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My wife has had a script for generic LORTAB (I know oxymoron) 500APAP/7.5 Hydrocodone 2 X per day. She has had this medication for over 5 years. Yesterday, she saw her prescribing doc (Internal Medicine Specialist) and in general conversation about her health, the doc mentioned that he just received paperwork informing him that LORTAB was being taken off the market in 2014.
I've been digging for info on the internet and all I could find on this subject was the FDA wants Hydrocodone/APAP combination products to be placed in Schedule II....and the time released (no APAP) Zohydro has been approved by FDA. Nothing about Hydrocodone products being pulled.
My wife's PCP said she would need to go to Pain Management.
This sounds like her PHP just doesn't want the hassle of all the patients he now has on Hydro, hitting his office each month for scripts with no refills (Schedule II restrictions)....and his reporting that the hydrocodone was being withdrawn from the market was his creative, if deceptive way of presenting his new policy to his patients.
If it is indeed true, could it be that just the Brand LORTAB is being discontinued? I also have suspicion that because hydro/combo pills are the #1 prescribed drug in the US and generics are very cheap, did an under-the-table profit motive suddenly cause the FDA to approve Zohydro, when it just rejected this same drug only six (6) months ago?
I know this post is a bit disjointed with many questions and accusations flying around. 99% of the hydro in the world is being sold only in the US. So, do any Americans have info on this subject above and beyond the cover stories on the internet? Ideas? Help?
I take 325/5 Hydros for breakthrough while using the Butrans patch 24/7, so this will effect me, too.
Changing the schedule or eliminating this medication will also negatively impact many other legitimate patients in pain who currently manage on Hydrocodone.
Hi there scar_tissue 68. I had been on vicodin 10/660 also known as hydrocodone/APAP generic name for about a year now. A few days ago I went to my pharmacy in Maryland and my pharmacist informed me that there is a new law that goes into effect stating that you can no longer get a product containing more then 325mg of APAP in one pill and that pharmacies will continue to use the stock on hand but cannot purchase more. My RX was changed to Norco 10/325 which does not give me near the high I was getting but I also may have built up tolerance at this point too.
I would think this rule applies everywhere in the US but I'm not sure about overseas. I am not aware of hydrocodone becoming a schedule II narcotic at all. That's a shame that your PCP is kicking you to the curb because it's not easy these days to find a PM doc who will just pick up where another doc left off so to speak. I know because I work in healthcare and we have PM specialists.
Hope this info is helpful to you and others. Good luck!
The FDA is recommending that hydrocodone's classification be moved from Schedule 3 to Schedule 2
beginning in 2014, according to The New York Times. Some doctor's and patient's groups are against the change in scheduling, which could lead to patient hardships, as a change in scheduling will mean a new prescription must be written every 30 days Currently, hydrocodone can be called in by a doctor and a patient may have 5 refills.
A new formulation of extended release hydrocodone, minus the APAP, has been FDA approved for distribution beginning in 2014. Called Zohydroo, the drug will be Schedule 2. Concerns were raised Zohydro could highly abusable, because it contains no APAP as a deterrent, plus I believe it's crushable, thus abusable. Since 2004 the FDA has considered moving hydrocodone products to Schedule 2.
OP, Since hydrocodone products are seriously being considered for a scheduling change it's quite possible your PCP doesn't want to dispense Schedule 2 drugs. Time will tell, but since Zohydro will be schedule 2, older hydrocodone products scheduling could very well follow. Older hydrocodone products will not be banned, but due to APAP overdosing being the number one cause of hepatic failue the FDA will only allow the APAP ose to be. 325mg. ALSO, the recommended daily dose of APAP will be reduced from 4gm. to 3gms.
Knowing Big Pharma's tricks I wouldn't be surprised if the drug loses generic status by changing the APAP dose. Once I was prescribed 5 mg of Flexeril. Since 5 mg was new to the market the makers sold it as a drug with a new patent. This was when 10 mg. of Flexeril had been a generic for decades.
Last edited by prescriptionperil; 10-09-2014 at 12:01.
Thanks. I agree perscriptionperil. This sounds like my wife's (really my wife, not a pseudonym) doc just doesn't want to deal with Schedule II hassles. The only good news is that a Schedule II can be prescribed for a 90 day supply, which would help the hassle of filling a monthly script.
@ ybanurse247. Thanks for your help. I hope this dust-up is only about APAP.
The Zohydro approval seems suspicious and profitable for the company making the new time release formulation. It will be on patent and far more expensive than most all the other common opiates on the market. From what I've read, Zohydro does not have an abuse blocking mechanism, such as Oxycontin. I'm sure that will change when people start shooting and snorting this new drug.
Yep, my gf had the same thing happen. Her dentist prescribed Lortab and she almost wasn't able to get it at the pharmacy. They said something about drugs combined with acetaminophen being dangerous and/or pulled from the market. Weird.
Yeah they've already taken vicodin off the market in California. Arial was informed at pain management today that norcos are now a level 2 narcotic and she can only get 1 month worth (120) at a time with no refills
Further word from the Mid-West about this. Here's what's transpired:
All opiates combined with APAP can only contain 325mg of APAP. (Good News)
Hydrocodone with 325/APAP has been put on a "watch list" of various things the doctor must do consulting and testing patients, if the script is over 15mgs/day and no more than 60 pills per month. My wife is still being sent to pain management, even though she falls below the new restricted guidelines. She is trying to get to here PHP to ask why.
Hydrocodone is still Schedule III, if combined with APAP. Perhaps the new guidelines in my state have forestalled the re-scheduling.
As has been shown by the recent escalation of Heroin related deaths in New York State, if you make pills harder to get, people who use recreationally will get their opiates, regardless.
In the meantime, the people with real need for enhanced pain relief are the ones who will suffer through new hassles and hurdles in addition to dealing with chronic pain.
I will preface this by saying that 1. I am unable to make my own new threads to ask questions and 2. About 4 years ago I fell off a ladder, while I was about 10 feet from the ground. When I fell I crushed/broke 4 vertebrae in my lumbar and thoracic regions. Causing my DAILY pain now and nearly paralyzing me. So my pain is legitimate and documented and I have had 3 surgeries since then and have been told I need another surgery soon and for the rest of my life will probably have to have surgery about every 5-10 years :/ Since falling I have been on various medications including many different pain medications. I started out on the typical 5/500mg hydrocodone and for about the last 2 years now I have been on Norco 10/325mg, 120 pills, 3-4 times a day as needed for pain. I go see my doctor about every 3 months and I take 3 other medications, (Gabapentin, Meloxicam, and Tizanidine), and my primary doctor prescribes all these too me about every 3 months WITH the proper amount of refills, which is usually the initial fill plus 2 refills to last me between appointments. I had to go for my normal appointment today, September 8th 2014, and was in need of my medications refilled for the next few months. I told him this and he said no problem except that we would need to talk about one medication, my pain medication (Norco). He told me that now he was unable to prescribe me the Norco with any refills and that I would have to come back EVERY MONTH now and get a WRITTEN prescription. He told me that he was unable to call it in to the pharmacy anymore and that the FDA or DEA has changed the drugs schedule from a Schedule III(3) to a Schedule II(2) drug. I'm not 100% sure what that means but basically he said it is going to be watched much more closely and that it has to be a NEW WRITTEN prescription now EVERY month and that it could NOT be called in or have refills.... I have always been scared about being labeled as a drug seeker or addict and I do NOT know what I would do without my pain medication. I have pain DAILY and I really don't know how I would deal with it without some sort of pain medication. I know that doctors don't like prescribing it because of the abusers and such and I feel like this is bullshit and that he is trying to cut me off. He DID write me a prescription today for 120 Norco 10/325mg, my usual doage, but it had no refills and it just seems like something is up. Mainly because when I went to drop off the prescription at my pharmacy I asked the pharmacist if the drug that I was getting was allowed to have refills and he said "yes you can get up to 5 refills if the doctor authorizes them"...... so I am SUPER confused becaue my doctor talked to me for a good ten minutes on how it is changing and that he cant do this and that and that they are watching these meds so closely now. Do you guys think that my doctor is going to try and cut me off and just made up this story?!?! I am TERRFIED because of not knowing how I could possibly deal with my pain DAILY without any pain meds..... Mind you I have NEVER asked for an early refill, claimed to lose my meds, or claimed that my meds were stolen. I have been with the same doctor for almost 4 years now and I have always gotten all my meds from him and always taken them EXACTLY as prescribed. So it's not like I have done anything to warrant this... I am just really really concerned and terrified and I would really appreciate everyone's thoughts/opinions on this issue!! Also, if there is something going on is there anything that I could say that would NOT make me look like a drug seeker or addict? Like basically a way to talk about my concerns with my doctor? I could REALLY use the help guys! Thank you in advance!
I think that your doctor, and the people who have informed EVERYONE else who responded with the answer to this question above are probably more reliable then a single pharmacy technician. No you're not being cut off.
I just did a quick search on the web and discovered that in an article dated 8/12/14, Hydrocodone is "About" to become schedule II. In the state where I live, I was just refilled for 90 10/325 Hydro + APAP.
I have an appointment with my pain management doctor this month and will dig into this from the POV of doctors in my home state.
AS of last December, the tighter restriction I reported in the OP are coming true, but as of last week, Hydro with APAP was still Schedule III or my docs office could not have called in the script.
Remember, your pain control food chain works like this (in descending order): Doctor, State Laws then Federal laws. Some doc are reading the writing on the wall and using the schedule II prescribing guidelines, now.
My bet is that you will be transferred to a pain management specialist, as the paper work and phone calls for opiates will be tough on a PHP's limited office capacity for these new opiate laws, plus Obamacare, plus Medicare, plus....
One thing. Calm down. Schedule II is a hassle, but it's only once a month. You were probably going to travel to your pharmacy anyway, so now you have to loop in the doctor's office on that trip for opiates. The problem will come when general inefficiencies make your quick trip into a day-long ordeal.
Other good news for us chronic pain patients, schedule II is no longer a jump a big jump up to Hydro compared stronger meds. Now, it's classified the same as all the the higher tier pain drugs. Let's hope it works that way.