Is indomethacin still being manufactured?
May 10, 2006 3:04 PM   Subscribe

(Note: I'm in the US) My pharmacist this week was unable to fill my prescription for indomethacin. I was able to find it at another pharmacy; but several pharmacies are out of it and my regular pharmacist says that the manufacturer has stopped making it. Does anyone have any information about this?

I'll consult my doctor, of course, but I doubt he'll know anything. My pharmacist didn't tell me much (actually, one of their staff said this was temporary, the other said it was permanent).

I'm very alarmed by this because nothing I've taken for my osteoarthritis (and related; results from collagen gene mutation) has worked as well as indomethacin. Vioxx is the only thing that has come close. Celebrex worked better than ibuprofen, but not as well as Vioxx did.

Because my pharmacist couldn't fill the scrip, I've gone about five days without the indomethacin and I can barely walk at all. It's a bit frightening to see how much the indomethacin has helped me—my disease is progressive and in the year since I switched to indomethacin it's gotten quite a bit worse. My doctor also prescribes a narcotic (was hydrocodone, now 65mg of codeine or whatever the dosage is in in the Tylenol #4) for me, as well; I've tried taking it both regularly and only when I've needed it for acute pain and, frankly, it doesn't help all that much. I'm taking four a day now as I don't have my indomethacin, and it's not doing much good. I mention this only to give a sense of why I'm alarmed at the possibility of not getting any more indomethacin.

Thanks to anyone with any information.
posted by Ethereal Bligh to Health & Fitness (16 answers total)
Try an online pharmacy, this was the first that came up: Indocin. I'm under the impression that Indocin isn't exactly the most popular of drugs (a ton of side effects, as you probably are aware), but it's been around much longer than Vioxx and I have no heard of a cancellation.

Tt must be temporary or the pharmacy has decided not to stock it. Have you tried Wal-Mart, Sam's Club or CostCo? I had a weird script once and they special ordered it, probably something a smaller pharmarcy couldn't do economically.

A search on google indicates nothing to suggest it was taken off the market, which would be somewhat big news. Drug manufacturer's aren't going to take a drug off the market unless they're forced to. If the demand drops they just raise the price.
posted by geoff. at 3:22 PM on May 10, 2006

EB, I'm sorry to hear of your troubles. Does your Rx list a particular manufacturer? I've found some references to recalls (Able Labs) and shortages (Merck) of indomethacin, but those are from 2004 and '05 -- nothing current. As for the name-brand (Artisid?), supposedly it's manufactured by Sun Pharma, but the Sun Pharma site doesn't appear to include it in their current product lists. I'll keep looking, though.
posted by scody at 3:31 PM on May 10, 2006

Also, I wonder if it might be helpful to contact someone at the Arthritis Foundation? It looks like this is your regional chapter. Maybe they might be up-to-date on any current shipment problems or product shortages that would be affecting your pharmacies' ability to get indomethacin.
posted by scody at 3:43 PM on May 10, 2006

EB - similar situation here in OR. But, and I have no idea why, a local pharmacist faxed a request to substitute Indomethacin SR. I have not investigated this, but obviously I. SR would be fine. I wonder if the generic and SR have different sources?

Anyway, ask about the SR variety first. Good luck. Also, people on indocin are generally in situations that must have indocin as their treatment, so it's not going to disappear forever. IV Indocin went throught this one other time also.
posted by docpops at 3:53 PM on May 10, 2006

I filled a prescription for Indocin one week ago with no problem at Metro Drugs on 8th Street in NYC.
posted by nicwolff at 4:12 PM on May 10, 2006

Response by poster: docpops, thanks for the info. Switching to the SR may be what I have to do if this is long-term. Right now I've found a pharmacy which can fill it from what they have. But the SR may be a problem for me as I'm self-paying...unless the SR is out-of-patent.

Thanks also to geoff, scody, and nicwolf!
posted by Ethereal Bligh at 4:18 PM on May 10, 2006

There must be an online support group for your disorder. I would bet if anything is amiss they are already discussing it.
posted by caddis at 4:58 PM on May 10, 2006

I don't know if this also holds for oral indomethacin, but the IV indomethacin used at the hospital where I work has been discontinued by one drug company and picked up by another one. The average wholesale price of our drug has gone from $100 (approximately) per vial to over $1100. If this is the case for the oral medication as well, the pharmacy may be holding out to find a less expensive product.
posted by makonan at 6:50 PM on May 10, 2006

Response by poster: caddis: for osteoarthritis certainly. My particular disorder? There's only a few families in the world that have it; it's an Arg519Cys point mutation in COL2A1. It doesn't have a name. It's characterized as "a type-II collagenopathy resulting in precocious osteoarthritis and mild spondyloepiphyseal dysplasia". None of that probably means anything to you, I just like writing it out because up until recently we didn't know anything at all and we just vaguely referred to is as "the disease".
posted by Ethereal Bligh at 6:55 PM on May 10, 2006

Response by poster: makonan: that's a bit scary. I'm self-paying.
posted by Ethereal Bligh at 6:55 PM on May 10, 2006

pharm tech in texas: what strength?
the 50mg was backordered by our preferred manufacturer (Ivax) several months ago, but we've had no problem obtaining it lately, and the 100mg has never been an issue.
what pharmacy are you going to? walgreens has their own distributor...if they're unable to stock it, check at the smaller "mom and pop" pharmacies in town (ahem. do this anyway if you're insured. seriously. chains blow.) if nothing else, they could have stock on the shelves from before the shortage.
posted by ktrey at 8:35 PM on May 10, 2006

just checked with AmerisourceBergen (huge southern pharmaceutical distributor) and apparently all strengths but the 75mg ER are "alternate ship", but not back ordered or out of stock. talk to your doctor about indocin suspension if you're really hard up. it's still available, but is potentially astronomically expensive.
posted by ktrey at 8:44 PM on May 10, 2006

ASHP's Drug Shortages Resource Center is a very reliable source for finding out about the availability of a drug. The front page lists drug shortages and drugs with limited availability. On the left side there are links to pages that list shortages that have been resolved and products no longer available. Because indomethacin isn't listed here, it is likely that you are having trouble finding it because of a problem with a particular distributor rather than the drug itself or the manufacturer.
posted by mokujin at 3:33 AM on May 11, 2006

Hey, EB, are you part of this family?
posted by nprigoda at 7:35 AM on May 11, 2006

Response by poster: I'm not sure—I'll read the article and see if I can figure it out. This is prior to Dr. Bleasel's work who isolated our Arg519Cys mutation; maybe she cites this article. Maybe you can tell. I know that this is us, along with at least five or six other papers with Bleasel as the lead author. I'd like to have that article; I've only read the abstract. Anything anyone with access can find out—Bleasel was kind enough to write us once she finished her main research with us. But otherwise, no one's every told us much of anything. It's sort of weird. We see orthopedics who do the repair work but otherwise don't care about its etiology, rheumatologists who care a little bit but who mostly just provide pain management. Prior to Bleasel, we were told that it's "like or related to either MED or SED" and basically nothing else. It was me who tracked down Bleasel and asked her what she knew. She was happy that I wrote to her and she mentioned how familiar our names were to us...she'd spent years of research on us. Anyway, she's the person who told me what I say above.

I found some new stuff about this mutation when I was searching yesterday; most notable was the research with transgenic gene with mice using the Arg509Cys that showed our disease in the mice. It looks to me like potentially a big deal because of all the varieties of type-II collagenopathies, ours is the phenotype that shows the least amount of dysplasias (most of the others are dwarfism, blindness, even early mortality) and mostly just precocious osteoarthritis. So it's a good way to look at congenital osteoarthritis and they've gotten some mice to show exactly that.
posted by Ethereal Bligh at 11:46 AM on May 11, 2006

EB, I've sent an e-mail to the address in your profile. I hope I found the right paper, but if not, let me know.
posted by nprigoda at 7:01 AM on May 12, 2006

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