Anyone having good results using the compounded Vancomycin?
Thanks!
Lilly
I've had success with compounded IV Vanco. IV Vanco has received a lot of scrutiny over the years regarding the quality of its generics and I think this scrutiny has helped. The latest studies have shown that all of the US generics are effective (though we just have a few anecdotal data points on its application for PSC). Oral Vanco has not received this level of scrutiny (outside of the PSC community) and I think this helps to explain why there are inferior generics on the market.
What is compounded IV?
Any plain English summary appreciated. Is there vanco in pill (tablet) form? Powder or liquid form?
From what I understand, compounded IV Vanco is Vancomycin taken out of the intravenous form and put into an oral solution. It is the 'same' medication, although different 'form,' than the encapsulated pill form of Vancomycin. My speculation is that the Vanco company has a patent of sorts on the actual capsule, which is obviously more conveinent, and therefore exceptionally more expensive while the IV form is less expensive, less ultilized (I'm thinking hospitalization scenarios, extreme conditions where IV is only option). That's just my ramblings, for what they're worth.
For an excellent explanation, I recommend looking up your nearest compounding pharmacy. Check out the Compounder Connect (bottom/middle of the page) at http://www.iacprx.org/. From there, you can search for pharmacies.
If you want it straight from the horse's mouth, Erin at Petranek's Pharmacy in Illinois is *fantastic.* She'll even give you cost analysis. 847-■■■■■■■■
Hope this helps! The IV form is about $200.00 for a 2 week's supply at 'traditional' dosage for PSC patients. What makes me even happier is that the compounding pharmacists know exactly what I was talking about and are already using the word "traditional.'
Vancomycin comes in two forms - oral (pills) and IV (powder). Both forms are the same exact medicine and IV Vanco can be taken orally if it is converted/compounded to a form that can more easily be taken orally.
Oral Vancomycin is more convenient. The main issue is that it is absurdly expensive; about 10 to 20 times as expensive as IV Vanco (1 month of 1500mg/day Alvogen is ~$4000 and Prasco is ~$9000). If insurance won't cover the drug, and insurance is not obligated to do so for "experimental" treatments, IV Vanco is a cheaper alternative (from $200-$800 per month). Unlike oral Vanco, IV Vanco may also not suffer from the problem of inferior generics, although this is just speculation at this point.
The easiest way to convert IV Vanco to a form that is easily administered is to get it compounded by a compounding pharmacy. They will mix a months supply of Vanco with water and an agent like Ora-Sweet to keep the drug suspended in the liquid. Individual doses of the resulting liquid are measured in mL and you drink each dose. The liquid needs to stay refrigerated. A more complicated alternative is to get a prescription for vials of IV Vanco and to compound individual doses at home. Individual doses can be measured out with a mg scale and mixed with water, then drunk. Alternatively, the powder can be measured out and placed into gel caps. An individual on this board wraps the powder in rolling paper and swallows the bundle.
Liquid Vanco will kill all of the gram positive bacteria in your mouth. These bacteria are often good, eating the food/sugar that lingers on your teeth. This will lead to a lot of plaque buildup and surface stains. Visiting the dentist quarterly is a good idea and is another cost factor to consider.
Jtb: Best. Reply. Ever!!! Thank you!
jtb said:
Vancomycin comes in two forms - oral (pills) and IV (powder). Both forms are the same exact medicine and IV Vanco can be taken orally if it is converted/compounded to a form that can more easily be taken orally.
Oral Vancomycin is more convenient. The main issue is that it is absurdly expensive; about 10 to 20 times as expensive as IV Vanco (1 month of 1500mg/day Alvogen is ~$4000 and Prasco is ~$9000). If insurance won't cover the drug, and insurance is not obligated to do so for "experimental" treatments, IV Vanco is a cheaper alternative (from $200-$800 per month). Unlike oral Vanco, IV Vanco may also not suffer from the problem of inferior generics, although this is just speculation at this point.
The easiest way to convert IV Vanco to a form that is easily administered is to get it compounded by a compounding pharmacy. They will mix a months supply of Vanco with water and an agent like Ora-Sweet to keep the drug suspended in the liquid. Individual doses of the resulting liquid are measured in mL and you drink each dose. The liquid needs to stay refrigerated. A more complicated alternative is to get a prescription for vials of IV Vanco and to compound individual doses at home. Individual doses can be measured out with a mg scale and mixed with water, then drunk. Alternatively, the powder can be measured out and placed into gel caps. An individual on this board wraps the powder in rolling paper and swallows the bundle.
Liquid Vanco will kill all of the gram positive bacteria in your mouth. These bacteria are often good, eating the food/sugar that lingers on your teeth. This will lead to a lot of plaque buildup and surface stains. Visiting the dentist quarterly is a good idea and is another cost factor to consider.