Personal Encounter Out of Stock Item

[razorbladekisses]

I'm used to telling patients so and so is out of stock but always make sure they have enough medication to keep them going or if not, I attempt to make alternative arrangements with the GP.

I wasn't at work this week and gave my Rx (2 items) to my Dad to get at Tesco pharmacy. They took in the Rx, he paid, did some shopping and returned to pick it up only to find out that Cipralex was out of stock. My Dad doesn't know what the drug is so just took the owing ticket and told me this information when he returned home. My Dad went to the pharmacy again today but it's still not available. I obviously can't have the Rx back because I've had the other item but I'm really suffering without the Cipralex. I haven't had any medication since Thurs. and I feel quite unwell. I only get a 2 week supply as it is and have to see the GP before I can get anymore. I'm close to tears right now.

Basically, I think this should be a reminder to everyone to check that a Rx can be fulfilled before taking it in or at least make other arrangements. Tesco don't appear to care at all

Also, does anyone know when Cipralex will be back in stock?

[johnep]

Suspect this subject to manufacturers quota as was being parallel imorted before.

If desperate perhaps your Dr can give you citalopram instead.
johnep

[razorbladekisses]

Suspect this subject to manufacturers quota as was being parallel imorted before.

If desperate perhaps your Dr can give you citalopram instead.
johnep

Thanks for the info.

Consultant just changed it from Citalopram to Cipralex no idea why.

[Web Ferret]

Phone Tesco and ask for when it will be in stock - Its it a temporary or long term problem?
Can tesco do intra-branch transfers?
The generic is an option and the pharmacist will be able to ring the GP and substitute and endorse script accordingly.

[Defblade]

Consultant just changed it from Citalopram to Cipralex no idea why.

Because he fell for the patent-extending-profit-protecting bumpf from the manufacturer?......

[johnep]

Most active molecules exist in two forms, left and right handed. The receptors in the body are also left or right handed and can only accept one or the other.(mostly left handed laevo form).

When you synthesise a molecule, you automatically get a 50:50 mixture of the two forms. Some years ago, a company devised a method of preferentially obtaining one form and went around pharma telling them this was an excellent way of extending the patent.

Every drug has a side effect and this is not always dependent on form, so if you can give the active form only, then you halve the dose and possibly reduce side effects. Thus 10mg laevo-citalopram (cipralex) is equivalent to 20mg citalopram. this would be the med reps pitch. Exactly the same for cetirizine and laevo cetirizine.

Example of a right handed active molecule is dexamphetamine.

A consultant using high doses of citalopram for panic attacks would most likely encounter side effects and thus be more amenable to the reps story.
johnep

[Sir_Dispensalot]

Tesco use AAH. guess what? AAH out of stock of cipralex, no date from wholesaler given as to when back in stock.
Check a numark or rowlands chemist to see if phoenix still have stock left.

If they do get your gp to fill you another script out for the cipralex.

[razorbladekisses]

Hello, thanks for all the info. and advice. Went back to Tesco and as Sir_Dispensalot said they don't know when they will be receiving any stock. GP has changed it to Citalopram 20mg.

John do you mean Cipralex 20mg is not equivalent to Citalopram 20mg?

It's getting a bit silly now as I was taking Citalopram 60mg and everything was OK and new consultant agreed but then decided to change it to Cipralex 15mg as it's apparently better. He then upped it to 20mg. Now as it's out of stock I am back taking Citalopram but only at 20mg

[Defblade]

Most active molecules exist in two forms, left and right handed. The receptors in the body are also left or right handed and can only accept one or the other.(mostly left handed laevo form).

When you synthesise a molecule, you automatically get a 50:50 mixture of the two forms.

Thus 10mg laevo-citalopram (cipralex) is equivalent to 20mg citalopram.

To jump into a Q to John....

20mg citalopram contains 10mg left handed and 10mg right handed. Only the left handed is active.

10mg cipralex contains 10mg left handed ONLY and so has the same amount of active drug as citalopram 20mg.

So no, citalopram 20mg is not equivilent to 20mg cipralex - you would need citalopram 40mg (containing 20mg left, 20mg right) to get the same action (or two citalopram 20mg if that's the script you've got )

[razorbladekisses]

I'm stupid

So when I was taking Cipralex (2 x 10mg tabs) that's the same as Citalopram 40mg?

and now...

I'm taking 1 x 20mg Citalopram which isn't equivalent and I should take two?

Have I understood properly?

Sorry to sound so stupid.