What kind of drugs are Klonopin and Norco? Medicare ? too!

[GJZH]

What kind of drugs are Klonopin and Norco? I see that many people with CP use these drugs yet they have never been offered to me...Do they cause dependence? Can they be used in conjunction with other drugs? Are there generics for these drugs?

I ask because I need to talk to my PM doc about going on a generic drug for pain because of medicare. I take so many medications for so many different health problems that I am trying to make certain I take as many generics as possible. Some drugs just do not have generics like Nexium, Singulair, and Allegra D, I think. When I spoke to the rep from BS she was certain that I would be paying out a lot of money for my prescriptions unless I could convince my docs to change my medications to something else..

I do think though that there is a generic for Flexeral and some of the other meds that I use...I have been looking through the book and I am certain of it.

Is there a generic for Topamax? I do not think there is for that drug either...and I am not switching back to Neurontin...That drug caused weight gain...and drunkeness..

Is there a way to get around paying so much out of pocket once I switch to Medicare?

[GardeniaGirl]

I can't speak to the Norco b/c I am not familiar with that drug, but Klonopin is a long-acting benzodiazapene. It is in the same class as xanax, valium, lorazepam, and others.

All of these are available generic.

I have severe inflammatory pain throughout all the connective tissue in my body -- so the tendons, the tissue around the joints, and tissues around muscles.

I also take a drug that makes me wired and anxious on top of that.

I take Xanax and it seems to help dull out the pain signals a bit as well as the anxiety I get from methotrexate.

I know a lot of CP patients use benzos for various reasons in conjunction with their other meds.

[Kira]

Klonopin is a benzodiazepine, in the same class as Valium and Ativan and Xanax and Versed. The drug's name is clonazepam and there are generics available.

Norco is a short-acting opiate that is very similar to Vicodin or Lortab, except it contains a little less acetominophen (Tylenol) for the amount of hydrocodone. A 5mg tablet of Norco contains 325 mg of acetominophen (Tylenol), while a 5 mg tablet of Vicodin contains 500 mg of acetominophen. Basically, it is a way to get a little less tylenol while still taking the same dose of hydrocodone. Norco is available in generic form.

Klonopin and Norco cause dependence the same way other benzos and opiates do.

The other meds that you listed... Topamax does not have a generic yet, as far as I know. It is pretty expensive, too.

Neurontin does have a generic (gabapentin). There are other anti-seizure meds used for pain that also have generics.

Nexium does not have a generic, but the active drug is essentially the same drug as in Prilosec OTC, which does have a generic. Nexium is esomeprazole and Prilosec is omeprazole. Prilosec OTC or generic omeprazole (depending on what your plan covers) is considerably cheaper than Nexium.

I don't think there is a generic for Singulair. There wasn't last summer when I was taking it.

Allegra does have a generic (fexofenadine). I am not sure if there is a generic version of Allegra-D, but it is fexofenadine + pseudoephedrine (Sudafed). Pseudoephedrine can be purchased very cheaply over the counter, but most if not all states require that it is kept behind the pharmacy counter now. Anyway, the generic fexofenadine along with an equivalent dose of pseudoephedrine would be the same as Allegra-D.

There is a generic for Flexeril (cyclobenzaprine). I believe it is fairly cheap, as far as meds go.

My suggestion would be to put all of your current prescription bottles in a brown paper bag and then sit down and talk with your pharmacist and/or prescribing docs about safely switching them to similar/equivalent generics. If you really need a med that isn't covered, see what you can do with prior authorizations and/or appeals. Also, many drug companies have prescription assistance programs for patients who can't afford their meds. It would be worth looking into those programs if you can't come up with another way to do it.

And of course, the usual disclaimer... I'm just talking about meds in general and not suggesting any particular treatment for you, since I haven't examined you or met you in person, etc, etc. Take it with a grain of salt and talk to your doc/pharmacist/etc before changing anything with your meds.

[Kathi49]

Gloria,

I was going to post earlier but GG and Kira pretty much covered it. I think you already know that I have taken Norco in the past and now Vicodin along with Klonopin. The Vicodin is for the pain of course and the Klonopin was originally prescribed for the small fiber PN. I have stayed with the latter because it does continue to help with some neuropathic pain. And, well, my Neurologist just recently told me there is an anxiety component to all of this as well.

And don't feel bad; I can't stand Neurontin or Lyrica...same SE's as you and worse. :( If I hate any med on this earth, it is Neurontin. And I wish I could deal with it because it does work.

And I was on Nexium for a long time; but just recently stopped it by doing kind of a slow taper so that I wouldn't get some rebound acid reflux. I seem to be doing okay so far. But if I have to go back to it, I will.

Anyway, I think I would do as Kira suggested...just talk with your doc(s) and pharmacist.

[GJZH]

Kira and Gardenia Girl,

Thanks for answering my post...

I have been on the generics for Nexium, but recently became ill so they switched me from those generics and put me on the Nexium...My stomach was not emptying...so they switched me to Nexium and Reglan....I do not know if I could go back on the generics, but I think I could try to switch back...I am on a regular diet now so it might be okay to switch back to the other drugs...

I would be afraid though to switch off the Allegra D...I have had two sinus surgeries...With the regimine that I use now for my sinuses I have had no setbacks...but I do not want to pay full price for these drugs either...

I might look at the different drug plans to try to determine if one of the other drug plans might work better for me...

[Mayzoo]

No medicare Part D plan will cover the klonopin sad to say. They do not cover any drugs in the benzodiazepine category. Other than that the others covered it quite well.

Mayzoo

[jena1225]

Just curious... I notice several people, like Gloria, talk about how generics med do not work on them like the name brand. How common is that? I have just never noticed any difference...

[suede]

Gloria,
If you don't mind answering what kind of insurance have you been using up til you became eligible for medicare.
I know after a lot of research and figuring it is more economical for me to stay on my husbands ins. plan..
Isn't all this just such a headache?

Jena, I have noticed some big difference in many of the meds between generic and brand and several difference depending on which lab they come from.

Linda

[Pharmacist.steve]

Just curious... I notice several people, like Gloria, talk about how generics med do not work on them like the name brand. How common is that? I have just never noticed any difference...

In the US .. nearly 60% of ALL Rxs filled are now generics..with step therapy the insurance industry is trying to get that number to 75%. With those kind of numbers makes one question those patients who say that NO GENERICS work for them. Due to what otherwise is considered inert ingredients which will differ from brand to generic and from generic to generic it is somewhat explainable when a patient has a less than positive response out of one particular generic source. Back when generics were less common ... I have heard docs who would say that when the generic didn't work .. the generic was CRAP ...but .. when a brand name didn't work .. it was just not the right drug for the patient...

[cindybear]

There is no generic for topamax...Does anyone know when they are going to have one...This month and next month I'm going to have to pay for full precription (donut hole )Cause of this expensive drug I must have..Horrible TN caused by a inoperable fisiform brain aneurysm...It's gonna cost me over 500.00 for just the Topamax..I think my pharmasict said it's 567.00 without insurance..Thats my most expensive drug..I've tried to get generics where I could..I thought, When I got medicare , I had to get this partd D,,That I couldn't stay on my husbands insurance and stay on his great drug plan..Now can I go back to it...His plan..On his part it shouldn't be a problem,,But the insurance since I've been off now for 9 months..Anyone knows,,Well, I have a supliment with my husbands plan now instead of the other...Which was better...Any thoughts...Hugs, Cindy

[Pharmacist.steve]

There is no generic for topamax...Does anyone know when they are going to have one...This month and next month I'm going to have to pay for full precription (donut hole )Cause of this expensive drug I must have..Horrible TN caused by a inoperable fisiform brain aneurysm...It's gonna cost me over 500.00 for just the Topamax..I think my pharmasict said it's 567.00 without insurance..Thats my most expensive drug..I've tried to get generics where I could..I thought, When I got medicare , I had to get this partd D,,That I couldn't stay on my husbands insurance and stay on his great drug plan..Now can I go back to it...His plan..On his part it shouldn't be a problem,,But the insurance since I've been off now for 9 months..Anyone knows,,Well, I have a supliment with my husbands plan now instead of the other...Which was better...Any thoughts...Hugs, Cindy

Topamax patent is up Sept 2008. If you had creditable coverage (good/better than Part D) .. you did not have to take Part D or Part B for that matter. Check with HR at your husband's work... should be open enrollment period end of the year... which should allow you to go back without penalties

[suede]

Cindy, Steve is right it shouldn't be a problem as you have not been uninsured since you have the medicare.
I know I almost dropped my DH's ins. when my medicare came through because I kept hearing how I was going to be penalized if I didn't start right up..
Thanks to Steve I did some more research and found out I wouldn't be as long as I continued with a ins. as good or better then what medicare had to offer.
I also found out that if for any reason I should not have my ins. any longer there will not be a waiting period for me to start up medicare.
I hope this helps.
Linda

Steve, I found there to be a rather big difference in brands of methadone, I had read here from many that they thought there was, but I didn't think it could be that much until one month my pharmacy had the other brand and wow, it did make a big dif. now my pharmacy has gone back to the other and I switched pharmacies.
I have also found this to be true with some of the generic brands of antidepressants.
Linda

[Pharmacist.steve]

Steve, I found there to be a rather big difference in brands of methadone, I had read here from many that they thought there was, but I didn't think it could be that much until one month my pharmacy had the other brand and wow, it did make a big dif. now my pharmacy has gone back to the other and I switched pharmacies.
I have also found this to be true with some of the generic brands of antidepressants.
Linda

I can't argue that some people and/or some generic brands may perform a little differently... I question those patients who claim that NO GENERICS - ALL PRODUCTS do not work for them... IMO .. it is sort of reverse placebo effect.

[curiousforever]

I can't argue that some people and/or some generic brands may perform a little differently... I question those patients who claim that NO GENERICS - ALL PRODUCTS do not work for them... IMO .. it is sort of reverse placebo effect.

Just curious - what benefit would those people obtain from claiming no generics work for them?

I get generics on most everything - as at a 'normal' post I wouldn't pay for most prescriptions - and here since the MTF pharmacy doesn't carry much - I have to pay out of pocket a bit. So I haven't had 'brand' on very many meds.

[Pharmacist.steve]

Just curious - what benefit would those people obtain from claiming no generics work for them?

I get generics on most everything - as at a 'normal' post I wouldn't pay for most prescriptions - and here since the MTF pharmacy doesn't carry much - I have to pay out of pocket a bit. So I haven't had 'brand' on very many meds.

These are the people that do not believe in generic/private label of anything. AND if they can get someone else to pay for it ( insurance) why not go FIRST CLASS..

It use to be that the insurance copays were $2 for generics and $5 for brands.. the insurance companies have now raised the brand co-pays to a % or $50 and it has changed some people "need" for brand names...

When the average Brand name Rx costs FIVE TIMES that of the average generic.. IT HAS GOT TO BE BETTER ... RIGHT ???

In general .. it is best if a patient stays on the same manufacturer product.. this is the major advantage that the brands have ... consistent inert ingredients...BUT even when changing from one generic company to another ... things will typically re-stabilize in a few days or weeks.. .it all depends on just how critical/fragile the disease state that you are treating.

[GJZH]

Linda (Suede),

I am on BS...but my husband is self-employed so we pay out of pocket....I was teaching and had insurance...When I quit teaching we went on Cobra and then picked up the BS that way when Cobra ran out...The BS policy we have is pricey and not great, but better than nothing...They will not be covering my daughter after June 30 because she will be turning 19. I thought they would cover her because she is a college student but they will not. We are trying to decide now whether to keep the BS or switch to Etna. With the Etna plan for the self-employed she can stay on the policy with my husband...My husband, son and daughter are healthy so it would be easy for them to be insured. Etna would never take me on as an insured.

The only thing that scares me with this Medicare is that I am only approved for my SS Disability for three years and then I am up for reevaluation...What would happen if they would not approve me again? I cannot see this happening as my condition is not improving, but worsening, but what if? I know BS has to insure people like me in the state of PA, but then I would be subject to pre-exisiting conditions for a year...It sort of scares me...

If my husband had insurance through an employer I would try to get insurance through his employer, but it is cheaper for us to go this route...but the drugs are going to kill us...unless I can find generics...I am trying to determine if I can switch them around...or switch to other drugs..

I know that Allegra D is the strongest of the allergy meds...and I cannot go to something else or I get a sinus infection...after what I have been through with my sinuses I am too afraid to switch off of that drug, but may try to decrease it to one tablet a day instead of two...and I might not need the Singulair...though I keep hearing that is an asthma medication...

The BS rep told me that BS is trying to revamp their drug program for next year and that I might see big changes for next year, so I am keeping my fingers crossed....I know right now they do not cover the patch at all for me...I pay out of pocket for that and that is $200.00...so I buy them 10 at a time...


Steve,

Didn't you mention the name of a Medicare D program that was supposed to be very good? I have just gone through 14 pages of posts and cannot find it...but I thought that you did???

[cindybear]

thanks. For the info, Hugs, Cindy