New Drug

PAlady said...
Lynn,
This is just my hunch, but if the drug rep wrote it by hand I'll be he/she didn't even get the spelling right. And based on what many of us saw happen to one of our members (from her posts) while she was trying it, I and a few others suspected that the pharmaceutical company/rep. had a role in why her doctor was pushing this. And now I read the pharm. rep. just left your doctors office. All suspicious to me.

If you search out some of the forums that drug reps post on (there's one REALLY big one that's easy to find) you'll find a LOT of posts that explain what the push is all about. From what I've been reading, a whole lot of drug reps are about to lose their jobs and the only reason they didn't lose them back in May was Nucynta's approval and pending launch.

I have no idea if this is allowed, but this puts it in a nutshell... written on August 3 of this year -

pharma rep said...
Over 50% of the sales reps have had no more than 2 Rx's written in their entire territory after the first 3-4 weeks of sales. There are a few territories that are doing well, likely because they have 'speaker/consultants' that are getting paid a lot of $$$ for their 'programs' that they put on. Speaker programs = get your top potential dr. to be trained as a speaker = get him a lot of gigs = kickback of added Rx's. An old game that the government will likely wake up to eventually. This product is a high copay product that competes with oxycodone, which is cheap. Every sales force is selling it, trying to make it go, even the dental sales division! What a joke; most dental surgeons only write for a day or two of any pain reliever and not an oxycodone.
Likely sales force cuts will come because with a $25M forecast, the product cannot sustain the level of field force in place.

If you're feeling really pushed into it (like someone we all know) you might want to find out if your doctor is one of these "speakers" first, because that would be the first sign that it's not necessarily in your best interest.

Sorry, I'm in a world of pain & don't have the energy to read through all the posts on this thread. Yes, Nucynta was the med my PM prescribed. I felt super horrible on it -- turned red from head to toe, felt like I was being cooked inside, had crazy thoughts & hallucinations, my heart was pounding very fast -- in short, I felt the worst I've ever felt on any prescription medication ever -- and it didn't even help the pain one bit.

So, I'm really not a fan of it. It is all talked up by the reps, but there is certainly already a sizable amount of anecdotal evidence out there about people having severe reactions to this drug & way more stories about people who may not have had negative side effects, but who did not benefit at all from the med.

From what I've read -- and I'm no expert, and neither were most of the stories I read -- this drug is somewhat similar to a combination of Ultram and Cymbalta. If Ultram seems to work for you & your pain, this drug might well be a good choice. If you tolerated Cymbalta pretty well, then perhaps you won't have the severe side effects I had. I do not tolerate anti-depressant medications AT ALL. I have had HORRIBLE reactions to all of the newer a/d meds I've tried. I developed Serotonin Syndrome from Wellbutrin & this reaction seemed somewhat similar to that.

I always wish people the best in finding meds that work for them, but I would advise you to be very careful with this med. Start with the lowest dose & don't buy a whole month's worth at first if you can help it. And most of all, if you feel horrible forget what the docs are parroting from the drug reps -- there are plenty of people who don't tolerate this drug.

From what I've seen, most common side effects are: racing heart, nausea, racing thoughts, bizarre thoughts, dizziness, hyperthermia, anxiety, sleep disturbances.

I hope it works out better for you than it did for me. Please be careful & take care of yourself.

hugs,
Frances

I'll be okay. I'm planning to go over to his office this Friday since I only work a half-day & to go through my file & pick out which records I need to get copies of to bring to a new PM. I don't trust him at all anymore and therefore don't want to just let him pick & choose which dates/information to provide to the new PM. It is so sad, but I don't feel I have any other options. He completely violated my trust in him. My PCP has recommended another PM who is In Network, but I haven't made an appointment with him yet. I am happy to go through withdrawals if needed. I know my PM will at least give me Catapres patches even if I'm not seeing him anymore as long as I'm not yet seeing anyone else. I think that will have to be the way to go. My pain has just been out of control. That Nucynta just really messed me up. I had to start back on the pill due to the severe stress on my body from the Nucynta & that has caused other issues (including horrible migraines). So I'm just pretty bitter over the whole thing, but it's time to move on now so I need to just let it go & work at moving forward, trusting that I have grown a bit wiser & that good things are in store for my future.

I sure hope that things work out for Lynn so that she doesn't have to go through all of that. It is so amazing to me how interconnected the parts of our body are that when one area is affected, many other parts suffer as well. It's a beautiful and scary prospect at the same time. :)

peace,
Frances

Francis, Thank you so much for helping me to understand. I did read on the drug something about Cymbalta and was put on it almost 3 years ago now. Within one week my husband and my sister both said to me "what ever they have you taking STOP" They both noticed a change in my personality and lack of enthusiasm about even being alive. So if this is partially the same thing there is absolutely no way on earth I am even going to let him give it a try on me. Not to mention Ultram gave me nadda relief either when I tried that several years ago.

Well, my appt. is tomorrow so I hope I don't have to fight this over with him. So far he has been great in prescribing medications that I not only can afford but tolerate well too, so most likely it will not be an issue.

Thank you all, for the ideas, info and caring input you have brought my way!!

Lynn,
I'm sorry to hear about your reaction to Cymbalta. I was told that was supposed to be super-well-tolerated as well -- much better than any of the other anti-depressants & it was supposed to make my pain meds work even better. Well, all it did was make me a miserable person.

However, it was different from how I reacted to the Nucynta. Nucynta, from many of the accounts I've read, makes you speed up. I guess that makes sense from an anti-depressant standpoint. I guess what concerns me is that it seems the equivalent of all those cold medicines that treat 10 different symptoms when you only have one or two. It is an unnecessary added med to have on-board. If you do have some chemical imbalances like depression probably it would help. But with me, I never tolerated the a/d meds b/c my depression-warding-off chemicals were just fine. I had issues with my thyroid & with estrogen and I needed those added hormones in my body, but the added depression-warding-off chemicals just ended up pushing me over the edge into a manic-like state. I wasn't sleeping, had crazy eating habits (binge/starve), was full of a lot of nervous energy which I would try to work off but then the pain would go sky high, had a racing heart rate, etc. It was just a mess. I got those with the super high dose of the Wellbutrin that I was on a couple years ago. I later found out that I was on double the maximum recommended dose for someone my weight. I think some of these doctors just don't even try to make sure their patients aren't harmed by these meds. :(

I'm wondering whether this dose, even though it was the lowest available dose, might have been too much for me. Perhaps a lower dose would have worked. I got so sick on Provigil when I first took it. Then a geriatric dose came out that was 1/4 of the previous lowest dose & I found it was a very helpful med. So maybe that was part of the issue with the Nucynta. But honestly, I just get a bit suspicious any time anyone tells me that something is just going to work perfectly without side effects. I just don't believe we currently are anywhere near the brilliance required to develop that sort of a pain drug. But that's just my opinion.

I really wonder how long this will be on the market before the FDA sharps cracks down on it. At first, there were talks about labeling it as an anti-depressant. Then the determination was made to label it a pain medication. Make no mistake, it was always an opioid with those norepinephrinergic properties. It's just that at first it seemed promising in treating depression. It might still be helpful for that. Heck, it might even be helpful for people in pain. But make no mistake, it is a C2. It is highly addicting for people who have addictive tendencies. It is habituating for the rest of us. And it only lasts for a few hours (supposed to be 4, but what tiny, tiny benefit I got from it wore off in about 2 hours). It is a short-acting med that is supposed to be used for breakthrough pain, not to replace CR meds. According to the FDA's own information, pretty much all of the warnings & information are class-based information that is put out there for all opioids. So don't put too much stock in those -- they are helpful, but do not really reflect any testing done on this particular med.

Maybe you could ask your PM if you could start with half a dose so if you do have a reaction to it, it will only be half as severe. Then, if everything is okay, you could try upping the dose. I did check with my doc & pharmacist who eventually got an answer for me and it is, according to them, okay to cut the pills in half. I did do that & it helped a bit, but I already had some of the meds on-board so probably that's why it didn't make that much of a difference to me. I definitely wouldn't try it when you have anything important coming up in the next 12 hours & it would be better if you are going to be around someone who can get you help if needed. It can cause Serotonin Syndrome -- though I imagine that is not too likely at the lowest dose unless you are combining it with new-line anti-depressant meds -- which is an EXTRAORDINARILY rare complication of meds that impact serotonin levels in the brain, but which can cause very serious health problems. It really almost never happens. Most of the time when it does it is because of someone being treated for the wrong condition, being given too high a dose of the med, or being given multiple drugs that all impact serotonin levels. I don't want to panic you (or anyone else about that). I got it from the Wellbutrin b/c I was on a ridiculous amount of it, didn't have that kind of depression (ie, I already had normal serotonin levels when I started treatment) & mixed with my migraine meds which also affect serotonin levels, it pushed me over the edge.

My only goal is to make people aware that it is a VERY rare, but real possibility, just as it was with Ultram when Ultram was combined with migraine meds or newer anti-depressants (or in a handful of cases with certain other narcs). More likely, if you get any side effects, they will be miserable but not super serious. If you get too hot like I did, you can take cold showers & wrap yourself in ice packs. It did eventually cool me off & I felt better by 17 hours later. :)


Keeping my fingers crossed for you that everything goes really well tomorrow. Gosh, I sure hope that your doctor is a bit more thoughtful about prescribing this drug than mine was. Perhaps it is a good choice for some people, but in my case, my PM apparently put zero thought into whether or not this was a good choice for me. If your PM is recommending this for you, he ought to have a good reason why. Just b/c the Nucynta rep said it's super wonderful is not a good enough reason, as far as I'm concerned. I take the decision to put any medication in my body very seriously & want to know what it is & why it is better than nothing, better than the alternatives & better than waiting.

Also, there is already a sizable black market for this stupid drug, so if you get it, make sure you lock it up really well. :) Crazy addicts, god only knows why they would want to feel their heart racing, their mind racing, their thoughts completely out of control just thinking about random crazy things, feeling hot all over -- makes no sense at all to me. But then again, I couldn't figure out why they wanted to feel like stupid zombies by taking the fentanyl either. I guess some people just don't make any sense at all. So the moral of the story is -- definitely LOCK UP THIS MED.


Let us know how things go tomorrow. ;)

Frances

It's probably a blessing that your insurance didn't cover the Savella. It's another SNRI, which is the same type of drug as Cymbalta and the anti-depressant portion of Nucynta.

It's almost like all the different drug companies are jumping up and down, waving their "revolutionary" new SNRI's marketed as pain meds around and yelling "Usss toooo! We got one tooooo!"

Lynn,
If you haven't already thought of it, I usually ice the spot where I've had an injection, especially for the first 24 hrs.

And Bionic - you never disappoint!

PaLady

bumping up for Jim

Wow, sorry to read about Nucenta problems. I like it: relief in 5 minutes, wears off in 4 hours with no residual loopy feelings. Can't say my other narcotics are so gentle.

Hang in there. We get it even if most of "them" don't.

From what I'm seeing, the average wholesale price of this drug is $181.25/100pills. I'm not sure how much your insurance covers, but that's just the price that I've found.