Morphine Sulfate - Generic For Avinza

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I was in an auto accident 8/21/96 and ever since then I have been dealing with Reflex Sympathetic Dystrophy (RSD). For the last 11 yrs I have been on Avinza 270 mg (2 120mg, 1 30mg once a day) by King Pharmaceutical and now my ins company is insisting that a generic is made and sold in the US by Acatavis Elizabeth. I cannot see anything current that it has been released. There is a legal suit between King and Acatavis because it states a generic cannot be released until 11/2017. Generics do not work for me and right now I'm fighting it, but would like to know if it is true about Avinza being made and sold in the US by Actavis. Please let me know if you're able to, I would surely appreciate it. Thank you!

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1

Hello, Lorraine! How are you?

The databases are showing that a generic for it was approved by the FDA last year and is available. Your insurance company will likely require that you try it to see if it works for you.

This is a narcotic analgesic, so it has the potential to be habit forming and may cause side effects, such as nausea, dizziness, drowsiness, dry mouth and constipation.

Is there anything else I can help with?

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2

Lorraine,
I also was informed by my Pharmacy that since there is now a generic form of this medicine, they will not cover the Avinza. Its something like $137 vs. $7 for my cost. Evidently, there was some kind of settlement on the patent resulting from a merger. I just started the generic today. I sure hope it works, for both of our sake. Will try to let you know.

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3

King (Tenn. company) has held the patent on Avinza for years: Avinza is the only manufacturer that uses fumaric acid to control the extended release of the morphine sulfate. Fumaric acid is found in breads, to make drinks tart, etc. and is a safe food additive, although at very large doses is unsafe. (Thus, Kadien brand of morphine sulfate extended release bragged theirs could be given at higher doses; but it is indeed different from Avinza in its release)

Fumaric acid is used in Avinza's beads to change the ph balance of the beads so different beads dissolve slowly at various ph levels and various times in the intestinal tract. It isn't released at all in the stomach. Thus, the medicine is released slowly over 24 hours. It is one of the safest morphine sulfate ER because most other brands release up to 30% of meds in first hour! Especially synthetic morphine sulfates like Oxycontin.Thus, the inactive ingredient in Avinza, fumaric acid, is what the patent is for. King (Avinza) purchased the design for the ER formula.

According to patients, Activa's morphine sulfate ER, Kadien 24 hour release and its generics don't last 24 hours. They are pellets & don't use fumaric acid to release at various PH levels. Patients say Activa's Kadien & generic Kadien release more meds than they should sooner, making people feel more drug effects & having more breakthrough pain, and needing to take more doses.

Activa has argued in court that they filed first to make Avinza in 2007, and thus may now make a generic. Their generic was approved this year after a major insurance provider refused to cover Avinza. The "active" ingrediant -- morphine sulfate ER-- comes in the same doses, however I am researching now to find out if the generic includes the same "inactive" -- yet imperative to working properly at releasing the medicine -- ingredient to control ph release levels as brand name Avinza -- fumaric acid on beads.

I'll let you know what i find out.

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4

Thank you so much for the information. I now have a much better understanding of Avinza!

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5

Hi Chip, how are you making out on the generic Avinza? I apologize for not responding sooner, but had problems with my computer. With my insurance I have to pay a brand penalty along with co-ins, so I pay $140.00, but will no doubt go up in Jan. 2015 another 50.00. I'm still afraid to try the generic, because once the script is filled for a month you're obligated to take it and cannot fill brand name. Also, since generic has been on the market, King Pharm. no longer provides a coupon to get $30.00 off. I hope it's working for you, please let me know! Take care and good luck!

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6

Hi Verwon, thank you for your response to my question. So far, I'm still on Avinza, but paying brand penalty for the drug. The problem with filling the generic and the insurance companies don't seem to care, is if it doesn't work you cannot fill the regular brand for one month. In my case, and I'm sure in many, many other cases, I depend on the Avinza to control my pain so I can function as normal as possible; if the generic doesn't work or work as well, there's a problem. Taking one day at a time. Thanks again!

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7

Anyone having trouble getting Avinza brand? I have been on Avinza brand 240mg (2 ea 120mg capsules) daily since 2008. Since the beginning of April 2015, my pharmacy is having trouble getting the brand name. They are being told that it is on back order.

Because the Avinza has worked much better for me than other pain meds, I am not at all interested in experimenting with other meds if the brand Avinza will be available again. While hoping that the brand is still going to be manufactured, I am taking the generic. I can tell you that for me, the brand is far better. The generic release is not as smooth as the brand and it doesn't seem to last as long as the brand, which requires more break through meds.

I live in Central Pa and have contacted all local pharmacies and none of them are able to get the brand Avinza from their supplier's. Does anybody know if the brand is still going to be manufactured since the generic was approved? If so, do you have any idea when it will be available again?

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8

Hi and I know exactly what you mean!!! I've been on 270 mg of Avinza since 2003 and now this is the second month I'm on the generic version. I was told by my pharmacy that King Pharmaceuticals is no longer manufacturing Avinza. The generic doesn't work for me either. I have been in so much pain since I've been on it. I'm very depressed because I don't know where to turn. Everything is generic that I'm on and it's horrible. Please if Avinza comes back on the market or if we haven't been told the truth about it let me know! Good luck and let's hope and pray we can get it again!

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9

Hello, Yanni & Lorraine, I, too, am unable to get Avinza brand. Last month my pharmacy filled script with generic with my consent. Today, they had nothing, telling me it's " on backorder" and they have no other information. Mostly homebound, With multiple chronic pain conditions, getting Avinza is a priority. Nothing else works, and yes, my docs have tried everything. When we found. Avinza to work in 2005, it was a lifechanger. Only once since then did we experiment with Opana; it was a disaster.
My heart goes out to you and Everyone who suffers .
No one can understand until they fall prey to pain. Prayers for a quick return of Avinza.
Tina in Florida

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10

Hi Tina, thank you for your input. I've been on this generic now for two months and it's getting worse. I'm always in pain, it does nothing for it and it makes me extremely tired. If I fall asleep, I'm comatose. Sometimes my heart beats so slow and hard I can hear it, feel it and it seems like it's going to beat right out of my chest. I was told Avinza was no longer being manufactured, but everytime I get the generic filled my pharmacy puts Avinza meds paperwork on it, very confusing. The narcotics are terrible when it comes to constipation also, and that's changed, not as bad, so I know the meds are not what they claim. Is there anything we can do to have King Pharmaceutical bring back the Avinza. I'm at witts end, as I'm sure everyone else is! Prayers and God Bless to anyone who is going thru this.

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11

Hello Lorraine, Tina, and anybody else who is searching for information regarding Avinza. I was so tired of hearing the Avinza is on long term back order that I decided to contact Pfizer (they bought King Pharma) via an email link on their website. Much to my surprise, I received a letter in the mail in which they provided a phone number and asked me to call them regarding my question. So I did and was only on hold for about two minutes and I was able to talk a pharmacist.

I am very sorry to report that Brand Avinza is no longer being produced, and not for a certain time period, FOREVER! Pfizer does not make the generic version. I rolled the dice and asked what, if anything is similar, and was told to talk with my Doctor. He also told me that there have been press releases out since last year indicating that this was coming. Makes you wonder who the pharmacies contact and get told long term back order. I am very sorry to report this information, but at least now we know that we have to tolerate the generic, or talk to our Dr.'s about switching.

I did come across a newer medicine from Pfizer called Embeda that seems to be very similar to the Avinza. From what I can tell, I think it has an ingredient that prevents the morphine sulfate from activating if the beads are crushed by abuser's. I do know that the Embeda is only available in the brand, but I don't know when their patent expires. Patent's don't seem to matter anyhow, the Avinza patent wasn't supposed to expire until late 2017. I see my pain Dr. very soon and I will be talking this over with him. I will be sure to pass on what he has to say. Anybody else feel like we are out on an island with this chronic pain? Stay strong, when you get to the point that it can't get any worse, it has to get better.

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12

A little more information I found regarding Avinza. I found an article on yahoo finance that addresses why Pfizer has discontinued Avinza and also talks about Embeda, which is another one of their extended release morphine products.

I don't know how to upload this article to this site. If this site will allow this to post, I am giving the exact path I used to find this article. Start at yahoo's search engine, and in the big search box type "yahoo finance article about embeda", then click on the first search result which says "FDA Approves Abuse Deterrent Labeling for..."

Read the entire article, but if you want to fast track, read the sixth paragraph and you will see why they have decided to discontinue Avinza.

I hope that this will go through and help everybody who is fed up with hearing that Avinza is on long term back order.

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13

Hello Yanni,
You got more information from them than I did. I was told the backorder story.
With no options, I went to my pain doc and got a new script for OxyCodone, since I use roxicodone for breakthrough pain already, thinking was it's not going to cause the awful side effects like all other long acting meds did. Just began taking it so not sure how well it will work . thanks for info on Embeda.
Tina

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14

Hi Tina, I just saw my Doc and got a prescription for Embeda. I will let you know what I think of it and how it compares to Avinza for me. I am hoping for the best.

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15

Hi Yanni, thank you so much about the info on Avinza and Embeda. I go to my neurologist on Tuesday and I'm going to request my script be changed to Embeda. I'm also having major problems with the generic brand of oxycodone/roxicodone. Every time I find a generic brand I can tolerate they fill a couple times and then I get told they no longer can get it from this particular pharmaceutical company/supplier. I was getting it from KVK Tech, no great, but helped. Now they are filling it with Rhodes Pharm, which I get deathly sick from. I e-mailed Pfizer asking if they produce oxy or roxi generic, but no answer. Will let you know I how make out with Embeda. Again thank you so much for the info, really appreciate it.

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16

Yanni, what was your strength of the Avinza? I take 270 mg a day. I checked on the Embeda and for me it would be either a little higher dose or a little lower. How is it working for you? Praying it works for you. Take care!!

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17

Hi Lorraine, I was taking 240 mg a day of the Avinza. I asked my Doctor to start me with a smaller amount of Embeda because I never know how a new medicine will react with the other meds that I take. I am taking 200 mg of Embeda a day (one 100 mg capsule twice a day) and it's far better for pain control than the generic Avinza. I am going to need the 200 mg of Embeda increased and will have it bumped up to the 240 mg at my next appointment. So far, the only difference between brand Avinza and Embeda is that i feel a little tired on the Embeda, but that could be due to the fact that the smaller dose isn't controlling the pain as well. I highly recommend the Embeda and hope that you have good luck with it as well. Please let me know what you think of it once you get started.

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18

I am very grateful for your time and thoroughness researching the difficulty filling prescriptions for Avinza. I take 60mg 3x per day, doc wrote it so when I am having a very tired day from Lupus and am in bed I don't have to take the full dose. Also if I am going to be driving I can take only 2 instead of 3 and it increases my alertness. I think my neuro knew this was coming down the line - he tried me on Kadian and Embeda a couple of years ago - basically he said it was because Kadian came in a 50 mg and it was a smaller jump than going from my 45mg 3x to 60mg 3x - but something in the Kadian caused indigestion - I was belching a lot and it tasted like paint thinner, it didn't seem to work as well or last as long. My husband also takes Avinza and he got his filled generic a month ago, he has been in pain ever since.
We also tried Embeda when it came out and got VERY inconsistent results - some days it seemed to work, others not, and it also did not seem to last the full 24 hours (but then we didn't feel Avinza did quite 24 hours which is why my doc started me taking 2caps and then 3x times per day).
I know it is a backward measure, but with the Embeda I noticed that I was having more stomach cramping and less constipation, but again it was inconsistent. I also had some stomach upset, thought not as much as with Kadian (brand). And lets face it - if one narcotic analgesic causes you to have constipation ANY equivilent medication will duplicate the side effect as well as the relief. Indicating to me that my perception of less pain relief was NOT just subjective to switching medication.
My question is this: What else is out there that has the same or closest similar INACTIVE ingredients, same or similar method of time release technology?
Also, my husband was told by a pharmacist that a new law was passed reducing the restrictions on generics - that previously they must deliver an "equivalent dosage" of the active ingredient with a +/- of 5% but that the margin of is now +/- 20 %. That's a BIG difference! That means that one capsule could be 20% stronger than my 60mg Avinza, and another could be 20% weaker - so if my pharmacist switches generic brands on me my dose could go up or down 40% from the brand that I am used to taking!

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19

Just went to Wikipedia and to the FDA doc which basically states that a generic can have from 80% to 125% equivilancy of the innovator product. So basically it can work 20% less or 25% better - since pharmacies (especially big-box type) generally purchase the cheapest generic with little or no consideration for quality the generic manufacturer can change monthly. How are physicians supposed to regulate the dose a patient receives? Be FORCED to use Pfizer's Embeda if they want consistent results. Which med does not work for me - seems to absorb better or worse depending on what i eat or how i feel. grr! Physicians should not have their hands tied by polititians.

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20

I understand completely! The politicians/government just doesn't care. They are so worried about who is using the drugs illegally that the people who need it (us) get screwed. I go to my doctor tomorrow and I'm going to fight to change my meds to what I think may help and then off to the pharmacy I go, which is even a bigger headache. I don't know who to believe anymore, very, very sad. Good luck!

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73

I have been taking morphine sulfate in replace of avinza and it's not the same. I don't like taking it at all. I feel like ever since I stopped using the avinza everything's been downhill and I don't know what to do. Is there anything that anybody can recommend to me that's equal to avinza please?

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72

Re: Annie (# 66) Expand Referenced Message
I take avinza. I take the generic brand. Its called morphine sulfate capsules. If u get tablets it Ms Contin.

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71

King pharmasudical Bristol out fondness bought by pfizer will pray for you. Dont give up find purpose in suffering for greater good. Write call local state agencys complain phone to medicare social security medicare. Exploitation of the week diseased infermed young aged is a sin its inhumane hurting all mankind

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70

Avinza developed comp. Oregan were partnered with King Pharmaceuticals in Bristol. Tn. King was to pay iterated dividends over the course of years. King's in trouble with the feds over irregularity in manufacturing regarding schedule 3 drugs. CO 30 days jail, 34 mil fines, no longer can manufacture meds. Pfizor bought King out. Oregan Co. Out. Dividends due to stop. Pfizer knew the date and already had a new more costly drug in sight. Now charged approx. 100 0/0 to 500 0/0 more profit. This is well out of my budget. I'm disabled, 61, R.N. WE ALL HAVE A VOICE. This is wrong, sinful and shameful. I have all of you in prayers. More regulation and stiffer fines from companies price gouging all Americans.

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69

All I can say is that I was on Avinza since 2005 maybe? 120mg daily. Worked great.
I was forced to get generic 120mg timed released morphine sulphate ER.
There are beads inside this capsule also.
I can't get Avinza at all (pharmacist says no longer made). I am NOT pleased with
the generic, however, my body is adjusting but now with constipation.
I go to the Pharmacy at the hospital as cheaper places do not carry the capsule one that I need and works the best 24 hour one is the only one that works for me generic......I do miss Avinza sooo much!!! Don't try `12 hour ones - don't work for me. Good luck and I know how bad pain can be - I slowly have been decreasing as I get older - hope the same works for you.
Don't listen to so many criticize the amount you take. You know what works!!

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68

I was on avinzia worked best no sideeffects also on tetracycline for intermittent psychosis worked great. Both discontinued affiliated pfizer. Reason profits. I'm sure tetracycline is being outplayed so it can like avinzia can be charging more than 100 0/0 in future. Anyone reading this check out history behind these meds patients consumer reports. I'm praying for you please pray for me. I cant afford Embeta or expensive creams for my conditions. I am a disabled R.N. God have mercy on all

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67

240mg of avinza per day? Unreal! I was on 90mg for 5yrs, had enough, cold turkeyed 3 weeks of hell, but now i take aspirin twice a day! My neck is fused, all of it, left ankle reconstructed, two torn rotator-cuffs with multiple tears, bicep tendinitis, carpal tunnel, tendinitis on wrist. If i can get off it, you can!

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66

I have to jump in here as I have been an Avinza user since it came out. I was taking
120mg 1x a day with great results. Then they quit making Avinza. I tried the generic, but it can go from being strong, to weak, etc. I am also getting depressed on generic.

My Doc tried to prescribe me Embeda, but my insurance would not cover it and I got the generic 12 hrCR - DON"T TRY IT!!! It was horrible for me!!

Had to go back to the doctor so he could change the prescription back to generic Avinza and now I realize a depression has set in plus the med is too strong.
.
I am afraid to make any more changes as I have had more doctor visits and pharmacy than I want to even believe.
This has been a nightmare for me.

I went from having my life back in control to just staying home. Hard to believe the one pill Avinza was really saving and giving me back my life!!!

Please I pray they bring the brand name back - although my doctor says it is all about profit, and I do believe him.

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65

Actavis is not manufacturing Avinza, at least not in the Atlanta MSA. I believe they were some instances where some of the pharmacy had somewhere unexpired left over and they sold them however there is no new manufacturing. The drug has gone generic to morphine sulfate er. I'm well aware that some generics do not work as well as others. I experience that when I was on fentanyl. I will be contacting this manufacturer again tomorrow I hope, I have had trouble getting in touch with him during the right hours, in any event I will call these people and anyone reading this can call the manufacturer direct and they will give you this information. My prescription was written for Avinza. However when I was trying to find a pharmacist to fill the prescription which was a replacement for some bad patches, no one had it in stock and every pharmacy, CVS, Kroger, Walgreens, Walmart, Sam's Club, Kmart, RiteAid -none had Avinza in stock & ALL told me it was discontinued. I immediately contacted my doctor because I was very sick and we had destroyed all of the remaining bad patches so of course I was in withdrawals and I have been put on a cocktail for opioid withdrawal syndrome. My doctor took action and contacted my pharmacy, Walgreens. She explained the situation to the head pharmacist she told him the prescription was written for Avinza, he told her that it was no longer available and manufacturing has been discontinued, she had written a prescription for the drug the day before and had heard nothing from her patient. He told her that the equivalent was generic and it was morphine sulfate er. This is what she told me the medication was in the first place however when she wrote the prescription she wrote it out as Avinza. My medication is going to have to be increased in any event however we have been putting it off until after I could get out of a donut hell hole and in January and February a very large ridiculous deductible. Those of us on Medicare Part D, the Obamacare plan was to get rid of the donut hole so of course the insurance company and they are going to slam us with large deductibles upfront. Sometimes it seems that we cannot win without losing but that does not mean we cannot fight! It sounds like what you may have to do is go up on morphine sulfate er if it is not working for you. Again this is what happened to me when Duragesic patches went generic. Manufactured by a number of companies, patches made different and people not getting enough of the fentanyl into their system. The pain clinic I was in at the time had numerous complaints from patients and most of us they increased the dosage. It sounds like that's what it's going to take for you to get some relief, I would contact the manufacturer regardless. Again that is what I am planning to do before I return to my pain doctor to ask them what the equivalent of morphine sulfate er would be for 50 or 75 micrograms of fentanyl.

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64

The only thing I've been able to get is the genetic.

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