Finding a Safe Online Pharmacy for Parkinson's Disease Medicine - part I

What if you can't find the PD medications you need for your treatment at a local pharmacy?

For those of us who were born in a time when information on almost everything was not readily available in our homes, it is amazing to be alive when vast stores of knowledge are finger taps away even when we are in our cars or hiking in the park.  When our children were growing, we kept a dictionary in almost every room.  A phone interruption at dinner time was not acceptable but stopping to look up the meaning of a word was encouraged.

When I was a child, there was an encyclopedia set to put one on the right track or just to read, page by page for the fun of learning about anything.  What do you want to know about Anacondas?

Now there is a huge overload of information.  We love that. But not all of it is factual.  Some is poorly edited or not accurate; some is sound- byte brief and some is just designed to separate us from our money. 

Because UCB has not been able to provide positive news about the Neupro patch availablability in the USA as they wait on the FDA, I thought I would continue the search of online pharmacies to see what I could find out there.  I found several online pharmacies which list the patch. I noticed was that the patch is very expensive. Because we had no knowledge of the prior US cost of the patch I decided to compare other medications for which I knew the price. They were expensive...not that expensive but at least 25% higher in price.  Of course there is also the question of the cold storage delivery.  And that is a BIG question.

We began to receive questions about the availability of other medications.   These questions were from markets with which we were not familiar. I just did a check on an L-type CCB, DynaCirc CR, availability and communicated with GlaxoSmithKline (GSK) as part of that search.  Turns out that despite the fact that they make the product and have offices in Australia, you can't find DynaCirc in there. You can, however, buy it from an online pharmacy in New Zealand, not to mention Israel, Canada and a few other places where I could not verify the online pharmacy.

I also found an online site which will check for some comparative prices and provide information about the pharmacies.  Therefore I did a domain search online because it is important to know the company trail - how long have they been operating their site - are they here today but gone when you are entitled to a refund or didn't receive the product they didn't really mail to you after charging your card. 

Since this company has been in business since 2002 with a 2008 update, we're passing that backlink along to you with a warning.  Although there are several ways to check for information things at the Pharmacy Checker website be advised, they do not list every bona fide online pharmacy, only their clients, and it is possible that they have some questionable clients on-board or at least did at one time.

This problem means that before you use any online company check the domain and also look for scam warnings. Due Diligence on your part.

Not all scam warnings are valid.  Some are just from customers who didn't read the shipping charges or the estimated wait time for arrival. Other complaints are very serious.  These complaints includethe company shipping the wrong item and labeling it incorrectly; taking  money for the brand and getting a generic which while similar might not be the same. And even worse, counterfeit pills.  Other scams include charging your card while not actually shipping the itemor submitting charges without authorization.

Companies can charge for shipping on a regular basis when you did not authorize such a program. Another danger is that you might receive out of date medication.

If your credit card is charged for any fradulent reason, report it to your card company immediately as this will enable to limit your obligation and in some cases your card company can bill back to recover your funds. If you reach this point, you can help others by reporting the scam and company to lots of online scam reporting sites and to any governing authority.

You need a prescription for prescription medication 
No prescription required is a red flag!

Another cautionary when ordering from a Canadian pharmacy is to look for the seals of accreditation. Some are real and some are fake. Note the seal and check with the issuer.  You can use either of the following links at the Canadian International Pharmacy Association (CIPA) to verify accreditation of the pharmacy you are considering. If you want to verify membership: contact CIPA.  They have a similar link under consumer safety. They will also list known sites which display a fake CIPA seal. There are other seals as well. Individual provinces will also require accreditation. As a matter of fact there is also a seal for the

Pharmacy Checker website.

Things to watch for: 

• Phone and fax numbers. Give them a call on their 800 number ostensibly to verify their mailing address or shipping & handling fees, whatever. But try calling at an off business hour.  Did you get a voice mail?  Anything?  Nothing tells you to move on. Don't leave a phone number or an email address.
• Does the site list an address - although this could be a mailbox company which would provide both street number and suite number they should be a legitimate pharmacy with a regular address.  I'm not so sure about companies which have drop shipping.
• Is their domain check questionable datewise?
• The AARP reported Double Drug Sting - just noticed this one - interesting 
• Do you have online access to the company pharmacist? 
• Do they ask for the prescription - if they don't - let your fingers walk away
• Is the price too low to be believed - don't believe and don't buy!
• Have you done your due diligence?  Are you dealing with a legitimate company? 

We wish that Parkinson's medications were available to all patients everwhere at affordable prices for everyone.  But the sad fact is then this isn't the case.  So we click our fingers on the keyboard and our options are displayed on the screen before us.   

Parkinson's, a Disease of Shortages

Help to find Sinemet, Plus and Sinemet CR for PD during the current shortage

Everywhere we look we can read that PD is a chronic progressive neurodegenerative disease which manifests because of a shortage of dopamine neurons in the brain thus causing no shortage of motor and non-motor symptoms.  So shortage is no stranger to the Parkinson's disease patient and we've talked about many of those for months.

We haven't talked from personal experience about levodopa-carbidopa (Sinemet) as a symptom relief treatment for Parkinson's disease.  About 8 weeks ago Steve began taking levodopa-carbidopa.  He is actually on a fairly low dose which seems to help a great deal with stiffness, a bit with tremor and not so much with weakness but he still hasn't titrated up to the full prescribed dosage - we're on hold for a totally different reason because we don't want to.
 

What we have seen is that you can set the clock by the wearing off because he immediately asks if he is due for any medication even waking from a sound sleep. But there are no side effects other than feeling somewhat drowsy.

It was his idea to take levodopa-carbidopa and his neurologist agreed to write the prescription. He has not reached the point where he needs a higher dose to be effective and so he has no reason to take the controlled release (CR) form for a steady, continuous delivery.  And because the first morning dose of the timed-release pills may actually take much longer to start working, we hope that we will be able to control the stiffness with the generic version.
  

Many people who require the steady release over 4 to 6 hours and many of these people will be affected by the shortages of:

• Sinemet tablet 12.5/100 mg
• Sinemet CR tablet 50/200 mg
• Sinemet Plus tablet 25/100 mg

These product shortages were announced by Bristol-Myers Squibb Pharmaceuticals Ltd in August 2009 and by Merck Sharp & Dohme Limited (MSD) in October 2009. The shortages are expected to last from 2010 through 2011.  If you're not sure it your pill is on the list, you can check the European Parkinson's Disease Association chart.

The product distributor, Bristol-Myers Squibb indicated in an August announcement that there were packaging issues which would cause a three week delay. 

Also announcing a shortage was Apotex, Inc for the generic Apo-Levocarb CR (200/50) available in Canada but now discontinued. Patients are encouraged to consult their doctors for treatment alternatives. Bristol-Myer Squibb is the distributor for Merck, supplying to Apotex. When announcing in Canada, no reason was provided, however other reports suggest that consumer stock-piling was already in progress creating a short supply.

The good news is that many generic versions, usually slightly weaker, still appear to be readily available, so it is not time to panic if you are using the medication for Parkinson's disease, parkinsonism, encephalitis caused parkinsonian symptoms, carbon monoxide or manganese poisoning.  Just how long this will last is unknown.

Merck has explained that the issue is not one of safety but rather a change in the supply source and the time frame required for proper jurisdictional approvals.  Because of contractual obligations, some markets may fair better than others.  Because of the length of time for regulatory approval, the wait time is uncertain.

People who are already taking Sinemet CR, Sinemet Plus of Sinemet 12.5/100 and are concerned about not being able to renew a prescription can call one of several numbers worldwide to speak to the customer relations department at Bristol-Myers Squibb Pharmaceuticals Ltd (800) 332-2056 or at Merck Sharp &amp Dohme Ltd or the parent company Merck & Co, Inc. 

The following countries have offices which you can contact at the Merck links above:

Argentina, Australia, Austria, Bahrain, Brazil, Canada, Chile, China, Columbia, Costa Rica, Croatia, Denmark, Ecuador, Egypt, Estonia, Finland, France, Germany, Greece, Guatemala, Hong Kong, Hungary, Iceland (see: Denmark), India, Indonesia, Ireland, Israel, Italy, Japan Korea, Kuwait, Latvia, Lebanon, Lithuania, Malaysia, Mexico, Netherlands, New Zealand, Norway, Oman, Pakistan, Philippines, Poland, Portugal, Qatar, Romania, Russia, Saudi Arabia, Singapore, Slovakia, Slovenia, South Africa, Spain, Sweden, Switzerland, Taiwan, Thailand, Turkey, UK, United States, Venezuela, Vietnam.

If you live in the UK, you can make sure that your physician has the following number:+44(0)1992 467272.

Thus far we have not seen warning for the other L-dopa/carbidopa combination medications.

Just a few reminders in case you are having an issue locating a supply:

• You can not split a timed release tablet    
• You could have a withdrawal problem if you simply stop taking the medication; consult your physician about a lower dosage prescription in order to titrate down.

And if this isn't bad enough, there is also going to be a shortage of Eggos until mid-2010 due to flooding at the Atlanta bakery in October, 2009.
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Addendum
Per information from the American Society of Health-System Pharmacists"

Back on February 23, 2010, GlaxoSmithKline (GSK) had acquired Reliant and announced that DynaCirc CR had been unavailable during the transition period. The 5mg and 10mg pills are available now.

Activis Group did make some changes in isradipine packaging. The 2.5 mg 100 count package is no loonger but the 60 count is available to pharmacies. The same is true of the 100 count 5mg package. Now only 60 count packages are available.

Watson Pharmaceuticals, which was formerly Cobalt, has isradipine available in 2.5 mg and 5 mg 100 capsule counts.

For those who have been taking the CCB Nimodipine, that shortage has been resolved.