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Old 02-23-2010, 04:07 AM #1
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Default Called the pharmacist because bottle from pdoc is different

Hi,

I've been taking 240 Verapamil SA.
When I picked up my new script the bottle said 240 Verapamil ER.
The pharmacist told me on the phone a few minutes ago that they were the same thing.

They are not the same thing!
Otherwise they would have the same name!

She said that I can bring in my bottle of ER in the morning and trade it for the SA -- the one that the computer shows I have been taking.


The pdoc messed this up by not specifiying -- just wrote 240.
Next time I will check the script in his office.

A little anxious here.
. . . have not slept in a week or two it seems.


The store is open 24 hrs and only 2 1/2 miles from here. Maybe I should go out in the car now while I am in the mood to deal with this.
I would have to leave hubby a note because he is sleeping.

M.
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Old 02-23-2010, 05:26 AM #2
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Lightbulb

There are two kinds of verapamil dosage forms.

One is the immediate release. Has no abbreviations after it.

The other is extended release. Some drug companies use various abbreviations for it... ER, XL, SA, etc.

One drug Cardizem has a very confusing set of abbreviations after it, for example.

Cardizem immediate release (no letters after the name)
Cardizem SR-- to be used twice a day --sustained release
Cardizem CD-- Once a day dose..generics use ER also for this
Cardizem LA-- a special dosage form to only be taken at night

Verapamil does come in the special night time release form, for hypertensive patients who do not have "dipping" --which is a lowering of blood pressure during sleep. The makers of Calan have a verapamil for night time only called Covera HS.
It is available as Verelan PM as brand and generic, in CAPSULE form. Both are to be given at night.

It appears that the tablets only, for verapamil, are the older form of extended release. If your RX is tablets, it is listed at the Orange Book as extended release. ER and SA are commonly interchanged.

If no SA or ER appears after the name, then the verapamil is immediate release and this can be a serious error, because they are not interchangeable. However, there is no immediate release made in 240mg size. Only in 120mg.

Here is a list of all the generics and brands available for verapamil. See if your brand (manufacturer) is on this FDA list.
I'd put up a link, but FDA does not have internal links, only generic addys. www.fda.gov
Quote:
Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations

Active Ingredient Search Results from "OB_Rx" table for query on "verapamil."


Appl
No TE Code RLD Active
Ingredient Dosage Form;
Route Strength Proprietary
Name Applicant
N020591 No TRANDOLAPRIL; VERAPAMIL HYDROCHLORIDE TABLET, EXTENDED RELEASE; ORAL 1MG;240MG TARKA ABBOTT
N020591 No TRANDOLAPRIL; VERAPAMIL HYDROCHLORIDE TABLET, EXTENDED RELEASE; ORAL 2MG;180MG TARKA ABBOTT
N020591 No TRANDOLAPRIL; VERAPAMIL HYDROCHLORIDE TABLET, EXTENDED RELEASE; ORAL 2MG;240MG TARKA ABBOTT
N020591 Yes TRANDOLAPRIL; VERAPAMIL HYDROCHLORIDE TABLET, EXTENDED RELEASE; ORAL 4MG;240MG TARKA ABBOTT
N020943 AB No VERAPAMIL HYDROCHLORIDE CAPSULE, EXTENDED RELEASE; ORAL 100MG VERELAN PM ELAN DRUG
N019614 AB No VERAPAMIL HYDROCHLORIDE CAPSULE, EXTENDED RELEASE; ORAL 120MG VERELAN ELAN DRUG
N019614 AB No VERAPAMIL HYDROCHLORIDE CAPSULE, EXTENDED RELEASE; ORAL 180MG VERELAN ELAN DRUG
N020943 AB No VERAPAMIL HYDROCHLORIDE CAPSULE, EXTENDED RELEASE; ORAL 200MG VERELAN PM ELAN DRUG
N019614 AB No VERAPAMIL HYDROCHLORIDE CAPSULE, EXTENDED RELEASE; ORAL 240MG VERELAN ELAN DRUG
N020943 AB Yes VERAPAMIL HYDROCHLORIDE CAPSULE, EXTENDED RELEASE; ORAL 300MG VERELAN PM ELAN DRUG
N019614 Yes VERAPAMIL HYDROCHLORIDE CAPSULE, EXTENDED RELEASE; ORAL 360MG VERELAN ELAN DRUG
A078306 AB No VERAPAMIL HYDROCHLORIDE CAPSULE, EXTENDED RELEASE; ORAL 100MG VERAPAMIL HYDROCHLORIDE MYLAN
A075138 AB No VERAPAMIL HYDROCHLORIDE CAPSULE, EXTENDED RELEASE; ORAL 120MG VERAPAMIL HYDROCHLORIDE MYLAN
A075138 AB No VERAPAMIL HYDROCHLORIDE CAPSULE, EXTENDED RELEASE; ORAL 180MG VERAPAMIL HYDROCHLORIDE MYLAN
A078306 AB No VERAPAMIL HYDROCHLORIDE CAPSULE, EXTENDED RELEASE; ORAL 200MG VERAPAMIL HYDROCHLORIDE MYLAN
A075138 AB No VERAPAMIL HYDROCHLORIDE CAPSULE, EXTENDED RELEASE; ORAL 240MG VERAPAMIL HYDROCHLORIDE MYLAN
A078306 AB No VERAPAMIL HYDROCHLORIDE CAPSULE, EXTENDED RELEASE; ORAL 300MG VERAPAMIL HYDROCHLORIDE MYLAN
A070577 AP No VERAPAMIL HYDROCHLORIDE INJECTABLE; INJECTION 2.5MG/ML VERAPAMIL HYDROCHLORIDE HOSPIRA
A070737 AP No VERAPAMIL HYDROCHLORIDE INJECTABLE; INJECTION 2.5MG/ML VERAPAMIL HYDROCHLORIDE HOSPIRA
A070738 AP No VERAPAMIL HYDROCHLORIDE INJECTABLE; INJECTION 2.5MG/ML VERAPAMIL HYDROCHLORIDE HOSPIRA
A075136 AP No VERAPAMIL HYDROCHLORIDE INJECTABLE; INJECTION 2.5MG/ML VERAPAMIL HYDROCHLORIDE HOSPIRA
A070451 AP No VERAPAMIL HYDROCHLORIDE INJECTABLE; INJECTION 2.5MG/ML VERAPAMIL HYDROCHLORIDE INTL MEDICATION
A070617 AP Yes VERAPAMIL HYDROCHLORIDE INJECTABLE; INJECTION 2.5MG/ML VERAPAMIL HYDROCHLORIDE LUITPOLD
N020552 BC Yes VERAPAMIL HYDROCHLORIDE TABLET, EXTENDED RELEASE; ORAL 180MG COVERA-HS GD SEARLE LLC
N020552 BC Yes VERAPAMIL HYDROCHLORIDE TABLET, EXTENDED RELEASE; ORAL 240MG COVERA-HS GD SEARLE LLC
A078906 AB No VERAPAMIL HYDROCHLORIDE TABLET, EXTENDED RELEASE; ORAL 240MG VERAPAMIL HYDROCHLORIDE GLENMARK GENERICS
A073568 AB No VERAPAMIL HYDROCHLORIDE TABLET, EXTENDED RELEASE; ORAL 120MG VERAPAMIL HYDROCHLORIDE IVAX SUB TEVA PHARMS
A074330 AB No VERAPAMIL HYDROCHLORIDE TABLET, EXTENDED RELEASE; ORAL 180MG VERAPAMIL HYDROCHLORIDE IVAX SUB TEVA PHARMS
A073568 AB No VERAPAMIL HYDROCHLORIDE TABLET, EXTENDED RELEASE; ORAL 240MG VERAPAMIL HYDROCHLORIDE IVAX SUB TEVA PHARMS
A075072 AB No VERAPAMIL HYDROCHLORIDE TABLET, EXTENDED RELEASE; ORAL 120MG VERAPAMIL HYDROCHLORIDE KALI LABS
A075072 AB No VERAPAMIL HYDROCHLORIDE TABLET, EXTENDED RELEASE; ORAL 240MG VERAPAMIL HYDROCHLORIDE KALI LABS
A074587 AB No VERAPAMIL HYDROCHLORIDE TABLET, EXTENDED RELEASE; ORAL 120MG VERAPAMIL HYDROCHLORIDE MYLAN
A074587 AB No VERAPAMIL HYDROCHLORIDE TABLET, EXTENDED RELEASE; ORAL 180MG VERAPAMIL HYDROCHLORIDE MYLAN
A074587 AB No VERAPAMIL HYDROCHLORIDE TABLET, EXTENDED RELEASE; ORAL 240MG VERAPAMIL HYDROCHLORIDE MYLAN
N019152 AB Yes VERAPAMIL HYDROCHLORIDE TABLET, EXTENDED RELEASE; ORAL 120MG ISOPTIN SR RANBAXY
N019152 AB Yes VERAPAMIL HYDROCHLORIDE TABLET, EXTENDED RELEASE; ORAL 180MG ISOPTIN SR RANBAXY
N019152 AB Yes VERAPAMIL HYDROCHLORIDE TABLET, EXTENDED RELEASE; ORAL 240MG ISOPTIN SR RANBAXY
A070468 AB No VERAPAMIL HYDROCHLORIDE TABLET; ORAL 120MG VERAPAMIL HYDROCHLORIDE ACTAVIS ELIZABETH
A071019 AB No VERAPAMIL HYDROCHLORIDE TABLET; ORAL 80MG VERAPAMIL HYDROCHLORIDE ACTAVIS ELIZABETH
N018817 AB Yes VERAPAMIL HYDROCHLORIDE TABLET; ORAL 120MG CALAN GD SEARLE LLC
N018817 AB No VERAPAMIL HYDROCHLORIDE TABLET; ORAL 40MG CALAN GD SEARLE LLC
N018817 AB No VERAPAMIL HYDROCHLORIDE TABLET; ORAL 80MG CALAN GD SEARLE LLC
A071483 AB No VERAPAMIL HYDROCHLORIDE TABLET; ORAL 120MG VERAPAMIL HYDROCHLORIDE MYLAN
A071482 AB No VERAPAMIL HYDROCHLORIDE TABLET; ORAL 80MG VERAPAMIL HYDROCHLORIDE MYLAN
A070856 AB No VERAPAMIL HYDROCHLORIDE TABLET; ORAL 120MG VERAPAMIL HYDROCHLORIDE WATSON LABS
A070994 AB No VERAPAMIL HYDROCHLORIDE TABLET; ORAL 120MG VERAPAMIL HYDROCHLORIDE WATSON LABS
A071367 AB No VERAPAMIL HYDROCHLORIDE TABLET; ORAL 120MG VERAPAMIL HYDROCHLORIDE WATSON LABS
A072923 AB No VERAPAMIL HYDROCHLORIDE TABLET; ORAL 40MG VERAPAMIL HYDROCHLORIDE WATSON LABS
A072924 AB No VERAPAMIL HYDROCHLORIDE TABLET; ORAL 40MG VERAPAMIL HYDROCHLORIDE WATSON LABS
A070855 AB No VERAPAMIL HYDROCHLORIDE TABLET; ORAL 80MG VERAPAMIL HYDROCHLORIDE WATSON LABS
A070995 AB No VERAPAMIL HYDROCHLORIDE TABLET; ORAL 80MG VERAPAMIL HYDROCHLORIDE WATSON LABS
A071366 AB No VERAPAMIL HYDROCHLORIDE TABLET; ORAL 80MG VERAPAMIL HYDROCHLORIDE WATSON LABS

Return to Electronic Orange Book Home Page
It has been my experience that the abbreviations after drug names for extended release are confusing. My Cardizem CD generic is now caller ER.

Calan SR does not appear on the FDA list. The other brand of long acting verapamil was Isoptin SR. They both shared the patent at one time. Neither was originally called SA.

So the bottom line? SA (sustained action),SR (sustained release) ER (extended release), XL (extended length), LA (long acting) are sometimes used interchangeably with drugs that are long acting. It can be very confusing.
For Verapamil... tablets are not generically interchangeable with capsules as a rule. The HS or PM form is not interchangeable with the regular extended release type (but these have no generic).
The immediate release type does not come in 240mg size so this does not affect you.

If you had extended release verapamil tablets, then you should continue with tablet form of 240mg.

My generic Cardizem CD does not have CD after it...it has ER.
I think they are trying to unify the abbreviations now, so that there will not be so many that are confusing to both doctors, pharmacists and patients.

You can look up your tablets for verification at www.rxlist.com
That website has an ID checker...you type in the letters/numbers off the tablets and it identifies the drug.
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Last edited by mrsD; 02-23-2010 at 06:39 AM. Reason: adding link
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Old 02-23-2010, 09:48 AM #3
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Thanks Mrs D

I have taken it for a few years now. The ones I get from mail order
always have a different set of initials after them than the ones
I get from a local Pharmacy.

I asked once my primary, and was told that the mail orders try
to use the cheapest of a form, so this was the same.

Donna
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Old 02-24-2010, 01:07 AM #4
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Hi,
I went to CVS around 10:00 pm tonight and asked for the same pharmacist. She took care of me.

I was sooo confused.
I nearly started to cry.

Somethings are hard now.
I need to be doing something different to fix things.

M.
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Old 02-24-2010, 11:30 AM #5
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Heart

Being sleep deprived is terrible, maybe you could ask your pdoc to prescribe a big med to use in these cases to knock you out. Something like zyprexa?
I am sorry for the upset...sounds like they are the same med from what mrs. D posted...but I understand your concern...when my lamictal went generic, it changed form a couple of times and the pharmacy would tell me such.
I am hoping that you get some much needed sleep ASAP.
((((HUGS))))
bizi
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Happiness is a decision....

150mg of lamictal 2x a day
haldol 5mg 2x a day
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I will not give up in this weight loss journey, nor this need to be AF. 3-19-13=156, 6-7-13=139, 8-19-13=149, 11-12-13=140, 6-28-14=157, 7-24-14=149, 9-24-14=144, 1-12-15=164, 2-28-15=149, 4-21-15=143, 6-26-15=138.5, 7-22-15=146, 8-24-15=151, 9-15-15=145, 11-1-15=137, 11-29-15=143, 1-4-16=152, 1-26-16=144, 2-24-16=150, 8-15-16=163, 1-4-17=169, 9-20-17=174, 11-17-17=185.6, 3-22-18=167.9, 8-31-18= 176.3, 3-6-19=190.8 5-30-20=176, 1-4-21=202, 10-4-21= 200.8,12-10-21=186, 3-26-22=180.3, 7-30-22=188, 10-15-22=180.9,
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Old 02-24-2010, 05:53 PM #6
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Quote:
Originally Posted by bizi View Post
Being sleep deprived is terrible, maybe you could ask your pdoc to prescribe a big med to use in these cases to knock you out. Something like zyprexa?
I am sorry for the upset...sounds like they are the same med from what mrs. D posted...but I understand your concern...when my lamictal went generic, it changed form a couple of times and the pharmacy would tell me such.
I am hoping that you get some much needed sleep ASAP.
((((HUGS))))
bizi
I hope you get some sleep soon. I'm also very glad that CVS took care of
things.

Donna
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