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 Post subject: Providone, crospovidone
PostPosted: Fri Jun 10, 2016 5:12 pm 
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Hi gang! I've been doing research on brand name and generic, how some get proper absorption from brand name but not generic. I have no clue if this has truth or not, but brand name contains povidone, some generic contains crospovidone, which some believe is the culprit in the absorption for some. I have this issue with generic, it is not in my head, I couldn't figure out what was wrong with me until I got insurance again and got brand suboxone. I was in withdrawal! Now my problem is I again have no insurance and suboxone film is causing me to fall behind financially and I'm just lost. I'm afraid to try generic again, if it doesn't work, what's the sense? Lowering my dose is not an option, I'm barely staving off cravings as it is. I guess I'm hoping for some advice. I do have the suboxone coupon, but it's still very pricey. Thank you in advance.

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PostPosted: Fri Jun 10, 2016 7:11 pm 
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Hey pugmommy! Nice to see ya post :)

This has been a debate for a long time because some swear it doesn't make any difference for them and some swear that there is a difference. I don't know either because I've always taken the film and the only time I didnt, I took subutex, it totally didn't do well with me. I only tried it a few days. Those days were terrible for me. I was an emotional wreck and felt bad physically. So I swore I'd never do that again lol. That was my one and only experience. I do think it could've been because it was pill form and I was only used to the films, so I figured I didn't get good absorption. I don't know, it could have been anything really. So I try to just chalk it up to that but I keep reading others that say the same thing so it's confusing. But there's tons and tons of ppl who do great on generics, I don't know why it'd bother some and not others, so could be absorption issues. I just have no idea.

I do understand the no insurance thing and spending extra on the films making it rough financially. That's exactly what I'm dealing with too. I use the coupon and that's all I can do. So I don't have any huge advice but I do understand ur struggle and why. Maybe u need to try different brands, maybe some are better than others, I wouldn't know because I haven't tried anything but the subutex for just a few days.

I hope u get something figured out. I believe that ppl who start out on the films, have a harder time switching to pill form.

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PostPosted: Sat Jun 11, 2016 9:04 am 
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Hey girlfriend I was hoping to hear from ya! I started on suboxone tablets with no problem., before film came out. Them I had roxane brand generic subutex and was fine for a long time, then out of the blue they stopped working. I also tried amneal generic suboxone, that was really bad as well and not much cheaper. Both of these contain crospovidone, I must not absorb. But the strange thing is the roxane worked fine for awhile.

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PostPosted: Sat Jun 11, 2016 11:02 am 
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I wish I could help ya better but as far as different brands and stuff, I'm at almost zero experience. I will say that I was convinced that the subutex I tried (they were white, that is all I remember lol) didn't absorb diddly squat. And it wasn't in my head because I hadn't heard any stories about different brands not working at that time. I was totally under the assumption that bupe is bupe...so I don't know how it would've been all in my head. It's very interesting what you've noticed about the 2 different ingredients.....that does sound like ur onto something. I wish the films weren't so dang expensive, the cheapest I've found them in my area is $9 and that's what I pay with a tiny bit of help from the coupon. I remember when I first started suboxone and was calling different pharmacies to price check, Kroger pharmacy was $13 a strip at that time! Now that's been 4 yrs ago, but crap! So yeah I completely feel ur irritation about the expensive part. I just wonder why it's so much in my area. But I just do what I gotta do. Hey pugmommy, u ever checked on zubsolve or bunavail?

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PostPosted: Sat Jun 11, 2016 9:41 pm 
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Yep I tried zubsolv,no cheaper even with coupon. I had a terrible experience, had terrible nightmares that were very real, withdrawal symptoms to the punt where I was seeking a methadone clinic and I now hate methadone, and very depressed and had suicidal thoughts which was really strange because I'm a naturally happy person that can see the brought side of everything. That was really scary. I don't know why it's so expensive, buprenorphine and naloxone are inexpensive meds and for some reason the 4mg strip are the same price as the 8mg

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PostPosted: Sun Jun 12, 2016 9:05 am 
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I'm usually that type of person too! Always trying to see the bright side. When my fiance had a heart attack and was in the hospital, I was so happy he was alive lol I thought.....gosh at least now we know he has blockages that needs stents and we caught it before he had a fatal heart attack. He was all down in the hospital but gosh it could have been worse.

Don't give up pugmommy, you'll get all this figured out. So there's absolutely no way u can stick with the strips at all?

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PostPosted: Sun Jun 12, 2016 7:37 pm 
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Thank you jennjenn. To top it off, my Pug had a grand Mal seizure last night. I'll keep you and your fiance in my thoughts and prayers, thank you for the kind words.

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PostPosted: Mon Jun 13, 2016 11:51 am 
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Thank you and I will keep ur pug in my prayers also. Poor guy, hope it never happens again.

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PostPosted: Thu Jun 16, 2016 2:02 pm 
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As the owner of a puggle I feel for you--- hope he's OK.

Just to get some things straight about povidone and crospovidone (which is just another synthetic formulation of povidone), both compounds are NEVER absorbed, by anyone. They are part of a group of compounds called 'excipients', and are included in many medications to help with their absorption. They act as 'disintegrants'-- meaning they allow the medication to 'unclump' and dissolve in liquids, such as saliva or intestinal secretions.

Molecules tend to clump together, sometimes into crystals, sometimes into other shapes. A pile of powdered molecules molded, packed, and dried into pill form wouldn't dissolve in the GI tract if not for povidone or other disintegrants. I remember reading somewhere about cheap vitamins that could be found in the stool, looking much the same as they did when they were swallowed. Not sure who admitted to doing the research for that article..

Buprenorphine IS buprenorphine. Period. The absorption isn't affected much by excipients, because nobody ever complains that their Suboxone or buprenorphine won't dissolve. Povidone or crospovidone are also added to increase the volume, because an 8 mg tab of buprenorphine would be the size of 100 or so grains of salt. Excipients like povidone and crospovidone also help some drugs dissolve, especially drugs that are fatty and don't usually dissolve well in water-based solutions. This last purpose does NOT apply to buprenorphine, since buprenorphine is very water-soluble. Zubsolv is supposedly absorbed more efficiently in part because it dissolves very quickly, and maybe that is due to excipients.

I realize that when I write 'bupe is bupe' it sounds like I don't believe those who complain about their medication. But honest, I work with people over this issue every day... I have an equal mix of people who insist Suboxone doesn't work for them and people who insist ONLY Suboxone works for them. Today I was reading TIP 43-- a guide about medication-assisted treatment put out by SAMHSA and the Feds that is over 300 pages long, very well-cited-- in a section that cited studies about the psychological triggers for withdrawal symptoms. TIP 43 and other TIPs can be downloaded for free... just Google them. TIP 43 is primarily about methadone, but some of the information applies to methadone and buprenorphine. The pertinent section was around page 100, if I remember correctly.

The TIP information mirrored what I see in my practice. For years, I've noticed that patients will complain about withdrawal symptoms even at times when their buprenorphine levels are at their highest. Patients also report that their withdrawal symptoms go away 'right away' after dosing, when in fact buprenorphine levels won't increase significantly for 45-60 minutes. People who have been addicted to opioids may remember how even severe withdrawal mysteriously disappeared as soon as oxycodone tabs were sitting on the table in front of them. The bottom lline-- withdrawal experiences are remembered, and those memories are 'replayed' in response to triggers or other memories.

In my experience as a prescriber, I've come to believe that patients with an open mind will learn to tolerate any type of buprenorphine (the exception being the 1 patient I've met who developed hives from meds with naloxone-- hives that appeared consistently on three distinct occasions). But withdrawal symptoms seem to be triggered, in many people, by the expectation of withdrawal symptoms. So someone convinced he will never tolerate Zubsolv, Bunavail, or Suboxone Film will probably never tolerate those medications.

As for buprenorphine, it IS just buprenorphine. Molecules with a certain name and structure are always identical to each other. They are not 'crafted' products like bookcases or tables; some buprenorphine molecules aren't made with a quality inferior to other buprenorphine molecules. And once a molecule is in solution, I don't see much role for excipients. Of course a tablet or strip could contain too much or too little active drug, but that is an FDA issue, not an excipient issue.

Once again I wrote far more than I planned. Halfway along I figured I'd turn it into a blog post, so I just kept going....


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