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If first you dont succeed…

·1483 words·7 mins

luvox.jpgAs I was taking my customary pharmacy-dookie this morning, I was flipping through the latest Drug Topics when I saw a nice little advertisement for Luvox CR.  Like Disco and bath-houses, someone is trying to bring back Luvox.  Luvox is one of those red-headed stepchildren SSRI’s that never really caught on.  Paxil, Prozac, Celexa, Zoloft all managed to get the ball rolling in the PR department.  Luvox however sank in the shadows and never really caught on.  It only got a little bit of press that one of the Columbine shooters was on Luvox.

Now, why someone would want to market Luvox CR is beyond me.  Luvox is dead! Deal with it! Why don’t we just bring back Reserpine?  Here you have a market of SSRI’s that cost pennies (Paxil, Prozac, Celexa) and you’re bringing a Continued Revenue formulation of a drug that did not catch on back in the day?  The company making this must be hiring Vegas Hookers as their drug reps to go deep throat every doctor in town to get him to write this shit.

What gets me is the whole “THERE IS NO GENERIC ALTERNATIVE” warning on the advertisement.  You’re right, but a quick phone call can give the patient a generic alternative that does the SAME thing and doesn’t have the trade name copays.  You know, if it came in bottles of 30 and the insurance would cover it, I might of just dispensed it and moved on, but since you had to point out that there IS NO GENERIC ALTERNATIVE like I’m some 4th grader who pooped his pants; it will be my duty now to switch everyone OFF of Luvox CR to either plain generic Luvox or some other generic SSRI.  Fuck you very much.

“But Angry Pharmacist, Luvox CR is DIFFERENT! ITS INDICATED FOR Social Anxiety Disease (SAD) and Dripping Anus Syndrome (DAS)”.  I’ll let you all in on a little secret.  An SSRI is an SSRI.  Ford and Chevy both make cars, but both will take you to the exact same spot.  Don’t give me the “This is indicated for this and our competitor is not” bullshit.  Doctors don’t listen to what a drug is “indicated” for (Uh, Neurontin?) just what works.  A $200 drug is not going to magically work better than a $20 generic.  You remember when reps were pushing Celexa? Remember when Lexapro came out the dumbass reps did a 180 and said how BAD CELEXA was? Yeah, its all about the Benjamins, don’t let the reps fool  ya.

So that Drug Topics advertisement? It was tempting, but I threw it in the trash vs using it to wipe my behind.

Comments #

Comment by rph3664 on 2008-06-04 08:26:37 -0700 #

TAP, the drug company is kidding itself that fluvoxamine will EVER catch on, in any format, because it’s really only indicated for OCD and has some very unpleasant side effects (the most remarkable being nausea, which often does not go away, in over 50% of the people who use it).
They tried to bring back Ponstel a few years ago. Did you see that? That’s an NSAID that’s only recommended for very short-term use, but by all accounts, Toradol works better and heck, Aleve probably works better and is OTC!

Comment by on 2008-06-04 13:09:07 -0700 #

you know its fucking bullshit drugs that drive the costs in our fucking healthcare system. Reformulation of fucking Auralagan…they changed 1 fucking ingredient and the price went up from $5 to $120. Fucking Soma 250mg? your fucking telling me its more effective than Soma 350 aka Carisprodol 350? FUCK THAT! I can’t beleive the FDA falls for gimmicks and scams like this and the patients suffer for paying for this shit as well as the pharmacies that are stuck with opened bottles of this crap!

Comment by The Forty-Eight Megabyte Hamster on 2008-06-04 15:04:00 -0700 #

You learn something new every day.
I had assumed Lexapro really was better, and chemically different than Celexa.
Is there really any difference as far as the body is concerned? I Ask mostly cuz the dosages are different, and thats what made me assume they were different.

Comment by on 2008-06-04 15:59:22 -0700 #

TAP, in this same light I’d love to hear your opinion of the new product that a rep came in peddling to my pharmacy a few weeks ago…Treximet? (for anyone who hasn’t heard about this BS yet)
I could barely hold my jaw up as she explained it to me and I saw the active ingredients. Sumatriptan and Naproxen? I almost just outright laughed in her face, but I try to be civil to these people. She then began arguing with the other RPh there that we’d better order it right away cause “She was seeing movement” and “Drs were starting to write for it” and didn’t I want to take care of someone who came in ASAP with a debilitating migraine? I said sure, but if the naproxen was THAT pertinent I’d just dispense the generic (whenever THAT becomes available) sumatriptan and sell them the $1/bottle of generic aleeve sitting on my OTC shelf.
Beyond ridiculous.

Comment by OzPharmStudent on 2008-06-04 17:23:02 -0700 #

The Forty-Eight Megabyte Hamster-
Escitalopram is the s enatimoer of citalopram and the the more active enatimoer. Some of the side effects are a bit less with the r enatiomer taken out but it’s nothing to write home about.
The SSRI’s block the 5HT re uptake channels and not the receptors so they will all have the same positive effects. The side effects are the only things that makes one more special then the other. Do you want the one with more or less impotence and ejaculatory disorders?

Comment by RJS on 2008-06-04 17:28:49 -0700 #

I think it’s a mistake to paint all SSRIs as the same. I know you know they’re not, but many of your readers probably do not. Basic activating/sedating/metabolism differences aside, most of the time they’re roughly equal, but there are niche times when they have significant clinical differences. For instance fluvoxamine is useful in PTSD with secondary sleep problems… moreso than the other SSRIs. But in that case it probably wouldn’t be used alone, and I would hope to God that said patient would be under the care of a psychiatrist up on modern psychopharm.
It also tends to be more useful than some of the other SSRIs when it comes to addiction and compulsive treatment of all kinds.
But I’ll be sure to send back any Luvox CR if it arrives, just like I did with Tekturna and Soma 250, because I hate pointless drugs and evergreening with a passion. 😛

Comment by K on 2008-06-04 18:25:21 -0700 #

MIGHT HAVE. For the love of god, stop talking like you don’t have a graduate degree, or even passed eighth grade. Should have, might have, could have.

Comment by on 2008-06-04 18:57:06 -0700 #

I can’t even imagine what your thoughts on the newly reformulated AURALGAN OTIC DROPS (generic didn’t go for more than a couple of bucks) that now want to milk people for a couple of hundred bucks.

Comment by nodrugs4u on 2008-06-04 19:31:12 -0700 #

It is true that Luvox has its particular niche in the field of SSRI’s. However, does the CR formulation really make patients’ lives that much easier that it justifies the extra costs. I don’t mean the $10 more in copay. We need to look at the overall healthcare costs. If we don’t keep things like this in check, insurance premium for EVERYONE will go up.
side note: I’m a propronent for generics. I actively discuss with patients to switch their meds to a generic alternative. One time, I changed 5 of patient’s drugs to generic alternatives saving the patient $50 a month. He saved money, and I increase profit margin. I even got a thank you card. It’s rare things like this that I don’t go postal.

Comment by one_angry_tech on 2008-06-04 20:25:10 -0700 #

I’ve already had a prescription for treximet.. but the patient has tried everything else under the sun for migraines.. so we will see.

Comment by Steph on 2008-06-04 22:28:41 -0700 #

Gaaaaaaaaaaahhh! A prescription for Treximet because “the patient has tried everything else under the sun for migraines”??? Did they TRY taking a tablet of sumatriptan with a tablet of Naproxen, and if that didn’t work, why will Treximet work, unless by some miracle (*cough!* placebo effect *cough!*) I hope no insurance company will cover this BS. You want it, YOU pay for it out of pocket.

Comment by Google Account on 2008-06-05 07:08:12 -0700 #

Jazz Pharmaceutics, who are selling this Luvox thingy really can’t be blamed. Their other products are Xyrem (also known as GBH or the date rape drug) and some product for an antidote to anti-freeze ingestion.