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Wednesday, April 13, 2011 Jazzicat, Community Member, asks

Q: I went to my pharmacy today to get my intal that I use via nebulizer, and was now told that all supplies of the ampules have been exhausted and I can't get them. Is this true?

I have been using intal via nebulizer for a year after not being able to get the inhaler because of the propellent laws in the US, but now I can't even get the ampules. What gives?
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Answers (4)
John Bottrell, Health Pro
4/14/11 10:20am

According to this FDA newsletter Intal inhaler will no longer be made.  There has been no mention as far as I've heard about the solution no longer being made.  I think if it were to be discontinued we would have become aware of it.  While doctors have  not ordered it in a long time, we still have a stock of it in our little pharmacy.  So do we have it available until supplies last?  Or is it still made?  I will look into it and let you know. 

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tanfan, Community Member
4/14/11 3:35am

I still see them (cromolyn sodium inhalation solution, which is Intal) listed here:  http://www.tevausa.com/default.aspx?&pageid=76&TherapeuticCategory=Antiallergics&adr=generic

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Jazzicat, Community Member
4/14/11 9:32pm

tanfan, I did look on the Teva sight and they do say that they have the inhaler solution available for use in the nebulizer. I could not find any prices on their sight however. I would really like to go back to the inhaler as the nebulizer is very inconvenient, but Teva appears to be in the us and I think I could use my insurance. I don't think my insurance will cover any perscriptions that come from Canada. Does anyone know for sure? If I decide to go with Teva do you get it directly from them or do you go through your regular pharmacy?

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tanfan, Community Member
4/15/11 1:26am

Jazzcat,

When I wanted this medication last year, my pharmacy simply denied that it was even available; however, I persisted by calling Teva, which gave me the phone number of the Teva distributor in my area, and someone there offered to call -- and did call -- my pharmacy to tell them it was available for order.  I soon had the medication.  Since it was a generic, it only cost me $5 for a 30-day supply (60 ampules), through my medical plan.

That said, I, too, much prefer using an inhaler to a nebulizer.  But rather than Intal inhalers, I am now using Tilade (nedocromil sodium) inhalers, which I get from Inhouse Pharmacy (http://www.inhousepharmacy.biz/asthma-allergy/tilade.html).  Tilade is related to Intal (it is also a cromone (http://en.wikipedia.org/wiki/Nedocromil)), but it is a newer medication than Intal, and was also formerly made and distributed in the U.S. by King Pharmaceuticals, but is now -- just like Intal -- only(?) available through Aventis.  (Apparently, Tilade never really "caught on" in the U.S., since I only came to know about it when searching (just like you) for a substitute for the Intal inhalers no longer available here.) 

For me, Tilade works better than Intal, which is why I continue to use it.  A side benefit is that Inhouse Pharmacy does not require a prescription -- but no, my medical plan does not pay for it (but my pulmonologist hardily approves of it). 

Be aware, however, that Tilade inhalers -- and the "new" (CFC-free) Intal inhalers, and for that matter, all "new" CFC-free (HFA) inhalers -- are more prone to clogging than the "old" CFC inhalers.  Thus, if the "new" inhalers don't seem to be working, they may be clogged.  For the "new" CFC-free Tilade and Intal inhalers, Aventis helpfully includes an extra plastic mouthpiece, which makes it "easy" to rinse out one mouthpiece (make sure you rinse it out thoroughly) and let it dry, while you use the other mouthpiece. 

Shipping time from Inhouse Pharmacy -- for me -- has taken anywhere from about 8 days to nearly 3 weeks (it really depends on customs in this country, since Inhouse Pharmacy ships very fast) -- so be sure you "plan ahead" if you take this route.  (It really takes a different mindset to "depend" on medications from overseas, since you can't just drop in on the local pharmacy for a refill.)  Also, in the past, I have noticed Inhouse Pharmacy to temporarily be out-of-stock on Tilade (though not in recent months) -- so, again, be sure you plan ahead if you decide to take this route.  (I always keep plenty of Tilade on hand.)

Good luck. 

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tanfan, Community Member
4/15/11 1:30am

(I should have addressed this to Jazzicat -- sorry!)

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John Bottrell, Health Pro
4/14/11 10:25am

Well, I received an answer.  Check out this press release.  You will see that pharmacies have been notified that Chromolyn will no longer be produced, and as soon as supplies are exhausted it will no longer be available in inhaler form nor solution.  There you have it. 

 

If you presently take this medicine, you'll need to work with your doctor on finding a good replacement. 

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tanfan, Community Member
4/14/11 1:04pm

Rick,

If you notice, the cromolyn sodium inhalation solution that I referenced above (http://www.tevausa.com/default.aspx?&pageid=76&TherapeuticCategory=Antiallergics&adr=generic) is a generic, made by Teva Pharmaceuticals, which is a large manufacturer of generic drugs. 

As of last year, at least (2010), it was still being made.

So, if there is any question as to whether it is still being made, I would direct that to Teva.  Last year, when I wanted this medication, and my pharmacy said it was no longer being made, the Teva distributor in my area actually offered to call -- and did call -- my pharmacy to let them know it could be ordered.  I soon got the medication. 

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Jazzicat, Community Member
4/14/11 9:06pm

Thank you very much for the information. Not exactly what I want to hear, but I suspected as much. After doing some research today I was able to find the original Intal Inhaler that I used to use. I contacted trumedcanada.com and they will send me an entire year supply. I telephoned my Dr. and will pick up the perscription tommorow and fax it to TruMed Canada. My Drs. office said they cannot fax it, but I can. Each inhaler is 5 mg. per dose and the cost is $49.65 per inhaler. Does anyone know if that is the dose that was on the inhaler we used to get in the states?  Just for your information I also checked with Panthermeds.com, but they were almost double the cost per inhaler as TruMed Canada. TruMed does get this perscription from a manufacturer (Aventis) in the UK so shipping time is 2 weeks.

 

The fax number for TruMed Canada is 888-771-6964.

I am so relieved that I can get this, nothing really works as well for me. 

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tanfan, Community Member
4/15/11 1:28am

The Intal inhalers previously available in the U.S. were 800 mcg (milligrams)/actuation, or 1 mg before passing through the mouthpiece (I think).  I briefly got 1 mg. Intal inhalers (200 doses/inhaler) from North Drug Store (http://www.northdrugstore.com/buy-Intal.html).  The 5-mg. Intal inhalers have 112 doses/inhaler (just as the 2-mg. Tilade inhalers from Inhouse Pharmacy (http://www.inhousepharmacy.biz/asthma-allergy/tilade.html)). 

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tanfan, Community Member
4/15/11 3:10am

Correction:  800 mcg = 800 micrograms.  (Too sleepy!)

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Jazzicat, Community Member
4/15/11 9:51am

Rick, as a respiratory therapist do you know about Tilade? How is it related to Intal? Can I get it in the states? Also, do you know if my insurance co (BC/BS) will pay me for a perscription that I get in Canada if I pay for it first?

 

 

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Jazzicat, Community Member
4/15/11 9:47am

Tanfan, thank you very much for the very detailed information. I appreciate your help. I am going to look into the Tilade as well.

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tanfan, Community Member
4/15/11 11:35am

Good!  Tilade works better than Intal for me, but I know for some people, Intal is still better than Tilade.

If you check out the beginning of this thread http://www.healthcentral.com/asthma/c/question/327786/81140#a234359, you can see that Rick recommended Tilade as a substitute for Intal, apparently before he realized that it, too, had been discontinued.  Here is the "discontinuation" letter for Tilade from King Pharmaceuticals:  http://www.fda.gov/downloads/Drugs/DrugSafety/DrugShortages/ucm089433.pdf. 

Here is (apparently) the "real story" behind King Pharmaceuticals' discontinuation of both Intal and Tilade inhalers, if you care to read about it (that their contract manufacturer for both went bankrupt):  http://www.in-pharmatechnologist.com/Industry-Drivers/Inyx-drama-highlights-crucial-need-for-due-diligence-on-contractors.

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By Jazzicat, Community Member— Last Modified: 10/16/13, First Published: 04/13/11