Saturday, October 25, 2014

Monday, August 03, 2009 wildflower, Community Member, asks

Q: Substitute for Intal Inhaler

What is a good substitute for the Intal Inhaler?  Been without Asthma attacks for 35 years using it but it will no longer be manufactured.  I have exercise induced asthma and asthma from inhalants.

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Answers (17)
John Bottrell, Health Pro
8/ 6/09 9:59pm

It's always unfortunate when a good asthma medicine is discontinued.  I have not heard about this classic asthma medicine being discontinued.  I'll see if I can verify this for you.  A medicine that is similar to Intal is Tilade that you and your doctor might consider. 

 

 

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wildflower, Community Member
8/ 7/09 7:59pm

Thanks for the reply.  From what research I have been able to do on the Internet, Tilade has also been discontinued.  I will talk with my primary care physician, but I am thinking I would like to try the Flovent HFA Inhaler since it is also an anti-inflammatory as Intal was but is reported to be better than Singular.  My next choice is going to Advair.  Not many choices out there.  I am 70 years old, and there has been little discovered about Asthma during my whole lifetime.  It makes you wonder.

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Kathi MacNaughton, Health Pro
8/11/09 6:07pm

I just wanted to chime in here... Actually, there has been LOTS discovered about asthma just in the past 20 years or so. Because asthma has reached epidemic proportions throughout the world, many research dollars go towards asthma research. Doctors know more today about how to keep asthma from interfering with life than ever. If you start taking one of the newer inhaled steroids, I think you're going to be pleasantly surprised how well they control your asthma symptoms.

 

There are a number of exciting developments on the asthma horizon. I report on asthma research regularly here on this site. For instance, my latest research post covered a discovery about the causes of asthma, use of statins in treating asthma, and clues to the connection between asthma and allergies. If you look through all my posts, you'll find other reports as well.

 

I don't mean to be argumentative, but I did want to correct your misconception that nothing much is being done about asthma. Nothing could be further from the truth. And that's a good thing! Smile

 

To your health,

Kathi

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Stephanie, Community Member
9/ 2/09 3:07pm

Your  response did not adddress the question.  Are you aware of any substitutes, even remotely that might be helpful for those of us who no longer have access to Intal inhalers.  Exciting developments apparently do not include alternatives to Intal.  What about obtaining Intal from Canada, UK, New Zealand?  Is this a viable and/or legal alternative? 

Stephanie

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healer, Community Member
10/ 1/09 4:19pm

It is legal, in most cases cheaper and they have been great (the Canadian pharmacies).

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Louise Marley, Community Member
2/17/11 11:00am

I've recently been able to buy Tilade from a manufacturer in the UK.  I worked through a Canadian pharmacy, in concert with my physician.  I'm very happy, and I must say I will resist inhaled steroids for as long as I possibly can.  I've seen the side effects, and they're not good.

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beth, Community Member
9/16/09 4:14pm

I appreciate the info you have posted.  But for those of us with children who have severe side-effects to inhaled steriods losing Intal is a major problem.  It is extremely frustrating with this thought process of "out with the old, and in with the new"... Newer is not always better.  I'm not saying that is what you were saying, I'm just expressing the frustration I feel with the drug companies.  We finally found a medication that doesn't give her any side-effects and relieves all asthma symptoms --only for it to be pulled from the market because it can't find a manufacturer to produce it without the CFCs.  (At least that is my understanding) 

 

Do you have any suggestions for those of us that need Intal and can't take steroids?

 

Thank you.

Beth

 

 

 

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healer, Community Member
10/ 1/09 4:25pm

I had the same problem.  I now have adrenal, sleeping and anxiety/panic attacks issues from Flovent and Singular.  I got off the Singular and the sleeping problems went away and the anxiety lessened.  I'm weaning off the Flovent and started on Intal.  the adrel problems are diminishing and the panic attacks have lessened.

 

Intal is a great medication.  I get it from PantherMeds.com and I get my Ventolin at CanadaPharmacy.com.  If your doc puts no substitions on your prescription, you can get the regular old ventolin or generic with the CFCs.  The old original formula.  Same as the generic.  It's much cheaper too, but you can't use your insurance.  Other countries still allow the CFC and want to give their people the best drugs available.  They cut down on their pollution by doing crazy things like buying smaller cars and fining polluting factories.  Go figure. 

 

Good luck.  It's working for me so far.  More work and longer to get, but I can breathe!

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Mom, Community Member
10/14/09 10:13am

I agree with your assessment of inhaled steroids and children.  Just found out Intal is not going to be manufactured and doctor wants my daughter to go on Singulair.  But reading recent safety reviews for Singulair, I'm not going to try it.  My daughter had horrible reaction to Flovent, aggression, insomnia, joint pain, restlessnes.  Her grades took a nosedive immediately, not willing to try this again.  Recent safety review for Singulair cites possible suicidal thoughts.  Cripe, dont doctors read any of this stuff.  They think you're nuts when you alert them to the possiblity of side effects.

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5dogwoman, Community Member
2/ 8/10 11:06am

You can still get the liquid type of Intal that you use with a nebulizer...it's takes some time everyday, but it works as well as the canister...you need your doctor to prescribe this.  It's Sodium Cromium, comes in packs of vials and you can get a portable nebulizer for inhaling it.  I can't sue steroids either, so this works for me.

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KK, Community Member
3/23/10 10:29am

So glad to see your comment. I have not been able to find intal nebulizer packets--nor has my doctor found them.  Please adivse.

 

Karen

 

kkuiper@mcenearney.com

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5dogwoman, Community Member
3/23/10 5:13pm

Here's the exact prescription written by my pulmonologist:

 

Cromolyn Nebulizer SolutionIVX

For:  Intal Nebulizer Solution Kin   Qty: 240

 

I got the portable nebulizer and this prescription filled at Drug Mart

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littledove777, Community Member
3/30/12 7:43am

i react severly mentally from all steroid inhalers not to mention oral steroids as well as other side effects like vomiting rashes weakness and i have also reacted to singular as well both with severe psychotic self injury and suicidal thoughts i wont take steroids ever again to me steroids is a death drug like hitler trying to take the weak off the planet am planning to pay out the bucks for intal if i can get it

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JuliaZ, Community Member
8/31/10 7:29am

Kathi,

 

Your rah-rah message is sort of true but also sort of not true. I think that lots of us who are older (I'm 43) who have had asthma all our lives are dealing with a slightly different kind of asthma than our kids and grandkids... I say this as the mother of an asthmatic.

 

Yes, we've come a long, long way from theophylline, thank goodness! But there are multiple KINDS of asthma, and the modern treatments seem to address asthma primarily from the inflammatory aspect. Those of us who have exercise-induced (not me), viral-induced (my daughter), or allergic-induced (me) asthma have been largely ignored.

 

Also, many of us who are older and who have had asthma for a long time before the introduction of modern drugs... albuterol was introduced in 1968 but was not commonly used until about 1980... have lung damage that's led to us having a more "brittle" asthma that does not typically respond as well to the steroids on the market now.

 

Intal was an excellent drug for those of us with allergic-induced asthma. There's not much out there that substitutes, although Tilade is chemically pretty close (though less effective in ME personally). I have found that a daily regimen of Zyrtec, 20 mg a day, helps keep my asthma down to a duller roar.

 

Ultimately, I think much asthma isn't caused by ANYTHING we're currently treating, and therefore, I think ALL the drugs we have are symptom-relievers only, even the ones we use as preventatives. They are not addressing the real problem.

 

I honestly think we've become too clean. Not as in too-much-handwashing clean (just watch at a public restroom to dispel that notion!) but as in not-enough-parasite-load clean. Societies where people, especially children, have light to moderate parasite loads have almost no asthma. We have virtually no parasites in the US... people freak out if kids even get lice... and our immune systems evolved powerful defenses against internal parasites that are now going unused... and I think they get misdirected.

 

If it wasn't so damn expensive, I'd go have a course of helminthic therapy. http://en.wikipedia.org/wiki/helminthic_therapy It turns out that it's not so easy to get infected "naturally" unless you live in a place where people commonly come into contact with domesticated animals, particularly pigs, and their dirt.

 

In short, Kathi, I think a lot of medical research into asthma is barking up the wrong tree. Medical science made this disease when it killed off our gut worms. Yes, getting rid of heavy parasite loads is good; they can cause malnutrition and anemia in extreme cases. But it seems that our immune systems do much, much better when they have a job to do, and a light to moderate heminthic population keeps it busy.

 

Julia

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angelwingstexas, Community Member
11/ 5/10 3:58pm

I guess you are trying to help, but what you have answered is not helpful.  Intal is an singularly different drug that addresses the core instigators of asthma and it does it without steroids.  Many people are completely uneducated about the havoc that steroids cause to the immune system.  So NO, I would not say that research has answered the question by adding steroids to every inhaler that exists out there.  GIVE ME INTAL everytime.

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303girls, Community Member
9/19/11 3:37pm

I'm happy to hear that much research has been done!  My main concern at this point, and it's a big one for me, is that I have a severe side-effect from inhaled steroids.  I used Intal for years, and was extremely happy with the  results.  Since it's been discontinued, I have tried 6 or 7 other asthma medicines.  The only daily control medicine now available for asthma is inhaled steroids.  My doctor has put my on Singulair, very quietly, as there is some type of medical warning that patients shouldn't take Singulair for asthma without also being on an inhaled steroid.  I take Maxair for my rescue inhaler, but when I take 3 or 4 doses per day for a few days in a row, I get a fast heartbeat, shakiness, and difficulty sleeping.  I'm left with no good options at this point.  I used to buy Intal inhalers when I visited Mexico -- I was that desperate.  My question is -- when will there be an daily control option that isn't a steroid?

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tanfan, Community Member
9/19/11 4:14pm

If you're willing to use a nebulizer, you can still get (in the U.S.) cromolyn sodium inhalation solution -- i.e., Intal nebulizer solution -- which is a generic (very inexpensive, or so I've found), made by Teva:  http://www.tevausa.com/default.aspx?&pageid=76&brandName=Intal%C2%AE%20Inhalation%20Solution.

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Susan, Community Member
12/ 1/11 9:03pm

Kathi I'm not being argumentative either, but I speak from experience, do you suffer from asthma yourself or are you just going by what you read and what you hear, I am 62yrs old, I have had asthma from the age of 18, I have to agree with the 70 year olds comments, who said nothing much has changed regarding asthma treatment in his life time, if it has I  haven't been offered any other treatment, I have been using ventolin inhaler for the past 42 years, also you say asthma has reached epademic propotions, the reason why it has is because there are a lot of people diagnosed with asthma when they really don't have it, you only have to go to the doctors and tell them you feel chesty and the doctor says you have got asthma and prescribes a ventolin inhaler, I know a lot of people who are heavy smokers and non smokers who have been diagnosed by their doctor as suffering with asthma and they know they don't have it, when I first started with asthma I was referred to a chest specalist who ran some tests on me before saying I had asthma, also I was in and out of hospital seriously ill at times, I know what an asthmatic breaths and sounds like and I could name a lot of people who are not asthmatic but have told they are by there GP, believe me there will be a lot of people diagnosed worldwide with asthma who clearly don't have it, asthma treatment is no more advanced now than it was in the 60s, also the researchers are no more closer to finding a cure or knowing what causes it, has for being pleasantly surprised with steroid inhalers, they may help to control asthma but it is a pity the doctors don't tell you that long term use of steriod inhalers and steroid tablets will eventually make you diabetic, there's nothing pleasant about that is there, also it has been known for years that certain allergies can be a cause asthma, but it is very rarely investigated because it is very rarely diagnosed by a specalist anymore.

Good Luck And Best Wishes With Your Research. Susan  

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gale, Community Member
8/25/09 7:00am

Thanks for your help. I read that Tilade has also been discontinued. My doctor is a bit at a loss with this too. Intal was the safest thing out there. So, I'm very concerned, due to my unusual sensitivities.

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healer, Community Member
1/21/10 3:14pm

Tilade was discontinued too.  Buy through Canadian or UK pharmacy with a prescription from your doctor.

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tanfan, Community Member
5/17/10 2:05am

I've been getting Tilade inhalers from Inhouse Pharmacy, no prescription required http://www.inhousepharmacy.com/asthma-allergy/tilade.html.  They have been working out great for me, better than Intal inhalers.

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JuliaZ, Community Member
8/31/10 7:06am

I also miss Intal... it was highly effective for me and the steroids are not as good. I use Advair because it's the only way to get Serevent anymore, which really helps me, but I also use Tilade.

 

I second the recommendation of InhousePharmacy.com. I have been using them since 2001 and have never once had any trouble. They really are great!

 

Julia

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traciJ, Community Member
9/ 3/09 10:52pm

Try getting intal made at a 'compounding pharmacy'. My 4 year old can not take inhaled steroids due to severe side effects. Intal has been his miracle drug. I go to a local compounding pharmacy and they make intal (cromolyn sodium) both in vials and inhalers. The pharmacist told me its VERY easy to make.

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wildflower, Community Member
9/ 4/09 9:18pm

Thanks.  I never thought of doing that.  Is it expensive??

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traciJ, Community Member
9/24/09 6:10pm

Sorry for the delay. This message went to my junk mail and I just now got it. Having the intal compounded costs me around $75 for 180 vials a month. I am sure the price varies from pharmacy to pharmacy.My son takes a vial 3 times a day via nebulizer. My insurance won't pay for it. The pharmacist told me if I could get him to do an inhaler it would be less $$$. I was paying alot more when he did'nt have Intal due to co pays and hospital bills. So it is VERY worth it to me.  

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traciJ, Community Member
9/24/09 6:14pm

CORRECTION! I meant to say the intal compounded costs $75 for 90 vials NOT 180 vials. Sorry.

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td123, Community Member
1/26/12 6:38pm

Hello,

I was wondering if you could tell me the name of the pharmacy where you have it made... I have been searching everywhere!

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tanfan, Community Member
1/27/12 2:10am

If you are interested in the vials of Intal (cromolyn sodium inhalation solution), you should be able to get them commercially from Teva (http://www.tevausa.com/default.aspx?pageid=3364&letter=C&ProductName=Cromolyn+Sodium+Inhalation+Solution%2c+USP&BrandName=Intal%C2%AE+Inhalation+Solution).

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tcam, Community Member
9/15/09 6:44pm

Thank you soooo much for the info. Calling the pharmacy now.

 

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healer, Community Member
10/ 1/09 4:28pm

Don't bother.  Go to Panthermeds.com for the Intal.  It comes from the UK.  they use the same old original drugs.  The kept the CFCs in their products as they are more concerned about the people's health in their countries.  That's what universal health care means.

 

I get my full strength, old fashion Ventolin (regular or generic, bith with CFCs - not that new junk the pharmaceutical companies are giving out that expires fast and you have to take twice as much for it to work) at CanadaPharmacy.com.  It's cheap too.

 

Can't use insurance, but the little guy sounds like me.

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Betty, Community Member
4/13/10 3:12pm

Intal Inhaler is available at TruMedCanada.com, a totally certified and established online pharmacy in Canada. You can check it out here:

http://www.trumedcanada.com/RX/IntalInhaler.aspx

 

Fast Shipping and awesome customer service are the two qualities I loved about them.

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jeffn1, Community Member
9/12/09 4:43pm

I was desparately concerned about the discontinuance of Intal.  When I tried to wean myself off of it, I felt horrible.  I was really concerned I would end up disabled, feeling dyspnea, oxygen deprived and listeless.

 

Amazingly, I find the inhaling Nasalcrom into my lungs seems to substitue perfectly.  I doubled the doses (4 puffs instead of 2 puffs).

 

I am not doctor, so check with your doctor first.

 

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Donna, Community Member
9/20/09 10:04pm

How do you inhale nasalcrom?  do you just squirt it into your mouth & breath as much in as you can?

I'm having a hard time feeling confident this would work...

Intal has been wonderful for me for years.

Donna

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jeffn1, Community Member
9/21/09 7:05am

Yes, I spray it into my mouth and inhale deeply.  I can feel it go into my lungs.  It seems to work better if the bottle is kept pretty full and it is shaken before using.

 

There probably is a better mechanism for dispersing the spray and getting it into the lungs, even if we no longer have access to inhalers specifically made for this purpose.  But, it seems to be working for me.

 

If someone finds a better spraying device (that sprays an appropriate merered dose), let us know.

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wildflower, Community Member
10/ 1/09 5:01pm

This sorta goes along with my experiences using Intal chromolyn sodium.  About 1986, I was having a lot of problems with food allergies despite avoiding and doing a food rotation diet.  My doctor suggested that I order chromolyn sodium in powder form from Canada and use it before meals or eating.  So, I guess we can conclude that chrmolyn sodium can be dispursed in a variety of helpful ways.

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spkngirl, Community Member
12/ 7/09 11:53pm

Intal should and can to be used all year round, but Nasalcrom (it is said on the package) is "seasonal" and shouldn't be used more than 3-4 months in a row. Does anyone  try to use it for a long period of time? How does it work?

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la, Community Member
1/ 2/10 12:41pm

I used it for several years and had no ontoward effects until recently.  My liver enzymes were elevated.  While I can't be sure that Cromolyn Sodium was the culprit, there have been some reports of liver disease from this drug.  My doctor told me to stop taking the Nasalcrom and my liver enzymes went down.  But I have to say I felt better while on it.  I take the Intal inhaler as well. This also has been discontinued. (The Nasalcrom)

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healer, Community Member
10/ 1/09 4:30pm

pantherMeds.com  get it full strength from the uK.  same old formula, little higher dose so you don't have to take as frquently.

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j., Community Member
10/19/09 8:59pm

thank you SO much for this info...i just ordered some for my son, and can now rest easy knowing that he will get the Intal that he needs! appreciate your willingness to share-had been looking everywhere in the U.S. & Canada.

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healer, Community Member
10/20/09 12:25pm

I spoke with a pharmacist at Aventis at she said that I should still take the 2 puffs 4 times a day of the 5mg.  She said that you can also take it up to 8 times a day at 2 puffs.  This is all new.  I'm learning too.

 

I also found that the inhaler made me cough and my lung felt funny for about a week of taking it.  Gargling and spitting it out helped.  I also used my rescue inhaler prior to use to cut down on the symptoms which are going away.

 

I hope this works out for your son.  I'm trying to fugure out what I can do about the CFC free inhalers.  They all seem to have corn based propellants now which a lot of children are allergic to and no one seems to know that.

 

FYI - they will send you two adapters for the inhalers form the UK.  They don't do that here in the US.  It's so you can wash one out daily and give it a full day to dry.  They said the canister gets clogged easier with the new propellants.

 

Good breathing to you and your son!

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Betty, Community Member
4/13/10 4:08pm

I ordered the original Intal Inhaler 5mg from TruMedCanada.com an year ago and am still ordering without any problems. Asthma is way better for me and I havent felt this good for a long time.

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bean, Community Member
8/24/10 8:27am

Thank you for this. I was going to get it from PantherMeds, but their Intal prices have skyrocketed in the last 6 months or so.

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Donna, Community Member
9/24/09 10:24pm

I spoke with my pharmacy today & they said that Chromolyn Sodium is available in ampules that you can nebulize.  I have a call in to my medical insurance to see about getting a nebulizer covered...  Time consuming but may be the solution for me.

 

I wanted to caution others - the steroid meds are great & if nothing else works, breathing is better than the alternative.  However, steroids work by damping down our over-active immune reaction to things others don't over-react to: this is chronic inflammation.  Works to breathe but then when we have a germ & need our immune response... - it's damped down.  So, for me, I chose to see if ANYTHING else could work.  The omega3 fatty acids

act to reduce chronic inflammation, quercitin helps also, & chromolyn sodium is great.

 

Donna

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healer, Community Member
10/ 1/09 4:19pm

I've been weaning off of Flovent now for 6 months.  It caused me tremendous problems.  Advair is worse.  I started ordering my Intal online.  It is available in every country but the US.  I use Panthermeds.com, but there are others out there too. 

 

I get my albuterol from canadapharmacy.com - you can get regular or generic without the HFA after the name.  So it's the original strength which is so much better than the new stuff they're trying to give us.

 

Good luck.  I'm 44 and I've had asthma sonce I was a baby.  I've worked in the health care field for awhile.  Other countries seem to be better at taking care of their sick.  Go to them.  It's working for me.  All you need is a presciption.  Panther will call your pharmacy for you if you want.  Oh, I forgot, most of it is cheaper there too, but your insurance won't cover it.

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jeffn1, Community Member
10/11/09 1:40pm

Thanks for the info, Healer. Does it seem that Intal 5 continues to be manufactured?

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healer, Community Member
10/11/09 1:50pm

That's what I ordered.  The Intal Inhaler 5 mg.  They also have the 1 mg and the spinhaler at various websites.  You are getting the real deal.  Order from Panther and it ships from the UK.  Plese pass on the word.  No need for all of us asthmatics to suffer. 

 

FYI, not sure if I mentioned it, but you can also get the original Ventolin from them too.  CFCs with the full dose and no additives.  They also have the CFCs generic.  You would not believe the cost difference of these things.  Allegra is over the counter.

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jeffn1, Community Member
10/11/09 2:00pm

Thank you.  I already ordered ventolin (since my insurer wants to restrict how much I use because the drug company jacked up the price for the stupid CFC-free version) from Canadian pharmacy online.

 

I have used Intal 5 and it seems to work well (actually with only 1 puff, instead of 2).  Although over-the-counter Nasalcrom seems to work well too (but requires 4 "puffs").

 

I am just curious whether the Intal 5 is still being manaufactured or these are residual stock.  I google it I find very little information.

 

My understadning is the 1 mg version is no longer manufactured.  At least that is what King Pharmacueticals said when I called them.  Of course, they would have an interest in saying this so people rush to buy out their remaining stock. . .

 

If anyone gets any new information, please post.

 

Thanks again!

 

Jeff

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cac, Community Member
1/21/10 3:04pm

I see that you all are ordering the intal inhaler from places online. I have been using it for 15 years and am can not tolerate any other inhaler. I spoke to my Dr. and he will not give me a prescript to buy meds online. Are there any places online that I can buy this without a prescript. Any help would be greatly appreciated!!!!

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healer, Community Member
1/21/10 3:15pm

No, you need a prescription everywhere.  I either fax them my prescription or I put it "on hold" at Walgreen's and they call for it.  A lot of doctors don't know that it's been discontinued.  Maybe you could find another doctor or tell him that you only can do mail in prescrptions now with your insurance?  I found a place where you can buy directly from the England instead of going through Canada.  The prices have gone up since they discontinued Intal in the US.  Let me know and I'll give you the name of them.  I don't have the info handy. 

 

They other option is that Intal also comes in a nebulizer solution.  The problem is that you have to buy hte nebulizer and do that 4 times a day.  Very inconvenient unless you work at home. 

 

For allergies I'm taking Astelin.  Way better than anything else I've tried.  Nothng's worked for me since Hismanal and Seldane.

 

The prescription are WAY cheaper in Canada and the UK and the same companies make them.  I'm a little leary of India though.  Not sure why.  In other countries Allergra is available over the counter and you can buy it online without a prescription  Keep in touch!

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KK, Community Member
3/23/10 10:36am

Please let me know what you're able get at Walgreens...I called the former manufacturer of Intal in England...all manufacture in England stopped the end of 2009. I am looking for either the nebulizer amp. or inhaler for Intal. Any help with this would be appreciated

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healer, Community Member
3/23/10 11:11am

You can't get anything at Walgreen's or any other pharmacy in the US.  Sanofi Aventis sold the US patent to King Pharmaceuticals.  Once they stopped making it last summer and the supply ran out - that was it.  It was all gone in December.

 

I'm not sure who you spoke with in the UK.  Sanofi Aventis is still manufacturing the Intal Inhaler and it is CFC.  I spoke with them in December.  You can order from Panther Meds based out of Canada or Cross Border Pharmacy that ships from the UK. 

 

I get mine from Panther Meds.  You can't order more than 2 at a time.  It's a flat rate $10 shipping fee.  You need to fax them your prescription from the doctor (most docs don't know Intal has been discontinued) or you can have them phone your pharmacy.  Plan on it taking about a month to get the first order, after that it takes about 2 weeks.

 

If you have any other questions, please let me know.

Annmarie Kostyk

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healer, Community Member
10/11/09 4:29pm

They are not manufactured in the US due to CFC regulations.  European nations, Canada and Australia believed the benefit of the inhalers to outweigh the CFC content.  Our government doesn't seem to think so.  According to the European manufacturers, they have no plans to discontinue producing these products.  Aventis, in the UK, sold the rights to the Intal Inhaler to King pharmaceuticals.  King discontinued as they could not find a way to produce the inhaler without CFCs.  Glad you found me on this site!  As for the albuterol elsewhere in the world, they offer both the regular and CFC free versions so you have a choice.

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jeffn1, Community Member
10/11/09 6:49pm

Thanks for the response and sharing your knowledge.  I guess the big thing I am wondering is whether intal inhalers (whether 1 mg or 5) are still being manufactured (presumably outside the US). Have you been able to confirm that?

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healer, Community Member
10/12/09 1:41pm

Both are still being manufactured outside the US and they will continue to be.  Aventis sold the US right to King pharmaceuticals who are no longer making Intal inhaler.  The CFC rules in other countries do not apply to inhalers.  Those countries thought the benefits to the patient outweighed that of the effect to the environment.  I wish the US thought like that.  The only made the 1 mg in the US.  The nice thing is that they converted my prescription in the UK so I received the 5mg dose inhaler.  Now I don't need to take 2 puffs four time a day.  Less puffs, less cost.  Good luck and keep in touch.

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jeffn1, Community Member
10/14/09 1:23am

Well, I hope you are right about Intal Inhalers continuing to be manfactured outside the US.  But this website (link below) states, "[t]here are no other manufacturers of cromolyn sodium in an inhaler presentation." 

 

http://www.ashp.org/Import/PRACTICEANDPOLICY/PracticeResourceCenters/DrugShortages/GettingStarted/CurrentShortages/Bulletin.aspx?id=553

 

I see no reason why there would not be other manufacturers as the drug itself, sodium cromolyn, is not under patent and there would appear to be not patent protection to CFC inhaler technology.

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healer, Community Member
10/18/09 2:19pm

I was wrong about one thing.  The Intal is CFC free as are all of the inhalers coming from the UK, India, Australia or New Zealand.  It just didn't state that on the websites.  It does, however, state it on the prescription that you receive.

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MikeC, Community Member
4/ 5/10 11:41pm

According to my doctor, the problem with a CFC-free version in the US is FDA regulations. The FDA would require the CFC-free version to be retested as a new drug. The cost would be prohibitive since the drug is no longer under patent. That is, once a company spent the money to obtain FDA approval any other company could manufacture the drug as a generic.

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Adelaine Saria, Pharmacist, Community Member
11/16/09 12:09pm

It looks like King Pharmaceuticals in the U.S. will not reformulate the Intal inhaler explaining its inavailability in the U.S.  I have found that many Intal inhaler users are reluctant to switch or substitute their therapy with other asthma medications including Singulair or steroid-based therapies.  If that is your situation, I would recommend seeking assistance from a mail-order pharmacy that offers international products.  CanAmerica Global supplies Intal inhaler from the United Kingdom (http://www.canamericaglobal.com/products/Intal_Inhaler/5/)  It has provided continued therapy for many Intal inahler users.  CanAmerica Global offers a worldwide network of international pharmacies.  CanAmerica Global and its pharmacies have been verified by the Pharmacy Checker Verification Program (http://www.pharmacychecker.com/ProfileRx.asp?PCID=514A367E-19BE-483E-9579-FCF6A3DC127B)  As a pharmacist with CanAmerica Global, I invite you to contact us toll-free at 1-866-648-9142 to discuss your Intal inhaler therapy and discuss the most suitable continued therapy that best meets your needs.

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dude, Community Member
12/ 2/09 7:05pm

Just discovered that Intal is discontinued due to CFCs. That is ironic because this delivery mechanism replaced a non propellant one that I used to use as a child. I can't rememeber the name. The powder came in a capsule. The capsule was inserted into an inhaler. The inhaler punctured the capsule, and you inhaled to deliver the medication. Worked great. I wish they would bring that back.

 

I too tried Advair. Had hip and neck problems. Played with it for about two years. In spite of everything that I have been told by the experts, it causes me a lot of trouble and I refuse to use it. No problems with Intal. I guess I'll try Panther like everyone else.

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spkngirl, Community Member
12/ 5/09 7:23pm

I've been using Intal since I was 16.It did a remarkable job for me. First it was Intal spincaps( that was the name of the drug in powder form), then I switched to CFC Inhaler - was not as good as spincaps, but worked, then it was banned. I can not take steroids - I tried...so I did my best to find Intal in its new form -HFA inhaler. It is being produced right now by the same manufacturer in UK, by the way, and you can buy it in Europe without problem not in the US. I have a friend who goes to Europe often and she bought and brought it for me. I was so happy! I had more than a year supply - 15 of them! When my last CFC inhaler was gone I tried this new HFA Intal and I was up to surprise! This new HFA repellent has ethanol in it , that made of corn... I didn't know about that...and I am allergic to corn products... I can't use it!!! All my 15 inhalers can be thrown away and I don't know what to do...

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Delarock, Community Member
12/ 6/09 5:17pm

Hah. I'll take them from you.

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spkngirl, Community Member
12/ 6/09 6:37pm

I'll give them to you. laevart@hotmail.com

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dude, Community Member
12/ 6/09 7:57pm

Spinhaler! Thank you.

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Tim, Community Member
12/13/09 9:11am

Just received my Intal Inhalers from Panthermeds.com and wouldn't you know they are the new CFC free inhalers. It took about 2 1/2 weeks from order to receive. they are only letting you get 3 inhalers at a time because all of us from the US are ordering. Its strange to receive the CFC free inhalers!!! If we can get them in the UK why not here in the US. I bought before the price went up so don't be surprised to pay $50 per inhaler.

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Tom, Community Member
12/28/09 2:40pm

All substitutes for Intal contain one form or another of cortisone, a drug with numerous side effects which render it unusable for many asthmatics.  King Pharma claims their reason for withdrawal is the CFC propellant, but other propellants are available and in fact are in use in other parts of the world.  I've used Intal/Tilade for decades and it has effectively controlled my asthma without noticeable side effects.  I've written the head of King Pharma to urge reconsideration of their decision on this product and would recommend others do so as well.  The address is:

Mr. Brian A. Markison

Chairman, President and CEO

King Pharmaceuticals

501 Fifth Street

Bristol, TN  37620

Good luck to us all.

Tom

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bean, Community Member
8/23/10 11:07am

I too had snail-mailed King Pharm a letter, last fall, urging them to reconsider. I also sent them a whole bunch of research as to companies where they might get their HFA inhalers manufactured. A rep from King surprisingly wrote back, but it was basically the same info as they have online. My guess is, that it was not going to be profitable for them after their expenses. I think that's what it comes down to; profit!

Also, King only distributes Intal (if you look on the CFC Intal box).

The manufacturer is in the UK:

Health Care Specialties Division

3M Health Care Limited

Loughborough, England LE 11 1EP

 

(and I thought 3m was just a tape manufacturer)

 

Anyway, maybe another US pharm co would be willing to distribute the Intal HFA inhalers from 3M, or Aventis, so that we can get it in the USA again. But if it won't make them a profit, it may be a lost cause.

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tanfan, Community Member
8/23/10 12:45pm

Thanks for following up on that. 

 

Also, check out this article (from 2007): 


http://www.in-pharmatechnologist.com/Industry-Drivers/Inyx-drama-highlights-crucial-need-for-due-diligence-on-contractors

 

and these excerpts:

There are lessons to be learned about the importance of rigorous due diligence of pharma contractors, now that Inyx' customers are facing possible supply issues and a scramble to find alternative manufacturers after the firm's collapse.

Inyx Inc. was a public company, with its financial records available for all to see. Despite predicting it would achieve profitability by the end of 2004, it continued to experience substantial recurring operating losses while, still borrowing heavily and accumulating a huge amount of debt.

 

 

 

With its knife-edge financial history, and the association of some of its management with past failed manufacturing ventures, Inyx' recent bankruptcy problems are hardly surprising. Adequate due diligence by the pharma companies who got involved with the firm could have avoided a lot of pain and exposure to vulnerability.

 

 

 

When Inyx Inc. bought Aventis' manufacturing facility in Manati, Puerto Rico in 2005, which was subsequently named Inyx USA, it also took over some of Aventis' manufacturing contracts at the site, along with those of two of its existing customers, King Pharmaceuticals and Kos Pharmaceuticals (now owned by Abbott).

 

 

 

Fast forward two years and the site is in a state of disarray, having been put into Chapter 11 bankruptcy protection, and its fate now hangs in the balance. It is the centre of a fierce ongoing court battle over its future, and there is much speculation over whether the business will be sold to a third party intact or placed under Chapter 7 and subsequently liquidated.

 

 

 

As reported in Outsourcing-Pharma.com yesterday, Aventis has had to take Inyx USA to court after it failed to deliver on a contract manufacturing and supply agreement, a situation that Aventis feared could "seriously harm its interests".

 

Placing all your inhalers in one basket...

 

Meanwhile, around the same time Inyx also signed several 10 year development, manufacturing and supply contracts with King Pharmaceuticals for two of its respiratory drugs, Intal (cromolyn sodium) and Tilade (nedocromil sodium). [my emphasis)

 

 

 

Again, the contracts were for the continued production of the CFC version of its products, along with the development of new formulations to enable the transference over to HFA, and their subsequent manufacturing once they reached commercialisation.

 

 

 

"Inyx will have many of the manufacturing responsibilities related to the production of our Intal and Tilade product lines. We believe that Inyx' manufacturing capabilities should provide a high quality continuous supply of these products," said King's president and CEO Brian Markison at the time.

 

 

 

This deal also went beyond a simple contract arrangement and extended into a strategic partnership - a first for both firms. King and Inyx agreed to co-market Intal and Tilade and each have a share in net revenues. Inyx was also to be responsible for the distribution of Intal HFA in Canada. Inyx' marketing of the drugs was being conducted by its newly established subsidiary, Exaeris, which is also now in Chapter 11.

 

 

 

In August King announced its decision to scrap the HFA versions of the drugs - it is unclear as to whether the Inyx disappointment was a factor in this decision.

 

 

 

The exclusive nature of the deals that Kos and King established with Inyx was a mistake in hindsight, as now, only two years into the contracts, Inyx is teetering on bankruptcy, and it looks as though the two firms may be left facing potential supply issues.

 

 

 

It is unclear what backup plans they may have had in place, nor the extent to which they have been affected, or whether they have been able to make alternate manufacturing arrangements.

 

(Sorry I haven't be able to condense this a little more (spacewise).)

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tanfan, Community Member
8/23/10 12:48pm

(The note about "my emphasis" (above) referred to underlining that I thought would present.)

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John sten, Community Member
2/21/10 1:46pm

If you want to replace the inhaler then Singulair is the option. However, singulair is not for relief from acute attack i.e it won't work for instant relief at the moment of attack.

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John Bottrell, Health Pro
3/23/10 8:20pm

The good news for you is there is far better medicine than Intal on the market to treat exercise induced asthma. Intal was a great medicine in its day, but has since gone out of favor for better medicines, and that -- I think -- is one of the reasons it is no longer produced.  The fact that Intal works great for folks like you, it seems, wasn't considered -- unfortunately.

 

So, what are your options. 

 

There are two ways to treat EIA. Which one works best for you is generally determined by trial and error:

 

1.  You'll take asthma controller medications like Advair and Singulair every day.  

2.   You'll pre-treat yourself before exercise. There are different methods of pretreating, some of which include taking:

  • 2-4 puffs of Albuterol with a spacer 5-30 minutes before exercise
  • 10 mg of Singulair two hours before exercise.  

Obviously this is something you'll want to discuss with your doctor.

 

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wildflower, Community Member
3/23/10 10:11pm

I posted the original question on this conversation.  I tried Advair when I ran out of Intal.  The Advair caused me to have lots of mucus buildup, to become dizzy at times, and generally not to feel well.  I also caught some sort of infections twice while on Advair.  I have gone back to Intal with great results.  I use it twice a day and am back to my old self again.  So, I disagree with you Smile that Intal is not a great medicine today. 

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mom with asthma, Community Member
4/13/10 7:47am

I can echo the discussion.  I was diagnosed with asthma in the last five years.  We tried several things unsuccessfully, then settled on Intal.  I didn't know how good I had it with the Intal.  My asthma has been out of control since they discontinued it.  I currently have bronchitis on top of asthma.  I have wondered, when they discontinued it for the CFCs, did they stop to consider the electricity needed to use the nebulizer, and the soap and water that would be needed to wash and "sterilize" the nebulizer cups?  I'm not an expert, but seems like we cut our nose off to spite our face in this one.  Maybe it was done so that it would "appear" like we are being environmentally friendly.  I go back to the doctor again today....

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wildflower, Community Member
4/13/10 10:12am

Just reordered Intal Inhalers from Panthermeds.com.  The price has gone up, and they will only ship 2 at a time.  Said there also might be a delay because of the manufacturer.  These are CFC-free. 

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MLindaG, Community Member
5/15/10 9:49pm

I have used intal successfully for 18 years.  I get asthma to dogs..........I use before I go to a home with a dog........no asthma.......I don't use it everyday just as needed.  I've tried singular and felt nausea and went into a cold sweat for 2 days.............tried another one and same thing happened...........there are so many side effects listed for these "new and better" meds..........plus they want me to take them everyday which I really don't want to do. 

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gore, Community Member
10/15/10 4:21am

I'm sorry, but while this response may be accurate for most, the people in this thread have found and STATED that, for one reason or another, medications with Sodium cromolyn were superior for them.  I use Intal inhalers because:

 

a)  It completely resolves my moderate asthma with no side effects or trouble at all.  Again -- complete relief.

b)  Other medications, both relief (such as albuterol) AND long-term steroidal medicines, AND even drugs in other classes such as singulair, were side-effect-ridden for me to the point that I cannot use them.

 

Therefore, why would I use the other drugs?  For some, even most, the mainstream treatment is the best.  For others, second-line medications such as Cromolyn-based preparations are proper.  Again, the writing of people on this page is testament to that.  Fortunately, my physician is not a religious devotee of the first-line medications (as are many asthma specialists I've been unfortunate to deal with) and understands this.  I will continue to do what it takes to acquire and use cromolyn-based preparations.

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Betty, Community Member
4/13/10 3:09pm

I found Intal Inhaler from a reputable online pharmacy in Canada called TruMedCanada.The link to the product page is http://www.trumedcanada.com/RX/IntalInhaler.aspx. Awesome!!! Thank you TruMed!!

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wildflower, Community Member
4/13/10 3:47pm

Thanks.  I will order from them next time.  First time I ordered from Panther, my experience was great.  This last time, the person was very rude, so I will take my business elsewhere.

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lillylangtree, Community Member
5/10/10 7:43pm

Fortunately, you can still purchase Intal online  from New Zealand and Australia in the the powdered form and the Intal Inhaler Spinhaler for approximately $25.00 for the medication.  Steroid inhalers are NOT the same and are NOT all that great or safe.  I have  a friend who keeps trying to get me on them and her voice sounds manish now and her asthma might be under control but the effects of the steroids are obvious (despite what the Doctor's tell us about the inhaler)  Advair is on the top list of drugs that the Doctor's wouldn't take themselves or their families.  I suggest you do research (detailed, on steroid inhalers, all of them).  Read about Intal.  It is called Cromolyn sodium and discovered by Dr. Roger Altounyan It is derived from a plant from Egypt, called Khellen. It works on  allergic asthma and it works with no deadly side affects (like paradoxical bronchospasms, etc.) It stops the response to the allergen, be it animal dander, molds, pollen, dust mites, adinfinitum.  All asthma is allergy aggravated.   Also, you can buy the inhaler at any drug store (the pharmacist told me that it is just as potent as the prescription) called NasalCrom.  That may be all you need.  I recommend that if you can, stay away from all steroid inhalers!

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lillylangtree, Community Member
5/10/10 7:47pm

I forgot the link to purchase the spinhaler and the intal.   The link is http://www.pharmacyescrow.com/s41121-s-INTAL-INHALER.aspx

 

It only costs about $10.00 for the spin haler and 25.00 for the Intal!

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spkngirl, Community Member
6/ 6/10 10:03pm

Have you tried to order Intal Spincaps from the link you posted? If yes, how long did it take to get the medication? Did they require doctor's prescription? How long ago did you received it? Intal spincaps is a life saver for me and I can't find them... If it worked for you I would be thrilled to hear it!

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lillylangtree, Community Member
6/ 6/10 10:37pm

Hello, Yes I ordered from them about 9 months ago and it took about 2 weeks to get, but the price is good and no, you do not need a prescription.  Here's another tip that a pharmacist gave me.  He told me the Nasal Spray Cromolyn  Sodium is the same as the inhaler (dose wise) and that it worked the same and you can buy at Walmart for about $10 and put in your nebulizer?  Just a thought,  as it really is the same medication.

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healer, Community Member
5/17/10 12:49pm

Thanks!  I went back to the Intal which I hadn't taken since I was part of the experimental stages when I was a kid.  It's safe to take when you're pregnant, so I figured it couldn't be that bad.  The steroid messed my body up-anxiety, panic attacks, mood swings, depression, adrenal gland problems, etc.  I was bummed when they stopped making it in the US.  I get mine through Panther Meds and it's shippied from the UK.  I also have a nebulizer with the ampules for it incase a shipment doesn't come in.  The ironic thing is that it's so much cheaper overseas and it's not generic.  Our medical/pharmaceutical industry is embarrassing!  Thanks for the tip for the $25 Rx.  I can get 2 for 1!

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lillylangtree, Community Member
5/17/10 1:54pm

Hi,  I have read that it is made from Khellen (an herb) and Cromolyn Sodium is dervied from it that's why I was drawn to it.  I only took it for a while and it seemed to work.  I stopped taking but now the allergies are on and I am wheezing at night now.  Where do you get the ampules from?  Also, does it take a few days to kick in before one sees results?  I refuse steroids as no matter what the Doctors say, I know they are terrible for you no matter how you take them, snorted, swallowed or inhaled and there is NO ONE in the world (especially the pharmaceutocal companies that will convince me otherwise)!

 

As usual, they pull it off the shelf if it's safe and works. 

 

Is that all you take for your asthma?  The capsules I get are powder and go inside of the spin inhaler.  Did you use the hand puffer from Panther Meds?

 

Thanks,

 

Jan

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healer, Community Member
5/17/10 3:18pm

I'm going to look into the Khellen.  Thanks.  I get the puffer from Panther Meds.  You save the more you buy. One is $65.80.  Flat shipping of $10.99.  You can get the spin haler capsules through many of the Canadian pharmacies too.  You can get the ampules from any US pharmacy - just ask you doctor to write a prescription for cromolyn sodium ampules for a nebulizer.  You will need a nebulizer too.  Those are a bit pricey.

 

I totally agree about the corticosteroids.  I read an UK article that said that asthma is on the rise as is uncontrolled asthma.  They noticed a trend in uncontrolled asthma since doctor's in the UK started prescribing corticosteroids.  I wonder what's going to happen to growing childrent hat are taking them.  I shudder to think!

 

I also take 3000 mg of Vitamin C per day, probiotics, B-Complex and fish oil.

 

I checked the last listed Intal price and it's $54 not $25 as the last post said from Pharmacy Escrow. 

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lillylangtree, Community Member
5/17/10 3:45pm

Here is the link about Intal (Cromolyn sodium)  http://en.wikipedia.org/wiki/Cromoglicic_acid  Very interesting to me as I don't normally use what drs prescribe.  I do have a nebulizer as I don't like to use the hand puffers because of the anti-freeze I read was the ingredient that propels them (and I don't think that is too good for the lungs) So I will ask my Doctor to prescribe Cromolyn Sodium Ampules for my asthma.  I also take Vitamin C , probiotics, vitamin D3 (very important for us) and Omegas 3, 6 and 9 as well as chlorella, and a prescusor to glutathione which our bodies cease as we age and is the master anti-oxidant in our cells.  Anyway,  do a google for glutathione and asthma.  Thanks for all this information, I really appreciate it.  I have expired Intal puffers (3 of them) from 2008, do you think that they would still be effective?  I am a bit afraid to use them.

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healer, Community Member
5/17/10 4:18pm

Thanks for all of the info!  I'd rather go natural myself.  I read a great book called The Asthma and Allergy Cure which was fabulous.  The old puffers should be thrown away.  Laughing

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tanfan, Community Member
5/17/10 4:43pm

I think you should still be able to use the expired inhalers.

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bean, Community Member
8/23/10 11:13am

Hmm...can Khellen be grown here in the USA? If we ship some of the Egyptian soil it grows in to the USA, along with Khellen seeds and harvest the stuff?

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Elpie-O, Community Member
6/ 5/10 7:49am

I was in a similar boat when I discovered that the Intal inhaler had been discontinued.  I had been on it for years and it controlled my asthma better than any other treatment that I have ever used. My doctor prescribed Intal in liquid form which needed to be taken through a nebulizer. At first I noticed that it was effective but not as much as the inhaler.  It was also very inconvenient. Shortly after I started taking Intal (through nebulizer treatments)  my acid reflux sky-rocketed. I don't know if it was the change from inhaler to liquid form but around this same time my asthma symptoms also got increasingly worse.  Although I was totally dependent on my four Intal nebulizer treatments a day, my asthma became less and less controlled.  I went on prednisone for about a month and I didn't respond to it. In the past a 15-day taper pack always was effective to bring my asthma back in to control. My doctor also put me back on Advair which was effective in the past, but it didn't work this time around.  I developed chronic fatigue which got worse and drastically changed my lifestyle.  After three and a half months, countless doctors' appointments, and several tests, Symbicort was prescribed. It took about 2 months before it controlled my asthma enough so I could cut back on my use of rescue inhalers and nebulizer treatments but my energy came back shortly after using it. I also want to mention that my acid reflux measurably improved after I stopped using Intal through my nebulizer. I am almost back to where I started from before the Intal inhaler was discontinued and I am even surviving allergy season. I don't know if my story will be helpful to anyone but Symbicort was what finally worked for me.

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lillylangtree, Community Member
8/24/10 7:08am

symbicort is simply another LABA and also just another steroid which I refuse to use at this time.  I would rather use my rescue inhaler, stop eating all dairy products (which cause asthma problems, excess mucous,etc), exercise my breathing and body, as well as take healthy supplements and watch for asthma triggers.  I am one that feels the cure is worse than the dis-ease or malady and refuse to follow remedies that do not cure, but in my opinion, make me worse in the long run.  Intal can be purchased out of the USA and if that's what worked for you before, then I would stick to it. I believe it was discontinued because it was quite harmless and really helped people with allergic asthma, but where's the profit in giving people something that works?  I really hope that you get better!

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Elpie-O, Community Member
6/ 5/10 7:49am

I was in a similar boat when I discovered that the Intal inhaler had been discontinued.  I had been on it for years and it controlled my asthma better than any other treatment that I have ever used. My doctor prescribed Intal in liquid form which needed to be taken through a nebulizer. At first I noticed that it was effective but not as much as the inhaler.  It was also very inconvenient. Shortly after I started taking Intal (through nebulizer treatments)  my acid reflux sky-rocketed. I don't know if it was the change from inhaler to liquid form but around this same time my asthma symptoms also got increasingly worse.  Although I was totally dependent on my four Intal nebulizer treatments a day, my asthma became less and less controlled.  I went on prednisone for about a month and I didn't respond to it. In the past a 15-day taper pack always was effective to bring my asthma back in to control. My doctor also put me back on Advair which was effective in the past, but it didn't work this time around.  I developed chronic fatigue which got worse and drastically changed my lifestyle.  After three and a half months, countless doctors' appointments, and several tests, Symbicort was prescribed. It took about 2 months before it controlled my asthma enough so I could cut back on my use of rescue inhalers and nebulizer treatments but my energy came back shortly after using it. I also want to mention that my acid reflux measurably improved after I stopped using Intal through my nebulizer. I am almost back to where I started from before the Intal inhaler was discontinued and I am even surviving allergy season. I don't know if my story will be helpful to anyone but Symbicort was what finally worked for me.

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Carol, Community Member
9/ 6/11 6:41pm

You can still buy Intal generic version in the US.  My pharmacy gets it for me.  It is made by IVAX Pharmaceuticals UK.  This is the neb solution 20mg/2ml

 

You can also get Intal brand from Austrailia online.  This is the spinhaler with the spincaps.  Insurance doesn't cover it, but it is worth it to me. 

 

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We hope you find this general health information helpful. Please note however, that this Q&A is meant to support not replace the professional medical advice you receive from your doctor. No information in the Answers above is intended to diagnose or treat any condition. The views expressed in the Answers above belong to the individuals who posted them and do not necessarily reflect the views of Remedy Health Media. Remedy Health Media does not review or edit content posted by our community members, but reserves the right to remove any material it deems inappropriate.

By wildflower, Community Member— Last Modified: 03/08/14, First Published: 08/03/09