'm having issues with is the eternal changing of the same tablet design and packaging, sometimes they are oval and shiny, other times more like little chips of flint but oval and the blister packs are designed to be as hard as possible to get them out without accidentally taking a bit of tin foil too. No consideration for the visually impaired at all. Not the same pill as you mention, three different types in fact all liable to change into the shape of each other and no tactile markings on the inner foil. An accident waiting to happen in my view. Brian
And its a common issue for all sorts of medication. However the yellow cards are really only for clinical effects not the ramifications of the packaging being at the discretion of the maker. Brian
Probably a bit specialised for here Jim.
Isn?t there a transplant group on Facebook etc? Chances are someone there will have been swapped between drugs.
You could also try finding out if they are used off label for other conditions- eg some eplsey drugs are used for pain relief- so if some is using one they could try either kind of group.
You could ask your chemist to pack your meds in blister packs for you.
I took it that Jim had noticed issues due to change of product. If product a) is OK but product b) causes side effects, that is definitely within the scope of the Yellow Card system.
The one medicine I take is available in four formulations in the UK. Some people seem tolerant of all of them, others one two or three. If someone is switched to a formulation that causes side effects, they would ideally Yellow Card it. I stick to what I know I can take without side effects.
(There has recently been research which seemed to show that ingredients used in all four formulations are actually inappropriate for use with the specific active ingredient. But it will be years before anything important changes.)
I suspect you'd do better asking on a directly related forum such as: Kidney Transplant Patient Support British Liver Trust Kidney Transplant
on
At least it looks as if it could have some relevance.
Some logic to antibiotics when you have dental treatment with some heart conditions so it may well apply to transplants. It seems, when you have some dental treatment, it can release high levels of bacteria into your blood stream. This can cause damage in the heart during the pump cycle. It is something parents of children with holes in the heart need to be aware of. It would seem logical it could apply to other heart conditions, including possibly those with transplants.
As for the side effects. Generic version usually means same active ingredient but different packaging and maybe pill style etc. It sounds more like the change is more dramatic. Either way, they should swap you either back or to something that doesn?t give you problems.
And I wonder how effective the system is?
My eldest son suffered an epileptic seizure four years ago (followed by cardio-respiratory arrest!) He'd not had anything before and didn't in the three years after, although he has since. The only difference that first time was that he had had a travel sickness pill for the first time, due to a forecast of severe weather during our ferry crossing to Ireland.
It was eventually put down to a reaction to the tablet. The paperwork says that it can increase the frequency of seizures in people who have epilepsy, but there is no mention of triggering them in someone that has never had any.
We suggested to his Consultant that it might be a good idea to fill in a yellow form (there's one in the back of every copy of the BNF and it can be done online now too). The Consultant responded that he'd never filled one out in his whole career!
How much information is failing to be collected if health professionals aren't informing the system of adverse reactions?
SteveW
+1 My prescription tablets never seem to be packaged the same each time. You forget to mention the packaging that launches the tablet to the other side of the room when the plastic foil finally gives way.
Is that with the same formulation from the same maker? AFAIAA every medicinal tablet is unique to formulation and maker by using shape, colour and marking.
Same formulation and maker? Mine vary but only when the maker and/or formulation changes.
Rupture the foil with a finger nail before pressing out from the blister side?
Well, blister me.
I wholeheartedly and completely endorse what you say. The best thing that ever happened was to allow patients (etc.) to make Yellow Card reports.
I am well aware that the system can be extremely slow and might, in the end, make little difference. But it is a start. They do get counted. Issues are identified.
The medicine I take, one comapny's product stopped delivery its claimed potency (in, I think 2012). Yellow Cards were what identified this to the authorities and the product was taken off the market (licence withdrawn).
A whole MHRA report was produced on the issues. The manufacturer had sourced an ingredient which was not so spec ification and that prevent the active substance being delivered.
That company, some years later, then launched a new formulation which was what they had been selling in Croatia (and elsewhere) for years. It too is controversial as many cannot tolerate it - but it does appear to deliver its claimed dosage.
I suffered from this.
asked my dentist he said it was a a load of nonsense to do that.....
Pharmacist at Edinburgh Royal said even the pill coating can cause problems so what chance do you have .... been back on the old pills now since friday night and all is fine.....
If you say so.
he said so ......in my case....
In my experience, that is often far worse. For a start, they rarely give you the patient information leaflet. You are likely not to know what make has been supplied (unless you work it out from details fo the tablets). There will be no batch number - in case of a recall. There will be no expiry date.
Also, many medicines are packed in controlled conditions to reduce deterioration of the medicine. That is lost if repackaged.
A lady in my village had a tooth abscess and shortly after developed a heart problem that was attributed to bacteria from the bad tooth damaging one or more of her heart valves.
She went downhill quite rapidly and died in the mid 70's despite being otherwise fit and sprightly (with 2 active dogs).
But you never manage to. Something foils your attempt.
This (the poor reporting by the medical profession) is a serious issue. The Patient Information leaflets that accompany medications sometimes list the occurrence of specific side effects, e.g. '1 in 100 people have adverse skin reaction', but this is based at least in some part on the non-reporting by doctors. For all we know this might in real life be
1 in 10, but the other cases never make it through the system. Let's hope the self-reporting sees some shift in this.Some fifteen years ago I'd been on a combination of medications for some time, when a warning notice went out that this could result in diabetes. Consequently I was taken off one of the medications, and my doctor at the time then prescribed some four others in turn, each of which resulted in some side effects or other - for one of them, I still have those effects. No-one took any special note of any of these or seemed to report them further.
The cosy relationships between pharma companies and doctors might have something to do with the problem.
Your son's Consultant's attitude was very poor.
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