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Intal Inhaler Discontinued!
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bettyu70 posted:
I was just notified by my daughter's physician that Intal is being discontinued. It is the last non-steroid inhaler available. She is unable to take ANY inhaled steroids due to severe side effects (including qvar, Asmanex, etc.)

Does anyone else share my concerns?? I am at a loss for what to do about this... One of these links is on the FDA website and is the letter from King Pharmaceuticals and why they are stopping production. I have copied and pasted a section of the letter.

"We would like to inform you that after careful consideration, King Pharmaceuticals?, Inc. will soon discontinue the manufacture of INTAL? Inhaler (cromolyn sodium inhalation aerosol). King will continue to accept orders for INTAL until current inventories are exhausted, so the exact date of product unavailability is not known. This action is not the result of any safety or efficacy issues regarding this product.

This decision is based upon many factors, including our inability to identify a qualified manufacturer for chlorofluorocarbon propellant inhalers and our inability, despite best efforts, to reformulate INTAL? to a chlorofluorocarbon-free or hydrofluoroalkane (HFA) propellant formulation. We are providing this notification to you as a healthcare professional so that patients currently using INTAL can be effectively and efficiently transitioned to alternative therapies. Because of the planned phase out of INTAL, please refrain from initiating treatment with this product. INTAL? will remain available through pharmacies and wholesalers until current supplies are depleted. INTAL? is distributed through King Pharmaceuticals?, Inc. No additional product will be available after King, pharmacy and wholesaler supplies are exhausted.

If you have any questions or concerns, you may contact our Professional Information Services Department at 800 776-3637."

www.empr.com/Intal-Inhaler-discontinued/article/141142/

www.fda.gov/downloads/Drugs/DrugSafety/DrugShortages/UCM175032.pdf
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Aqua14 responded:
It sounds like it's just the hand-held inhaler formulation of Intal that is being discontinued. The American Academy of Allergy Asthma and Immunology has charts of asthma medications on its website, and apparently there is a nebulized formulation of Intal (link below). You could ask your daughter's doctor whether she could continue to take the nebulized version of Intal. True, it's not as convenient as a hand-held inhaler and you'd have to buy or rent a nebulizer, but if it works for her and is still available, it might be your best option.

Link: www.aaaai.org/patients/resources/medicationguide/cromolin_theophylline.stm

Hope this thought helps. Take care & good luck. Judy
 
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abbymay16 responded:
I am beyond frustrated with this news. First they discontinued our CFC based albuterol inhalers and now this??

Intal was the ONLY medication we found that settles out my airways, prevents chronic asthma issues and stopped my asthma cough. So believe me I share your concerns.

There was a nebulized formula of this medication but I believe it was discontinued a few years ago. I contacted my pharmacy but they have not seen it in years, but they are going to do some checking for me as to whether or not its still available.

I also put a call in to Kings pharmaceuticals and I am waiting a return call....I will let you know what I find out.

Mattie
 
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GrimmellD responded:
I have a few more ideas, longer-term. I also use Intal and have done so since 1972. It's based on understanding WHY this happened. Everyone should know that the Intal inhalers are being discontinued, because CFC (chlorofluorocarbon) propellants have been phased out by law and treaty. The drug manufacturer hasn't been able to find a way either to use another propellant, or to go without propellant, so they are giving up on the medication.

Solution 1: Intal was originally available as a spincap. A device held a capsule full of Intal powder, a capsule very much like any other, and needles punched two holes in the capsule. The patient then inhaled through the device, where a propeller spun the capsule, giving a steady stream of the fine powder, which was inhaled naturally. I used the spincaps until they were discontinued in the 1980's. Why on earth would a drug maker not revive the system? It used the air as a propellant.

Solution 2: We all need to write to Congress and the White House about creating an exception for medical use to the CFC outlaw. CFC's were eating away the ozone layer, but it has been repairing itself over the past 15 years, even while asthma inhalers were still using CFC propellants. Evidently, they are not harming the ozone.

I will be writing my letters now.
 
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gone76 responded:
Intal Inhaler-

My son has been on this inhaler for years. He also has glaucoma. His eye specialist says this is the only non steriod inhaler out there and that steroid inhalers are known to raise the pressure in the eyes which is extremely bad for him. If we go we a steroid inhaler his eye doctor must moniter the pressure every 4-6 weeks. Not good at all. We are trying to find alternatives but it doesn't look good. I will keep you posted.

EWhite
 
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Laura0711 responded:
Did anyone look to see if there are any generic versions. I don't if there but since thie company is giving up on the drug doesn't that mean that other companys will be able to make it?
 
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carobeau responded:
Oh No! My physician ordered this for my son, who has had a bad reaction to his preventative steroid inhaler. I visited or called 8 pharmacies and 2 hospitals before I found out that it was discontinued. One tried to convince me that not all corticosteroids would have the negative effect my son had and just get a prescription for a new steroid, another tried to get me to buy an OTC cromolyn sodium nasal spray for allergies, another suggested getting a prescription for Xolair though said it can cause anaphylaxis! Finally the Safeway pharmacy dispensing my flu shot today said their supplier/warehouse had some Intal but couldn't dispense it as it was discontinued which goes against the above info that it could be dispensed until the supplies run out. I have called my doctor and am awaiting a reply and researching all I can. Anyone had positive responses or info on Xolair, Salmeterol, Singulair, Accolate or Tilade?
 
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abbymay16 responded:
The Intal (cromolyn sodium) is still currently available in a generic nebulized solution. While not as convenient as the inhaler it works as well since it is the same medication just in a different form, so if your son has a nebulizer this is a viable solution for now.

My pharmacy did some research but there are so far no indications the nebulized formulation will be discontinued yet. It is currently still being manufactured by five different companies.

I use the OTC cromolyn nasal spray and for me it IS as effective as the inhaler, so that is an option you can try.

Otherwise there is no other medication of this class to substitute the Intal with.

check with your doctor and see if you can get a prescription for the nebulized solution.

For those of us who rely on Intal inhalers, we all understand your frustration.

Good luck

Mattie
 
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Aqua14 responded:
On your other questions. . . .

Xolair is indicated for people older than 12 whose more severe asthma is resistant to other therapies. Check your insurance policy, as there may be restrictions on paying for Xolair. It is fairly expensive. And yes, there have been instances reported of anaphylaxis, and researchers are trying to figure out why that is.

Singulair has a mild asthma controller effect, and doesn't work for everyone. Some people have side effects. However, it might be worth a try.

Salmeterol (brand name Serevent) is a long acting bronchodilator. Due to FDA black-box warnings, no good physician would prescribe Serevent by itself for a person with asthma. The black-box warnings were to advise physicians and consumers that use of Serevent ALONE (without an inhaled steroid) increased the risk of death in people with asthma. Commonly asthmatics use Serevent as part of the combination medication Advair.

You may find more suggestions for alternatives on the aaaai.org website, here: aaaai.org/patients/resources/medication_guide.asp

Based on conversations on this and Dr. Enright's asthma board, my impression is that not many people take Accolate, which is in the same category of med as Singulair (leukotriene modifiers).

Unfortunately Tilade, which is in the same class of meds as Intal, has also been discontinued for essentially the same reason that the Intal inhaler has been discontinued: www.fda.gov/downloads/Drugs/DrugSafety/DrugShortages/ucm089433.pdf

Just wondering -- what was the inhaled steroid that your son had a bad reaction to, and what exactly was his reaction? It is true that not all the inhaled steroids are the same -- for example, dry powder inhalers contain additional ingredients to make them powdery. For example, the dry powder inhaler Asmanex contains lactose (milk protein), so people allergic to milk would not be able to take that medication.

Hopefully some of this information will help you. Take care and good luck. Judy
 
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moogyie responded:
There is no generic version. While CFC's may be a part of the reason for the discontinuation of Intal, the bigger reason is that the patent has expired, and no generic company has elected to manufacture the product. I am at wits end. I have suffered with asthma all my life until 10 years ago when a doctor started me on a new regimen of inhalers that included Intal. I have not had more than 4 episodes in the last 10 years, and those were due to respiratory infections. No other regimen works as well. I do not know what I will do now.
 
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lilbatz responded:
This is for the person who says the Cromolyn Sodium nebulizing solution is available. If you live in the States, and aren't using a compounding pharmacy, it was discontinued by Teva and King about 2 years ago. I would love to find a US supplier.

Does your pharmacy get it overseas? All the chain pharmacies in my area have not had it for 2 years, and I'm paying $150/month via a Canandian online pharmacy.

Since King decided to burn us again with trashing the MDI Intal, I found a few non US pharmacies that will ship.

Sorry creatures of the pack ice, but me staying out of the hospital will save more green house gases being made than my little MDI.

And it took me years to get off the steroids, and I just can't take them. I'm not drinking the Flovent/Advair Kool Aide all the allergists and pulmonary doctors are handing out.

Interesting that the EU and Australia will still have it.

NJ
 
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lilbatz responded:
FWIW

4 years on Xolair, which was a total waste and time sucker. Time sucker because my allergist made me stay the 2 hours after the shot, which is in the FDA guide lines. Between the insurance hassles, wasting 2 hours of my life twice a month and minimal results, I wouldn't go back.

Singulair, I might as well been popping Tic-Tacs. Did nothing for me.

Tilade was discontinued about 2 years ago in the US. Intal was the last mast cell stabilizer availiable in the US. I heard you can get Tilade via online pharmacies. I have never used it.

When I'm not on Intal, my asthma medications increase to at least 4. When I have my steady supply from Canada, I take Intal qid and Zantac 300 mg/day.

This is why I feel burned. I trade Intal for steroids, albuterol, Singulair (which makes the doctors happy but does squat for me), some antihistamine which will poop out and I'll have to try another. It is all madness.

But if I'm sick and miserable, health care is making money.

Good luck

NJ
 
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abbymay16 responded:
I do live in the US, and I just picked up a box of the generic nebulized cromolyn manufactured by Teva--this is not a compound pharmacy, just my regular pharmacy. I took my script in and they had to order it but had it in 24 hours as it was in stock at their warehouse.

According to Teva's website it is still available in the generic form.

www.tevausa.com/default.aspx?pageid=76

I also found it at an online pharmacy: (and I am sure if they have it others do as well)

www.drugstore.com/pharmacy/prices/drugprice.asp?ndc=00172640659&trx=1Z5006

My pharmacy did a check and found five different manufacturers still producing the generic nebulized cromolyn.

You didn't say where you live, but all I can tell you is that I picked up a box this month so it is still available.

Mattie
 
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arthurro responded:
Intal was also the best asthma medication I had used. I decided recently to try Tilade, which is available prescription free from Inhouse Pharmacy on the internet. I just received 3 CFC free inhalers for about $90. So far I think it works even better than Intal. The only thing I don't like about it is that it is flavored with menthol, but I guess I can get used to that. Why mess around with prescriptions and high US prices when you can easily get what you need prescription free from an international pharmacy? Steroid inhalers don't work for me because they make my voice uncomfortably hoarse, even when I diligently rinse and gargle after inhaling. I also don't like the idea of suppressing my immune system on a daily basis when there are safe and effective asthma meds like intal and tilade. I also tried singulair but it stopped working for me after a couple of years. I am also concerned that it may have adverse liver effects. Its ironic that big pharma makes the best meds hard to get. Screw 'em. Go international.
 
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Adi_Saria_Pharmacist responded:
It looks like King Pharmaceuticals in the U.S. will not reformulate the Intal inhaler explaining its inavailability in the U.S. I have found that many Intal inhaler users are reluctant to switch or substitute their therapy with other asthma medications including Singulair or steroid-based therapies. If that is your situation, I would recommend seeking assistance from a mail-order pharmacy that offers international products. CanAmerica Global supplies Intal inhaler from the United Kingdom (www.canamericaglobal.com/products/Intal_Inhaler/5/) It has provided continued therapy for many Intal inahler users. CanAmerica Global offers a worldwide network of international pharmacies. CanAmerica Global and its pharmacies have been verified by the Pharmacy Checker Verification Program (www.pharmacychecker.com/ProfileRx.asp?PCID=514A367E-19BE-483E-9579-FCF6A3DC127B) As a pharmacist with CanAmerica Global, I invite you to contact us toll-free at 1-866-648-9142 to discuss your Intal inhaler therapy and discuss the most suitable continued therapy that best meets your needs.


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