Is Generic Kadian Available Now? (Top voted first)

Has the generic Kadian been approved and is it now available?identifyvea

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Only thing left is morphine ER (long acting) same thing, bottom of the barrel. I had to switch, lost insurance and it is about $100 give or take (costco is cheapest) for my script and went down with a state script help form to about $65. But you get what you pay for. It is not high tech like Kadian, it does NOT work as well, it nearly caused me to have an obstruction (bowel) or blockage, it is just junk! It helps some for my pain but not at all like Kadian which was smooth and no "plugging up" problems. Even my doctors agree, Kadian is the best for morphine as they develop in labs with everything latest technology. Morphine ER has been around forever and never updated or upgraded to a smoother release and stomach problems. Sorry. I think they said that now since it's gone generic, the prices will keep going down as other companies will manufacture also. But at this time I can not dish out $800 a month either even for the generic. But if I get an obstruction from the morphine ER I swear I'll take legal action. Every since I started it I've had nothing but problems.

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I was prescribed Kadian for 6-years at 2 X 100 milligrams per day. 1-year ago I decreased my intake to 2 X 60 milligrams per day. For insurance purposes, my pharmacy automatically switched my prescription to the generic Kadian made by Watson. I have been using the generic for 2-months. I find the generic by Watson to be incredibly unstable. There have been several instances where I feel extremely over-medicated to the point I cannot keep my eyes open and find often find myself nodding-off while using my computer or watching television. There are also times when I feel nauseated; not always, but often. Other side-effects I’ve experienced are the inability to focus and complete one project at onetime; prolonged grocery shopping trips; checking and rechecking locked doors, light switches, stove burners, etc., before leaving the home… meaning, the drug is causing confusion and a mild form of paranoia.

There are some users of this drug that would not have a problem with their generic drug being stronger or feeling over-medicated. Something tells me though that it isn’t that the generic is stronger, but something is wrong with the time-release aspects of the drug. I pay very close attention to the adverse affects of this generic version. At times, it feels as though the medication does not disburse as ‘evenly’ as the Kadian brand. I feel as though the generic brand accumulates a build-up of the drug in my body and then disburses an increased amount approximately every 3-days. Needless to say, this could be very dangerous and even fatal. It is my intention to report this problem to the FDA and whoever else should be alerted. If anyone else has experienced adverse reactions to generic Kadian, please post your concerns.

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Thank you all for commenting in this thread! IMHO, it contains the most complete and accurate description of the problems associated with being dependent on the opiate morphine sulfate in its' various forms that I've come across yet, and I just want to add my own experiences to confirm what some of you wrote, and summarize what I've found to date. Maybe it can help some of you, too; I hope so.

Background: my sciatic nerve root was shredded by a "blown" disk in the mid 90s, and my pain has been severe and chronic since. I began treatment with the usaul OTCs many doctors start with, but within months was on T&C; then after a few years was at the maximum dose and could not continue. My doctors tried various meds during that time; I am one of the patients who almost died using the defective Fentanyl patches, and suffered withdrawal serious enough to end up in the ER on generic extended release morphine sulfate tablets, until we tried Kadian capsules. So far, it has been the only medication that controls my pain to a manageable level, without ANY serious side effects, just as some of you have described.

Until now.

Before I explain, I think we need to be very conscious of our terms here, because some people have used the words "tablet" and "capsule" somewhat loosely, but they are NOT the same, they are NOT equivalent in action OR effect, and they do not LAST the same amount of time, especially in generic form, nor perform as well as the brand name Kadian capsules. I hope we can all agree on - MS Contin is NOT the same as Kadian capsules, nor are the various MS tablets. Let me just stress that for those who would try to say "they are all the same," as some have here - what I've discovered from having used the various forms over the years is that TABLETS are NOT the equivalent of Kadian in any way; they do NOT act the same in the body - they are gone much too quickly for me, for example, as if I get a full 24 hour dose in less than 12 hours! I used to go into withdrawal at least once a day on them - sweating, shaking, mounting confusion. The absorption mechanisms are so different and seem to be entirely dependent on how a body absorbs the coatings, in terms of duration of effect; in fact, having been on so many I think I can safely say that NONE can compete with Kadian capsules for long-term release in the body. Those tiny "beads" each have a coating that seems to actually work more evenly in more people than any other type or brand that I've been prescribed and I think that no single coated tablet can come close. That's been my experience and echoes that of what I've read from others across the websites, at least. Mine included an elongated pill which was easier for me to cut into quarters, which was a bit better - but it is NOT a long-term solution, just a stopgap measure to keep me out of the ER again until I could get another medication! So the generics and tablets were finally all out, at least for me.

Once settled on Kadian caps, as high as 100mg X2 daily, things have always gone smoothly, with no real side effects - other than those listed for long-term opiate users, which I had never heard either, thank you SO much for listing them, PAC! My GP came close to putting that mystery together, although my pain specialist never brought it up and probably doesn't even know; and I think it's time for me to find someone who does. I've lost all my armpit hair, and my testosterone was so low my GP gave me an Rx for monthly shots. I am now in my 60s, so some testerone loss is natural, but my levels were very low, and that fits the long-term opiate use profile.

However, I am now forced to use the generic form of Kadian since the supplies being sold as "generic" but stamped Kadian seem to be gone. It's now the bi-color Watson "equivalent", and I could see and feel the difference right away! The action IS inconsistent in my experience - for some reason, although the contents are supposed to be the identical "little white beads" as Kadian. Since I had a couple of leftover 80 and 100 Kadian capsules, I decided to compare them with the new generic - right away I could see that the (3) 80mg Watsons DO NOT contain the same number of beads as the Kadian 80s - just hold them up to the light and compare side by side. I opened them and emptied them into a pill divider (I keep it for nausea), side by side - and it's clear that the Watsons contain about 10% LESS medication than the Kadians; this is consistent with every Watson I held up to the light.

In fact, I took digital pics of each, and with free software ("ImageJ" from the NIH website), used the "Cell Counter" plugin to actually count the beads in each capsule - you can do this yourself to prove what I found! Here are my results with 100mg and 80mg caps:
100mg Kadian - 1) 251 beads 2) 254 beads
80mg Kadian - 1) 201 beads 2) 204 beads
80mg Watson - 1) 181 beads 2) 184 beads 3) 182 beads
Here is the math I did to show the difference:
@ 100mg/250=0.4mg/ea
250 x 0.4 = 100mg
@ 80mg/200=0.4mg/ea
200 x 0.4 = 80mg
@ 80mg/180 = 0.444444444444444444mg/ea (not consistent!)
180 x 0.4 = 72mg, NOT 80mg... 10% LESS

Not only are they dropping the bead count by approx 10%, but the individual beads in the generics, under 10X magnification, are less uniform in size and shape, with the majority being smaller than the actual Kadian beads. Draw your own conclusions about what it means to us as patients, but my body felt the difference within a day of the changeover. I KNEW something was different, despite all the assurances that they are identical - they are NOT, and you can prove it also.

As for what kind of "windfall bonanza" this can give them, I'll only point out at the retail rate of $20/capsule in my area, they are making an extra bundle on every single capsule - all perfectly legal under FDA rules for generics? My understanding is that generics must reach the same strength in the bloodstream in a given time, but how can that happen when we get 10% LESS per capsule?

Here is the URL of the FDA site about generics - please read the rules yourself and draw your own conclusions.
fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/UnderstandingGenericDrugs/default.htm

Why am I posting this? There's a lot of misinformation and misunderstanding about this issue, and it's hurt a lot of patients like me, as this forum shows; I am trying to explain why our experiences with these potent opiates differ so widely, aside from our individual biological differences. I hope others will compare the other strength capsules that I don't have access to, and together maybe we can prove there IS a measurable difference between the brand and the generic, and get it corrected. My contention is simply that 10% less medication and inconsistent bead sizes DOES make a difference in bioavailability AND action - if others can verify that, maybe we will suffer a bit less and still save some money by having more consistent generics in the future.

I also hope it helps some of you who bravely posted here, too - thank you all for spurring me to action!
JL

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Wow, my heart goes out to you both. I'm on the other end of the country, and I haven't had to drive 120 miles, but it's ridiculous that you've had to risk going into withdrawal in order to get your meds. I was irritated that insurance gave pharmacies no time to find (and order and stock) the generic before saying they wouldn't pay for the name-brand. In CA, I have to see the doc every month to get my prescription, and get it filled. I'm not able to get any advance supply, and I worry that if (God forbid) the poop hits the fan, and for some reason I'm unable to get my meds - I have no reserves. It's scary being so dependent for day-to-day pain relief.

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I was on the PAP with Actavis for the Kadian 100 mg 2 X's daily for about 4 years. When the program ended in Dec, My doctor prescribed MS-CONTIN (Morphine Sulfate is the generic form) 100mg 2 X's daily.. This is my 3rd dose of the Morphine Sulfate ER and I am a mess, unbelievable nausea, Sweating, mouth watering, headache, pain, feeling completely ""drunk" and "out of it" .. ALL DAY When I spoke to the pharmacist about my concerns, she said it "IS" the equivalent to Kadian but I would still have the side effects, My thought is IF MScontin is the SAME as Kadian, then Why am I having the terrible side effects?? She couldn't really explain that but she said that it would take 1 to 2 weeks for my system to adjust to it, I had started taking Kadian when I could no longer benefit from the DURAGESIC patches, and when I changed over, there were absolutely NO side effects what so ever, it was a very pleasant and undisturbed transition.however, this is to say the least HORRIBLE.... as far as the costs, I called CVS they wanted $ 275. for a 30 day supply (60 tabs) then called Walmart they quoted a WHOPPING $1,182.73 for 30 days( I bout pissed myself..LOL) then I called Walgreens, they said to join their prescription savings plan for a nominal fee of $5.00 and I could get my 30 day supply of Morphine Sulfate ER for $129.99 ...without being on their "plan" the cost was $ 272... I would like to know where the "hello" Walmart gets off charging such a ridiculous price when everyone else is pretty much wihtin a few dollars of each other??... I hope this helps anyone else.I don't know whether to "wait" this out and see if the side effects clear up or maybe get the does lowered but like I said earlier, I JUST started this prescription and if I change the dosage, then I just wasted $134 (minus 3 pills) Oh yea, and the pharmacist said you can't cut them in half so I guess we are all just SCREWED once again I feel by the drug companies, etc... ( I am a bit bitter at this point so PLEASE forgive me)

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I was given 40 kadians for my Jan. refill and told that the other twenty would be generic when they came in. Well I went into withdrawels with watsons crap and called my insurance and was told no they did not require me to change, so my wife went back to my doc and got a Kadan script and we switched Pharmacies and all isas was. Why would Walgreens tell me something my iinsurance did not require and put me through hell?
Now I deal with a small pharmacy andcan only figure that Watson was allowing Walgreens more profit and therefore screw the little guy. Well not this guy but am interested if anyone else has had a similar experience.

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Toonces1, I tried generic Kadian for two months early in 2012 and had a similar experience to yours. I wanted so badly for it to work (for financial reasons) but it's just not the same. The difference was subtle... did not release evenly, pain relief was not as effective, I felt "on edge" and irritable similar to PMS. On Kadian, my pain is 1 out of 10 vs. on generic it was about 2 and no opiate, I rated it 7-8. I'm back on Kadian and paying full price without insurance for now. I previously took MS Contin and switching to Kadian was such a blessing. I did not feel it "kick in" or "kick out" and woke up pain free. I used to take a booster dose of MS Contin a few hours before I woke up so I could get out of bed... I dropped that on Kadian. This has been the most "normal" I've felt in the last 10 years and it's unfortunate that big pharma, the insurance industry, and government agencies can't help us out.

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@JL,
You sound like a scientist to me, a very well educated one. I appreciated your paper.
Found it to be informative, with the correct investigating and study to prove. The only kind I will bother with. Being a scientist, I can relate to formulary much better than complaints. So thank you very much.
Have had to be on the Kadian since I broke my back in two places, and fractured my neck. Refused to let them experiment on me after about four failed attempts, with the fifth leading to possible, most probably being paralyzed waist down. That's when I said enough is enough. Spent the next five years on the couch losing my life. Finally agreed to the Kadian 60 mg x 2 day, with 15mg of oxycodone three times a day for breakthrough. Still not pain free, but don't expect it, I'm realistic and realize it can't be done. Plus I have my life back, how could one not be more blessed? I was considering going with Watson and their generic, due to what else; money that is until I read your paper. Now I won't even consider it. Have been on for 8 yrs. now, no complaints.
I know this is way later than when you wrote, but had to thank you anyway. You were the deciding factor in my final decision.
BJ

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I applied for the patient assistant program 20 days ago for Kadian. I just got the reply. It states that the program is no longer available as Kadian is now available in generic form. It was released November 10th, 2011 so should be hitting the phramacies anyday. I called my pharmacy, Costco, and they do not have it yet and do not know the name if will come under. Hopefully sooooon!!

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This situation is so unfair. Now, there is no Patient Assistance Program for any oral morphine product that I know of. I just dropped my very expensive health insurance only because I knew I could get on the PAP. I'm sure I'm not the only one who is in this position. Who can afford $800 a month for medication especially if youre not working. This is crazy. Even discounted, the generic Kadian is not affordable. Now what am I supposed to do - withdrawal I guess. This sucks!

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PAPnomore, yes they are both extended release morphine sulfate, but the way they are absorbed by the body is very different. This should be evident by the fact that a tablet has to dissolve whereas Kadian just has a thin capsule filled with the tiny spheres of medication. Before being on Kadian, I was on MS Contin and I can assure you that there is a huge difference in the way my body responded to treatment. I don't know if your doctor is correct regarding the tablet releasing medication more quickly but even if he is, that's a BAD thing, in my opinion. These are long-acting opiates, I don't want it to release medication FASTER, I want it to control my pain LONGER.

I'm in the same boat as everybody. I just went to fill my Kadian last night and was told that I'd be paying a higher co-pay unless I opted for the generic. I have the same doubts as TeeTee - it makes me nervous to switch to a generic medication. I pick up the new prescription on Monday and I'll let you know if I notice any difference.

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I'm still not sure, but went thru quite an ordeal getting my rx for Kadian this week. The pharmacy charged me an exuberant amount for my rx and we had to go to heads with them about the abuse they were dishing out. I was told that there was a generic that just came out, but have not seen actual proof of this.....

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It has just been so horrible here in Florida since generic Kadian started being manufactured in Nov11. I use the 60mg generic Kadian as my insurance company (Tricare) refuses to pay the rediculous cost of the brand name. The problem here in the Lakeland (central) area is that no one carries it yet. I spend days on the phone calling all of the (acceptable) pharmacies and usually have to special order in advance. The pharmacies here are really liery about inquiries over the phone so many you just have to drive to, in pain, and take the time to inquire if your meds are in stock. Last month I had to drive 120 miles out of county because of course they date prescriptions here and there's NO working ahead of time, so you are locked in to THAT date. So...what I am forced to do is go without some evening doses so I can get ahead of the game with a few extra pills ahead, then pray I find GENERIC Kadian before withdraws set in. I really hate how things are so tightly controlled here but I try to understand that there are abusers and rules to control them. Kadan has been a life saver but I will be so glad when I can finally get my body fixed enough to be able to go without ANY pain meds. God please let tat day come soon.

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From what you described, you didn't get the generic equivalent of Kadian. MS Contin ES is not Kadian. My bottle says MS Contin ES Capsule. Kadian is now available as a generic, and I don't know why your doctor wrote you a prescription for something else. It isn't the same - yours are a pill (I'm guessing) that has a time-released coating on the outside, while Kadian is a capsule with little balls inside. I used to be on OxyContin, which is a pill - and I know that it didn't last as long as Kadian. I'm not sure what the going rate for your dosage in Kadian is, but you might call around and find out - and get your doc to write you a script for Kadian.

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Hi 8 year! Thanks for the reply.. I know that I am not getting the generic of Kadian, I was stating that Morphine Sulfate was the Generic of MS Contin ER.... .. My doctor prescribed another med becuase I had to start paying for my meds and no insurance and this is the closest he could get me without having to go cold turkey quitting......The Pharmacist was telling me that MSContin is only the Equivalent of Kadian.. (Meaning that they both are Morphine Sulfate .. and yes mine is a pill... I checked today with the pharmacies in my area to see what the actual Generic Kadian would cost me as I have no insurance to help pay for it.... Walgreens wanted 783. for Generic Kadian and $1200. for kadian.. Walmart wanted $973. for Generic kadian for me at 100 mgs 2 x's daily.. When I asked why so high, they said "The newer the med, the higher the cost and since Generic Kadian is brand new, lets' just screw with the poor people!!! Where does Actavis come off giving less than 30 days notice to find something else to use that would not cause so much destruction. I appreciate the help that they did give me, please dont' get me wrong, but now I am faced with having to buy my meds that I CAN NOT AFFORD.. I have never had a house payment that high!! it just shows that the pharm co's are all about money and NOT people, because if they did, they would know that people can not afford to pay a price as ridiculous as that hince they are on their PAP.. but knowing the dangers of abruptly stopping this med and not offering another program to remain on is only about MONEY! So as much as I would LOVE to be back on KADIAN and back to my somewhat NORMAL life I was coping with, at $700 - $900 A month.. I don't know who could afford that, do you? It's just a fricken shame

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I just wanted to give an update. I am now on the Watson generic Kadian and it is going fine so far. It has been about 3 weeks since I have switched and I haven't experienced any withdrawal symptoms and my pain control seems about the same. My doctor did tell me that the brand company sold off some of their excess stock when the generic first became available because they new their sales would go down, so some of the generic drug companies bought the actual Kadian from Aventis and sold it as generic but it really was the brand drug. That;s why some people got the "generic" from the pharmacy that looked exactly like the brand and even said "kadian."

But, I got the real generic now and I can tell because the capsule is different. I have the 60mg capsules and they are pink and white, whereas the brand 60s were just pink. Just thought you might find that interesting.

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Has anyone been able to find a patient assistance program for the kadian or generic.. I have no prescription insurance and can't afford to buy even the generic.. at $ 800 for 100mgs 2 x's a day... ridiculous in the pricing of this stuff!!!

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I'm so sorry to hear about the problems you have had with the generic Kadian. I sure hope that when I end up on the generic that I don't have problems and get sick with withdraw from it. I don't know where you live but in Ohio and Florida if you go to fill a script for any narcotic or opiate to be more specific they will only fill the script for the amount prescribed. In other words if you have a script for 20 mg Kadian X2 a day (60 pills) and the pharmacy only has 50 pills if you choose to fill the script you lose the other 10 pills and can not get the last 10 when another shipment comes in because it is a "controlled substance". I don't get it but that is what I have been told more than once when I needed my script filled and I had to run around to 5 or more pharmacy to try and fill it. Florida is really strict on scripts because of the "pill mills" here and only pain management doctors can write the scripts now. My doc is so over run with referrals from other docs since they can't write the scripts that they are working late into the night and even some Saturdays! BWC wants to throw a fit and only cover the generic but from my understanding the generic isn't that much cheaper than the original Kadian.

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Appreciate comments by all in re: to generic Kadian. I surfed the net tonight to see if Kadian's patent had expired and was so excited at first to see that it had; however, after reading all posts I am sorely disappointed to learn the pharmaceutical companies are once again pulling their old tricks. The FDA states that the specs for a generic drug’s active ingredient must fall within the concentration range of no more than 25% and no less than 20% of the active ingredient per tablet/capsule. Sounds like Silversurfer may be suffering from taking poorly manufactured generic Kadian.

As a chronic pain patient requiring MS ER since 2006, I can relate to the above mentioned symptoms of somnolence, intermittent sweating and difficulty w/concentration, as well as nausea occasionally. I can say I’ve used MS ER almost exclusively (after losing ins. 6 mo. into illness.) My side effects have been fairly consistent but I have occasionally come up with a new symptom, or constellation of symptoms. I have had this happen several times. About 3 yrs into my use of MS ER w/ no change in dosing, my neurologist diagnosed me with narcolepsy as I kept falling asleep throughout the day. (Not surprising as I have the genetic marker for it.) I have been found to be deficient in estrogens, testosterone and DHEA.
Treatment w/Estrogen and Testosterone has helped me some w/energy and overall feeling of well-being. As I have learned, a person using opiates (narcotic pain relievers) for greater than 3-6mo, WILL become deficient in Testosterone if male, and if female they will become deficient in female hormones, as well as Testosterone. Symptoms range from mild to incapacitating nausea, fatigue, muscle loss, loss of appetite, lack of or decreased sex drive. These symptoms may be mild to severe in nature. Women may quit their menstrual cycle, experience changes with loss of mons fat-pad, have difficulty w/frequent urination and men may experience loss of facial hair growth, and lose armpit hair and experience fatty deposition in hips/butt. I say all of this just to drive home the point, not all symptoms are due to medication variations. Chronic narcotic use takes its toll on our bodies in so many horrible ways, but fortunately if you communicate well with your doc and you have a good physician, then most symptoms can be treated.

My fiancée is on chronic pain mgt as well and uses MS ER too. One yr ago he almost died from a severe Testosterone Deficiency. During March 2011 he got off the sofa and went outside maybe twice. He awakened w/severe nausea daily and suffered incapacitating fatigue, as well he dealt w/his usual severe pain that we all know is only moderately controlled w/MS ER. After much reading he asked his physician to please check his testosterone b/c of his symptoms. Of course she said no b/c he didn’t look to have muscle wasting nor did he have the other symptoms she thought of to be common w/a testosterone deficiency. At his next appt. 3mo. later in March 2011 he asked again, and she agreed to check it. To her total surprise his testosterone level was at 130ng/dl. Normal range is approx. 300-850 ng/dl for men, and for women 15-70 ng/dl.
It took him several months to really start feeling better using weekly testosterone injections and it’s a constant battle to keep levels w/in normal limits b/c he requires opiate use for pain control. He states that when he has a flare-up of pain and requires more MS ER, the quicker his symptoms of testosterone deficiency return especially nausea, i.e. requiring more testosterone. Most physicians are not aware that chronic opiate use will compromise production of estrogens and testosterone. Our physician is very aware of the problem now and makes sure all of her patients don’t suffer from these hormone deficiencies.

Moral of the story, don’t assume all symptoms that come along are due to medication or a change in medication. However, keep up the good work and let the FDA know all about your experiences w/MS ER and/or generic Kadian. We have definitely found differences in the pain relief of varying brands of MS ER and that ought not be! The FDA really does need to crack down on their generic drug regulations so that we can depend on the generic drugs we take and depend on them to work correctly w/out increasing our risk of suffering or potential death.

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I have been taking the generic kadian now since it came out in November. At first I didn't really notice much, a small increase in pain, but there are always ups and downs with chronic pain so I just chalked it up to that. I didn't experience any other side effects. However, I have begun noticing that my pain seems to rise pretty predictably in the 1.5 to 2 hours prior to my second 12-hour dose. I NEVER had this problem with the brand kadian. In fact, I could go about 18-20 hours on the brand kadian without redosing if I had to, but I took it every 12 because every 24 wasn't quite sufficient and every 12 was the only other reasonable option. I kept and eye on this for several weeks and it is like clock work. On the brand I never, ever had pain in the morning when I woke up, but now I almost always have discomfort or even outright pain when I wake up in the morning until about 1 hour after I take my dose. Likewise in the evening before my evening dose, my pain control spirals downward and I usually end up with break-through medication until it's been about an hour after I have taken the kadian right before bed I feel okay again.

This is not a huge difference, but now that I have had several months to see, I can tell a small difference. Has anyone else experienced a similar effect?

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