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Using a Compounding Pharmacy to Replace Midrin or Epidrin

Midrin (and all other Midrin-like drugs, including Epidrin) have really, truly been discontinued. I’ve tried to hide from the truth, but can no longer deny that the ONE medication that allows me some semblance of a life has been discontinued for bureaucratic reasons. While there are no similar medications on the market to replace Midrin, having a pharmacist compound the medication is an option.

What are compounded medications? Quite simply, they are medications that pharmacists mix up from their component materials. You can locate a compounding pharmacy in most US states. All you need is a prescription from your doctor. Insurance companies generally pay for compounded prescriptions, though there may be additional costs that you pay for up front, then contact your insurance company for reimbursement. (I found this answer online and have no first-hand experience. If you know more, please leave a comment.)

But there’s a catch… the individual ingredients may be difficult to obtain. Midrin is composed of¬†isometheptene mucate, dichloralphenazine, and acetaminophen. One pharmacist reported that she is unable to obtain dichloralphenazine and my headache specialist said that¬†isometheptene mucate is backordered many places. However, these are only a few reports. It’s up to you to share what you learn!

If you’re a Midrin devotee, keep calling pharmacies — some still have a stash. I found mine at an independent pharmacy. Have your doctor call in a prescription for as many as possible. Insurance will probably only cover one month; if you pay cash, you can probably get a three-month supply. They cost about $1 per pill. Also try your mail-order pharmacy for a three-month supply that insurance should cover. (FYI, Costco and BioScrip are out.)

Read Teri Robert’s post for the politics of Midrin’s discontinuation. She has also found that Prodrin is available, though it doesn’t contain dichloralphenazine.

UPDATE: The Midrin equivalent is being manufactured again! Contact your local pharmacy for availability and pricing. Near me, it’s available at CVS, Walgreens, Walmart and a local independent pharmacy. My insurance covers it with a generic copay.

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Prescriptions More Common Than Explanations

I always tell you to talk to your doctor before taking any medications or supplements or latching on to a diagnosis. As well-intentioned as these pronouncements are, I sometimes feel like I’m doing the same CYA that drug companies do in ads. Really it’s that I want you to be safe and hope that a doctor’s input may help.

I know even that may be a long shot, a belief backed up by a recent study. The findings indicate that many doctors prescribe medication without explanation of the drug’s purpose and side effects or even it’s name. According to the New York Times article on the study:

“Although there were variations, depending on the type of medicine
prescribed, 74 percent of the doctors mentioned the trade or generic
name of the medicine, and 87 percent stated its purpose. Sixty-six
percent said nothing about how long to take the medicine, 45 percent
did not say what dosage to take and 42 percent failed to mention the
timing or frequency of doses. Physicians mentioned adverse side effects
only 35 percent of the time.”

So you can’t always rely on your doctors for information on drugs, is there anyone who can help?

Check with your pharmacist. They are trained to know drugs inside and out. Many enter the field with a goal of helping people, but the reality of the job doesn’t involve much of that. Most pharmacists I’ve met are more than happy to explain medications — even if they are over-the-counter — and answer questions. If the pharmacist at your local Walgreens is a dud, try the Walgreens that’s two blocks down the street!

Talk to a friendly person in your doctor’s office. Maybe you get along great with the nurse who takes your blood pressure; it can’t hurt to ask for clarification that you don’t get from the doctor. In some offices, a physician’s assistant or nurse practitioner returns phone calls for the doctor. You may find that they have more satisfactory answers to your questions. If you get along well with the PA or NP, why not consider making your next appointment with him or her? Or if you’ve always seen the head honcho of the practice, you might consider seeing some other doctors in the practice. They may be less harried and, thus, have a more patient-friendly demeanor.

A naturopathic doctor is another option. By focusing on the person instead of the patient, much of the appointment is about addressing the person’s questions and concerns. Licensed NDs are trained to integrate their treatments with those of western medicine — understanding pharmalogical treatments is a vital component of this practice.

Last but not least, ask your doctor! Yes, it seems like the job should require such explanations, but it’s also a high pressure job. Haven’t you ever forgotten to explain things to your co-workers, employees or clients? Being a recipient of information is as big of a job as being the giver of that information. You aren’t a passive recipient. You’ve got to ask your questions to have them answered. Of course, if your doctor consistently comes up short, it’s probably time to look for a new doc.