Abixaban

I heard that in England they have a generic version of abixaban manufactured by Teva .I don't think it is available in the US but is the FDA working on approving it. Would it be equivalent to Eliquis

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alfrae13
I heard that in England they have a generic version of abixaban manufactured by Teva .I don't think it is available in the US but is the FDA working on approving it. Would it be equivalent to Eliquis

It is available in the Canadian Pharmacies that deliver to the US — Dr. Natale’s team offered to send my prescription there so they must regard it as equivalent. The question is cost though and if you have insurance in the United States and pay a co-pay it might be less expensive to get it through your insurance than through Canada where you have to file pay the full price out-of-pocket.

Teva and Sandoz both sued to have Bristol Myers Squibb's patent invalidated in the UK and they succeeded. But in the US, BMS got that patent renewed in the US until 2028, so you won't see a generic Eliquis here until then at the earliest.

They are selling genetic in Israel (Teva is an Israeli company). You can mail order it from the states. A few readers claim the price is cheaper, especially during the donut period.

For those who want a $50 referral discount, go to:

[www.israelpharm.com] one time $50 with a $75 order and free quick expedited shipping:
ref6604998 Is the $50 off code.

Disclaimer: I don’t get any financial benefit from the referral code because I don’t live in the states to buy from them anymore. But it’s a great pharmacy that I used to buy my drugs and my American family still uses their own accounts to save money and get great expiration dates. I recommend after your first purchase to generate your own code your friends and family can use and benefit if you calculate any savings.

Also heard Canadian pharmacies are the most cost-effective source of the generic. And that they're well-regarded / safe.

Believe apixaban was also being manufactured in Ireland... not sure this is current info though.

/LarryG

A year ago I actually tried to buy Sotalol to stockpile for my move if they didn’t offer Sotalol in stock on their drug basket inventory…which they did offer but had a 6 month out of stock wait on the drug. At the time I contacted a pharmacy in Canada to buy. I ended up not buying from them because it seemed like a scam because no doctor Rx was required. It worked out because I’m no longer on any arrhythmia drugs. I take cardizem which is readily available where I live at a substantial discount.

I think George recommended an Canadian pharmacy once for himself and son. Am I right George? Which pharmacy was it?

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susan.d
I think George recommended an Canadian pharmacy once for himself and son. Am I right George? Which pharmacy was it?

A legitimate Canadian pharmacy will require a prescription! I have been happy with Canada Pharmacy [www.canadapharmacy.com] Look for CIPA Rx on the website for a Canadian Pharmacy = Certified Canadian International Pharmacy.

They offered Sotalol 60 tablets for $32 and they didn’t sound legit by not requiring a Rx. George used a different pharmacy. Maybe he will chime in the name.

I've used goldpharma.com for probably at least 15 years. They are a broker for pharmacies in Europe. I've used them to purchase branded, blister packed, flecainide (Tambocor - only generic is sold in the US from what I've seen) as well as some meds used off label for my son with brain cancer as Susan noted. This was for part of an experimental protocol (he's still alive at 6 years from diagnosis and initial tumor resection - he was initially given 12 to 18 months, I'm guessling less than 1% survive to 6 years). He also did standard of care but hasn't had any surgery in 6 years, radiation in over 5 years & chemo in 3 or 4 years. I subsequently found a US doc that would prescribe the meds for him. They do require a prescription, but will connect you with a European doc who can prescribe. From memory, a lot of the pharmacies that filled the orders were in Germany.

I searched for Apixaban & nothing came up. Eliquis did come up costing $134.47 US for sixty 5mg tablets (plus shipping & so on).

I have 6 month supply of eliquis from 2021. I know label suggest it has shelf life. But can I use it if needed in future? Stored in temp controlled closet with my other meds stock pile.

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Kleinkp
I have 6 month supply of eliquis from 2021. I know label suggest it has shelf life. But can I use it if needed in future? Stored in temp controlled closet with my other meds stock pile.

Here is a story from 2017 on meds generally. Have no idea how stable Eliquis is. In my own experiment from taking 8 year expired (and also blister packed) flecainide (posted here), I'm guestimating the flec had lost about 1/3 of its potency, which turned out to be fortuitous for me. I'm not suggesting others follow my lead.

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GeorgeN
I'm not suggesting others follow my lead.

It seems the US military might do just that. I can't find the study now, but several years ago I read about a study commissioned by the US military. As you might imagine, they hold huge stockpiles of vital medications, and those stockpiles have to be rotated periodically to account for expirations, and that's extremely expensive. So the study they commissioned looked into how long meds actually last, and the answer was for almost all meds, far longer than the expiration dates printed on the bottles. Sure, some meds are more sensitive, but most meds when stored properly (cool, dark, dry) can be used for 5 or more years beyond expiration. I need to find that study again....

I can't be certain, but my guess is that ointments are probably less stable. Antibiotic creams, maybe steroidals, that kind of thing. Salicylic acid, or aspirin, will break down in a few years due to exposure to air. Again, not sure about those that are enteric-coated.



Edited 1 time(s). Last edit at 08/02/2023 12:29AM by gloaming.

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Carey
It seems the US military might do just that. I can't find the study now, but several years ago I read about a study commissioned by the US military. As you might imagine, they hold huge stockpiles of vital medications, and those stockpiles have to be rotated periodically to account for expirations, and that's extremely expensive. So the study they commissioned looked into how long meds actually last, and the answer was for almost all meds, far longer than the expiration dates printed on the bottles. Sure, some meds are more sensitive, but most meds when stored properly (cool, dark, dry) can be used for 5 or more years beyond expiration. I need to find that study again....

Carey, that is mentioned in my linked article above. They said in 1986 the FDA & the military created the Shelf Life Extension Program where they actually sample lots out of the stockpile and test for potency. "Each year, drugs from the stockpiles are selected based on their value and pending expiration, and analyzed in batches to determine whether their end dates could be safely extended. For several decades, the program has found that the actual shelf life of many drugs is well beyond the original expiration dates.

A 2006 study of 122 drugs tested by the program showed that two-thirds of the expired medications were stable every time a lot was tested. Each of them had their expiration dates extended, on average, by more than four years, according to research published in the Journal of Pharmaceutical Sciences."

"An official with the Department of Defense, which maintains about $13.6 billion worth of drugs in its stockpile, says that in 2016 it cost $3.1 million to run the extension program — which saved the department from replacing $2.1 billion in expired drugs. To put the magnitude of that return on investment into everyday terms: It's like spending a dollar to save $677."

They also mention a case in Calif. where a cache of meds were found in the back of a pharmacy, from the 1960's. 14 chemicals were analyzed and 12 were still potent.

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gloaming
I can't be certain, but my guess is that ointments are probably less stable. Antibiotic creams, maybe steroidals, that kind of thing. Salicylic acid, or aspirin, will break down in a few years due to exposure to air. Again, not sure about those that are enteric-coated.

I think liquids are the least stable, especially once opened - bacterial contamination being a primary issue. My wife takes low dose naltrexone. Naltrexone at 50 mg is used to treat alcohol use disorder and opioid dependence. Naltrexone blocks the effect of opioids and prevents opioid intoxication and physiologic dependence on opioid users. Low dose, generally less than 5 mg (down even in the 0.1 or 0.001 mg range), is a whole other thing. The use is off label and can be for autoimmune issues, pain and a host of other things. My wife would get a doc to prescribe it, then get it from a compounding pharmacy. The compounded med is in a liquid format, which had a life of about a month, in the fridge. After some years of this, we got the 50 mg capsules from Europe and compounded them ourselves, at a minor fraction of the cost. Compounding is easy, we have a gram scale and put 50 grams of (boiled, filtered) water in a small container (50 g = 50 mL) and put a capsule in and shake. Then she uses disposable syringes to measure 3 mL (=3 mg of Naltrexone). We use the disposable syringes so we don't introduce bacteria into the solution. It has a life of a month in the fridge.

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gloaming
ointments are probably less stable. Antibiotic creams, maybe steroidals, that kind of thing.

Three weeks ago I accidently used Neosporin expired in 2021 on my groin wounds, wondered why they are not healing

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GeorgeN
I think liquids are the least stable, especially once opened - bacterial contamination being a primary issue. My wife takes low dose naltrexone. Naltrexone at 50 mg is used to treat alcohol use disorder and opioid dependence. Naltrexone blocks the effect of opioids and prevents opioid intoxication and physiologic dependence on opioid users. Low dose, generally less than 5 mg (down even in the 0.1 or 0.001 mg range), is a whole other thing. The use is off label and can be for autoimmune issues, pain and a host of other things. My wife would get a doc to prescribe it, then get it from a compounding pharmacy. The compounded med is in a liquid format, which had a life of about a month, in the fridge. After some years of this, we got the 50 mg capsules from Europe and compounded them ourselves, at a minor fraction of the cost. Compounding is easy, we have a gram scale and put 50 grams of (boiled, filtered) water in a small container (50 g = 50 mL) and put a capsule in and shake. Then she uses disposable syringes to measure 3 mL (=3 mg of Naltrexone). We use the disposable syringes so we don't introduce bacteria into the solution. It has a life of a month in the fridge.

I do the same thing with Naltrexone—compounding it myself is easy and greatly reduces the cost. I get the 50 my tablets from Walgreens and use 50 ml of distilled water then measure out my 4 mg dose.

George, if you feel comfortable doing so, would you please PM me and tell me more about the Naltrexone and autoimmune...without giving away too much personal info, of course. My wife has a litany of issues going back 15 years, but she seems to have inherited some awful genes from her mum that are hounding her in later life. Thank-you.