Doxycycline Shortage

[Half Note]

http://www.wired.com/wiredscience/2013/06/summer-is-lyme-disease-season-but-the-price-of-the-cheap-drug-to-treat-it-just-soared/


If you’ve been reading for a while, you might remember some (http://www.wired.com/wiredscience/2011/08/drug-shortages-dangers/) posts (http://www.wired.com/wiredscience/2011/02/running-out-drugs/) about nationwide shortages of drugs. The Food and Drug Administration was concerned, and so were very senior physicians working in infectious disease, cancer, everyday emergency medicine and even veterinary care.The crisis faded from view, as they do. So it wasn’t much noticed that back in March, the American Academy of Pediatrics warned of an FDA alert over an apparent shortage of doxycycline, an old and inexpensive drug that is used mostly for uncomplicated infections such as sexually transmitted diseases and acne. It is also used, though, as the first treatment for a new case of Lyme disease — and that, more than anything, has sparked alarm.

Lyme is a problem mostly in the northeastern US and also the upper Midwest (though other little-noticed tickborne infections (http://www.wired.com/wiredscience/tag/ticks/) occur in the southeast and on the West Coast). Maine is one of Lyme’s hotspots, and last week the Bangor Daily News reported (http://bangordailynews.com/2013/05/28/news/lewiston-auburn/supply-low-price-high-for-popular-lyme-disease-antibiotic/):

“We’ve had availability, but the price is going up and that’s obviously a concern, too,” state epidemiologist Stephen Sears said. “And, sooner or later, if it’s getting to be short nationally, it’s going to get short here, just as other drugs have.”
He said the department has heard Doxycycline’s price is now five to 10 times higher than it used to be, but he said that is hard to gauge because pharmacies all price differently and insurance companies pay differently.
Senators from Maine and Minnesota urged the FDA last week (http://bangordailynews.com/2013/05/24/health/collins-sounds-alarm-on-shortage-of-critical-lyme-disease-drug) to do what they can to alleviate the problem — which seems to be a combination of higher demand and reduced supply from the manufacturers. According to the FDA’ s running tally on shortages, of the four distributors of doxycycline, one can’t get any until September, and one has restricted its sales to its current contract customers only.
Last night, this issue showed up in my Twitter feed. Dr. Judy Stone, who practices in western Maryland and Maine (and blogs at (http://blogs.scientificamerican.com/molecules-to-medicine/)Scientific American (http://blogs.scientificamerican.com/molecules-to-medicine/)) announced the price of the drug at her hospitalcommunity pharmacy had gone from $20 to $3,000.
Here’s the conversation that ensued. Participants are physicians Eli Perencevich and Amesh Adalja, and investigative journalist Katherine Eban, who knows more than anyone about the internal complexities of drug manufacturing.

[Half Note]

Didn't see the other thread started about this - this one can be deleted, sorry.

[johnnybgood]

I got a prescription last week from my doctor, had it filled...no problem.

[rocketsocks]

Ah man, sure hope this doesn't turn out to be Lymes. I'll see if it grows this week.21872

[atmilkman]

Ah man, sure hope this doesn't turn out to be Lymes. I'll see if it grows this week.21872
I hate to say it socks but it doesn't look good. Better get to the doc right away tomorrow.

[atmilkman]

Look at this then look at yours. http://upload.wikimedia.org/wikipedia/commons/thumb/8/8e/Bullseye_Lyme_Disease_Rash.jpg/220px-Bullseye_Lyme_Disease_Rash.jpg (http://www.whiteblaze.net/wiki/File:Bullseye_Lyme_Disease_Rash.jpg)

[rocketsocks]

Look at this then look at yours. http://upload.wikimedia.org/wikipedia/commons/thumb/8/8e/Bullseye_Lyme_Disease_Rash.jpg/220px-Bullseye_Lyme_Disease_Rash.jpg (http://www.whiteblaze.net/wiki/File:Bullseye_Lyme_Disease_Rash.jpg)wow that's much bigger than mine, but same structure and symmetry.

[Drybones]

I got a prescription last week from my doctor, had it filled...no problem.

What was the cost? Where did you get it? I searched the internet looking for it for my dog, had to order out of country which is questionable. The only product I found in the USA was $1000 for a small quantity.

[johnnybgood]

Hey Socks, that's what mine looked like too.The tick was embedded behind my knee where it went unnoticed for days. Had it not itched like hades,that SUCKA might still be there :)

[johnnybgood]

What was the cost? Where did you get it? I searched the internet looking for it for my dog, had to order out of country which is questionable. The only product I found in the USA was $1000 for a small quantity.

$20 at CVS Pharmacy. This was last Wednesday.

[rocketsocks]

Hey Socks, that's what mine looked like too.The tick was embedded behind my knee where it went unnoticed for days. Had it not itched like hades,that SUCKA might still be there :)
Yikes, yep gonna have to address this tomorrow.

[Blissful]

Don't fool around, go in and get an antibiotic. Even dog tick bites, if the head is left in, can get easily infected. My hubby is at the dr now for it

[Unitic]

Don't wait Socks, the rash is not always a Bull's Eye (mine wasn't), and perhaps as few as 50% who are infected get or ever see a rash. The antibiotics are SO much more effective if you treat this while the bacteria is still only in the bloodstream. It is a corkscrew shaped spirochete, and like its cousin Syphilis it will literally drill into your organs and tissues over time, where it can become MUCH harder to treat. One of the proposed reasons the Lyme bacteria wreak such havoc in your joints is that the collagen tissue has reduced blood flow and it can hide and survive there. It can take only a matter of days for the bacteria to disseminate. It's also a Catch 22 that the common and very insensitive blood tests (ELISA and Western Blot) will likely be negative within the first week of inoculation since they only test for the presence of Lyme specific antibodies and your immune system will not likely produce enough for a positive result for at least a week. If I were you (and I learned all this the hard way...after the fact), I'd see your MD immediately and insist on a minimum 28 day course of Doxy. The bacteria is only vulnerable to the antibiotics when it reproduces, and it is a very slow growing bacteria that divides on a roughly 28 cycle. The medicine must be in your system when this cycle occurs.

[Drybones]

$20 at CVS Pharmacy. This was last Wednesday.

I tried the local CVS today...$230 for 100 pills.

[drifter]

+1 on do not wait, recommend getting to doctor or find a 24 hr med center and get on antibiotics

[RF_ace]

Must be a clap outbreak

[rocketsocks]

Don't wait Socks, the rash is not always a Bull's Eye (mine wasn't), and perhaps as few as 50% who are infected get or ever see a rash. The antibiotics are SO much more effective if you treat this while the bacteria is still only in the bloodstream. It is a corkscrew shaped spirochete, and like its cousin Syphilis it will literally drill into your organs and tissues over time, where it can become MUCH harder to treat. One of the proposed reasons the Lyme bacteria wreak such havoc in your joints is that the collagen tissue has reduced blood flow and it can hide and survive there. It can take only a matter of days for the bacteria to disseminate. It's also a Catch 22 that the common and very insensitive blood tests (ELISA and Western Blot) will likely be negative within the first week of inoculation since they only test for the presence of Lyme specific antibodies and your immune system will not likely produce enough for a positive result for at least a week. If I were you (and I learned all this the hard way...after the fact), I'd see your MD immediately and insist on a minimum 28 day course of Doxy. The bacteria is only vulnerable to the antibiotics when it reproduces, and it is a very slow growing bacteria that divides on a roughly 28 cycle. The medicine must be in your system when this cycle occurs.Yikes, thanks you for all the info, have an appt. tomorrow...thank you all....

[Teacher & Snacktime]

Ah man, sure hope this doesn't turn out to be Lymes. I'll see if it grows this week.21872


Sorry, Chum, to see that bite.
Soon, you know, you won't feel right.
Your joints will ache, your head feel light;
I feel for your upcoming plight.

Get yourself, with all do speed
some help for your medicinal need.
Take a dose of the special pill
that cures the creep that makes you ill.

Now you've got a case of Lyme
you know you'll have to take some time
to rest and heal so in that time
turn your efforts to games of rhyme.

I'll be here waiting.

[Swordpen]

Don't wait Socks, the rash is not always a Bull's Eye (mine wasn't), and perhaps as few as 50% who are infected get or ever see a rash. The antibiotics are SO much more effective if you treat this while the bacteria is still only in the bloodstream. It is a corkscrew shaped spirochete, and like its cousin Syphilis it will literally drill into your organs and tissues over time, where it can become MUCH harder to treat. One of the proposed reasons the Lyme bacteria wreak such havoc in your joints is that the collagen tissue has reduced blood flow and it can hide and survive there. It can take only a matter of days for the bacteria to disseminate. It's also a Catch 22 that the common and very insensitive blood tests (ELISA and Western Blot) will likely be negative within the first week of inoculation since they only test for the presence of Lyme specific antibodies and your immune system will not likely produce enough for a positive result for at least a week. If I were you (and I learned all this the hard way...after the fact), I'd see your MD immediately and insist on a minimum 28 day course of Doxy. The bacteria is only vulnerable to the antibiotics when it reproduces, and it is a very slow growing bacteria that divides on a roughly 28 cycle. The medicine must be in your system when this cycle occurs.

Bingo!!! Good advice!

[Unitic]

Hope you'll keep us posted. Depending upon where you live, you may find few MD's with more than cursory knowledge of Lyme and many may downplay the serious nature of this nasty infection out of ignorance. Even the CDC says this must be primarily a clinical diagnosis based upon symptoms and patient history and the blood tests can only be used to confirm a diagnosis, and not on their own to rule out Lyme. Virginia just enacted a Lyme disclosure law that mandates that MD's provide a written disclosure to their patient when administering either of the blood tests I mentioned, stating that a negative result does not necessarily mean you do not have Lyme. Here is a link to a pdf copy of the 16th edition of treatment guidelines written by Dr. Joseph Burrascano, one of the leading Lyme Literate Medical Doctors (LLMD's) in the US who was featured in the excellent documentary Under Our Skin (highly recommended and available free on Hulu.com). http://ilads.org/lyme_disease/B_guidelines_12_17_08.pdf. I printed these out and took them to my primary care Doc when he tried to only use the blood test (Western Blot) to diagnose me. When he admitted he knew little about Lyme (and it is a VERY complex infection that often comes with one or more co-infections from the same tick...I also had Bartonella), he gave his blessing when I told him I was going to see a LLMD in another state (KY has no LLMD's). With the CDC estimating more than 1 million new cases in just the three years between 2009 and 2011, you'd think this epidemic would be attracting widespread attention, but it is still be largely ignored. Further, a new peer-reviewed study recently published in The International Journal of Medical Science found that one common strain of the Lyme bacteria (there are more than a dozen strains and the blood tests only check for one) was found in the Lone Star tick, a very common and aggressive species found all along the AT. Here is a link to an article about that study with a CDC map of the range of the Lone Star tick. http://lymedisease.org/news/lyme_disease_views/lyme-south-lone-star.html. Be informed, be your own health advocate, and be safe!

[Tri-Pod Bob]

Ah man, sure hope this doesn't turn out to be Lymes. I'll see if it grows this week.21872

Don't know what part of the country you picked this up, but if it was in the northeast US (my neck of the woods), have your doc check for the "Big 3"......Lyme, ehrlichia, babesia. This should be called the "Big 4" in my book. Ehrlichia has now been divided into 2 different disease types to include anaplasmosis. Was primarily an animal disease until it transmuted to humans in 2009. I was diagnosed as the 1st documented case in Mass. this past Nov. Treatment is the same as Lyme right now (3 -4 wks of doxy) due to lack of human clinical info. Depending on the disease stage, you could feel like S**t for a wk or so. Stay in bed. Lots of fluids. After that, the body joints ache like hell for awhile. A few months for me....was into Stage 2 at diagnosis. Celebrex was script of choice for my doc. Worked somewhat ok. Good luck with it

[T-Rx]

The federal gov't took some actions in the early part of this year that impacted the companies that manufacture tetracyclines. Doxycycline is a member of the tetracycline family of drugs. Most tetracyclines including doxycycline have been around for 30 - 40 years. There are only a few companies that produce tetracycline/ doxycycline and that number has decreased in recent months. This shortage has caused the price of doxycycline to pharmacies to increase by nearly 10 fold. If pharmacies still have old stock purchased prior to the shortage the price will be very reasonable, if there stock of doxy is recently purchased then it is a different story altogether and the price to the patient is much greater. Hope this helps.

[Not Sunshine]

In Virginia, I recently spoke with Walmart pharmacy, where doxycycline has been on the $4 list for years - they reported it was now near the $100 price because, according to the person I spoke with: Hurricane Sandy wiped out a pharmaceutical supplier. Doxy was also a useful antibiotic against "MRSA" - resistant Staph infxns which often cause abscess and cellulitis. $4 antibiotics seem to be disappearing - locally our only choices are: amoxil, PCN, keflex, cipro and Bactrim DS (erythromycin and doxycycline and clindamycin have been removed in recent years).

[rocketsocks]

Hope you'll keep us posted. Depending upon where you live, you may find few MD's with more than cursory knowledge of Lyme and many may downplay the serious nature of this nasty infection out of ignorance. Even the CDC says this must be primarily a clinical diagnosis based upon symptoms and patient history and the blood tests can only be used to confirm a diagnosis, and not on their own to rule out Lyme. Virginia just enacted a Lyme disclosure law that mandates that MD's provide a written disclosure to their patient when administering either of the blood tests I mentioned, stating that a negative result does not necessarily mean you do not have Lyme. Here is a link to a pdf copy of the 16th edition of treatment guidelines written by Dr. Joseph Burrascano, one of the leading Lyme Literate Medical Doctors (LLMD's) in the US who was featured in the excellent documentary Under Our Skin (highly recommended and available free on Hulu.com). http://ilads.org/lyme_disease/B_guidelines_12_17_08.pdf. I printed these out and took them to my primary care Doc when he tried to only use the blood test (Western Blot) to diagnose me. When he admitted he knew little about Lyme (and it is a VERY complex infection that often comes with one or more co-infections from the same tick...I also had Bartonella), he gave his blessing when I told him I was going to see a LLMD in another state (KY has no LLMD's). With the CDC estimating more than 1 million new cases in just the three years between 2009 and 2011, you'd think this epidemic would be attracting widespread attention, but it is still be largely ignored. Further, a new peer-reviewed study recently published in The International Journal of Medical Science found that one common strain of the Lyme bacteria (there are more than a dozen strains and the blood tests only check for one) was found in the Lone Star tick, a very common and aggressive species found all along the AT. Here is a link to an article about that study with a CDC map of the range of the Lone Star tick. http://lymedisease.org/news/lyme_disease_views/lyme-south-lone-star.html. Be informed, be your own health advocate, and be safe!Wow, thanks for all the info, there is so much info and mis information out there....this was my doctors feeling as well.

Well, i'm not taqking any Doxy right now (No fever, No chills, and the tick wasn't on long enough to transfer) but will keep posting should this turn out to be.

I've seen that documentary and it is very compelling...and damn scary! seems to me there's a huge steering from insurance Co. to not treat with long term antibiotics......no doubt a money thing.

thanks again Unitic for all the advise....had I got to the doctor sooner meds might have been an option, just hope it in fact does turn out to be nothin.

and I forgot to ask about any shortage of Doxy, just got caught up in my own deal...ugh! sorry folks!

[rocketsocks]

Sorry, Chum, to see that bite.
Soon, you know, you won't feel right.
Your joints will ache, your head feel light;
I feel for your upcoming plight.

Get yourself, with all do speed
some help for your medicinal need.
Take a dose of the special pill
that cures the creep that makes you ill.

Now you've got a case of Lyme
you know you'll have to take some time
to rest and heal so in that time
turn your efforts to games of rhyme.

I'll be here waiting.your such a word smith, thanks teach21902


Don't know what part of the country you picked this up, but if it was in the northeast US (my neck of the woods), have your doc check for the "Big 3"......Lyme, ehrlichia, babesia. This should be called the "Big 4" in my book. Ehrlichia has now been divided into 2 different disease types to include anaplasmosis. Was primarily an animal disease until it transmuted to humans in 2009. I was diagnosed as the 1st documented case in Mass. this past Nov. Treatment is the same as Lyme right now (3 -4 wks of doxy) due to lack of human clinical info. Depending on the disease stage, you could feel like S**t for a wk or so. Stay in bed. Lots of fluids. After that, the body joints ache like hell for awhile. A few months for me....was into Stage 2 at diagnosis. Celebrex was script of choice for my doc. Worked somewhat ok. Good luck with itYep, I'm in NJ...unfortunately these symptoms mimic some that I have for arthritis (achy joints and fever at times), and while I'm not flaring right now....these ails are not new to me.... unfortunately, so should this happen...it's back to the Docs...thanks Bob...good info there as well.

[johnnybgood]

As someone who works in the medical profession ,MRSA can be introduced through a bug bite, resulting in a break in the skin tissue, giving this antibiotic resilient virus an open invitation to your body.
In any case, the bacteria could lie dormant until many months down the road until a compromised immune system fighting off another bacterial infection allows Methicillin- Staphylococcus aureus to rear it's ugly head.

Just something to think about Socks. :)

[atmilkman]

In Virginia, I recently spoke with Walmart pharmacy, where doxycycline has been on the $4 list for years - they reported it was now near the $100 price because, according to the person I spoke with: Hurricane Sandy wiped out a pharmaceutical supplier. Doxy was also a useful antibiotic against "MRSA" - resistant Staph infxns which often cause abscess and cellulitis. $4 antibiotics seem to be disappearing - locally our only choices are: amoxil, PCN, keflex, cipro and Bactrim DS (erythromycin and doxycycline and clindamycin have been removed in recent years).

Antibiotics have a street value that is comparable to narcotics.

[Teacher & Snacktime]

Yep, I'm in NJ...unfortunately these symptoms mimic some that I have for arthritis (achy joints and fever at times), and while I'm not flaring right now....these ails are not new to me.... unfortunately, so should this happen...it's back to the Docs...thanks Bob...good info there as well.

I have to say I'm surprised. I have lupus, which often presents itself like rhematoid arthritis would...the aches, pains, fever, immflamation, etc. I have only to suggest I've seen woods in the distance and my doc is ready to treat for lyme as there's no distinguishing it from the "normal" crappy feeling. It's a better-safe-than-sorry situation (the steroids and other meds I take fairly assure a negative test result). I'm not a fan of long-term antibiotics either, but I personally think in this case they may be in order.