Obtaining Femara Tablets

[bobbin]

That sounds hopeful then!

Having finally got up to date with Femara, am now in battle with AstraZeneca over Losec MUPS 20mg!! Here we go again!!

Just tell AstraZeneca that you will contact the doctor and request that they prescribe a non-AstraZeneca alternative. In fact, tell them that you will advise all of the local doctors to avoid prescribing Losec MUPS due to poor availability. AZ may suddenly show an interest in asking you about your monthly usage so that they can consider increasing your quota.

If the patient has difficulty swallowing, omeprazole capsules (most generics) can be opened and the contents dissolved in a bit of water. This is much cheaper than Losec MUPS! The only brand that you can't use is Mepradec because Mepradec capsules contain a small tablet instead of the beige granules which are present inside other types of omeprazole capsules. Don't recommend Nexium (even though they are dispersible) because Nexium is made by AstraZeneca

Here is the advice from the SPC for omeprazole caps.......

The capsules may be opened and the contents swallowed directly with half a glass of water or suspended in 10 ml of non-carbonated water, any fruit juice with a pH less than 5 e.g. apple, orange, pineapple, or in applesauce or yoghurt and swallowed after gentle mixing. The dispersion should be taken immediately or within 30 minutes. Stir just before drinking and rinse it down with half a glass of water. Alternatively the actual capsules may be sucked and then swallowed with half a glass of water. There is no evidence to support the use of sodium bicarbonate buffer as a delivery form. It is important that the contents of the capsules should not be crushed or chewed.

[tinx25388]

Thanks for that info!
Can that still be used for patients with a PEG?

[bobbin]

Thanks for that info!
Can that still be used for patients with a PEG?

I believe that it can.

The granules (from inside the capsule) should not be mixed with the feed. Give seperately and take care not to crush the granules because they are enteric coated. The tube should be flushed after administering the dose.

Using acidic juices such as orange juice should help to protect the enteric coated granules during administration.

This study suggests good efficacy of omeprazole granules when mixed with orange juice for administration via a PEG.....

Sharma et al. evaluated omeprazole given by gastrostomy tube using intact granules suspended in orange juice. In this open-label study, 14 male patients received 20 mg of omeprazole for seven days. Mean baseline 24-hour intragastric pH was 1.8, which rose to 4.9 after seven days of therapy with the omeprazole suspension (P < 0.0001). The proportion of time the intragastric pH was above 3 was also measured during the baseline and post-therapy 24-hour periods. At baseline, the mean time at a pH above 3 was 21%; after treatment, this proportion rose to 80% (P < 0.0001).

[ziggy]

Just keep complaining, give them hell. If you ask for a manager they always give in at the end and you'll get however many you need. Just takes persistance. Some of the staff are easier to get round than others. I've managed to get myself a few boxes for stock at last.