Methotrexate: Hi there. Has anyone come across a... - NRAS

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Methotrexate

Angela123 profile image
20 Replies

Hi there. Has anyone come across a shortage of MTX manufactured by Mercury Pharma? I went to Boots yesterday with my prescription and when I got home the tablets looked completely different - tiny little pills and made by Tiva. I've never had anything other than the Mercury Pharma ones (blister pack, while & purple box) and panicked. I took them back and didn't quite believe the story about being out of supply, so I drove round or phoned up every chemist for miles around and it's true. There is a production issue at the suppliers which won't be rectified until mid Feb, although some chemists think it will be longer. I managed to get 21 tablets and an IOU from another branch of Boots, but am warned that when these run out in 3 weeks I will have to take whatever they've got. Am I being over cautious? I seem to remember reading somewhere that you should try to stick to the same brand. Angela.

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Angela123
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When I was on mtx, the chemist that I used at the time was forever giving me different brands of the drug. When I mentioned it to the gp he said the it should not make any difference as the chemical is the same. However I did find that one particular one did not agree with me I informed the chemist and they gave me the one that I was ok with. Hope this helps you.

Angela123 profile image
Angela123 in reply to

Thanks Georje. I think I was just thrown by how different they looked. When I was ringing round different chemists, several of them mentioned different names, and one showed me tablets that looked very much like mine but not my brand. It's such a powerful drug and I have slight nausea with them anyway. My husband says maybe the different brand might be better!

in reply to

This is quite a common problem, not just with Methotrexate. Manufacturers use different fillers, and these ingredients can cause side effects that you wouldn't get with a different brand. But the Methotrexate part is the same with all of them, and will work in the same way. But if you get unacceptable side effects, mention it to your pharmacist. x

Angela123 profile image
Angela123 in reply to

Many thanks. That's very helpful. I suppose that's the only thing I can do - try them see. Angela

jackiestu profile image
jackiestu

How interesting, I had this problem with Boots and they had me panicking because they said there were no methotrexate to be had anywhere due to a problem with the manufactures and that they hadn't had any stock since November last year. They gave me my script back and I want to Tesco pharmacy who said they had 7 boxes in stock and they hadn't heard there was a problem, got my medication but it is now in a bottle not the blister pack so this must be from a different manufacturer, so a little worried now in case they cause side effects that I'm not used to.

in reply to jackiestu

The only way to know, is to try them. They might not cause any more problems than your usual ones.

This article might interest you:

consumerreports.org/cro/new... x

Angela123 profile image
Angela123 in reply to jackiestu

Thanks Jackie. I'm sure they'll be fine. One chemist showed me the ones they dispense in a bottle and they were yellow and looked the same size as my regular ones. The Tiva MTX were tiny little black things (unless that was due to the packaging).

jackiestu profile image
jackiestu

Thanks for your reply and also the link, will take the tablets anyway and hope that they don't give additional side effects.

nomoreheels profile image
nomoreheels

This does seem to be a general problem from time to time Angela but not always noticed if a generic med is generally prescribed but if you're normally dispensed a branded med then that's when we realise. My Surgery is attempting to follow the directive to reduce prescribing costs & prescribing, where possible, generically as they're obviously lower in cost to the NHS. That said it is preferable for us to keep to one brand for the sake of identification & content (drug & colours, shape, fillers, enteric coating etc) but as MTX has been around a good while now not only is it made by quite a few recognised drug companies but it's also produced generically yet all are virtually the same. So much so I would doubt you'll notice the difference. I certainly had no noticeable or additional side effects when there was a general shortage of MTX prefilled syringes, in fact if it wasn't for the fact my pharmacist had to ring around for mine each week for a good while & exhausted all her supplies I'd to go on the hunt round all the chemists myself, some of them raiding chemists stock in the next province for me. The only difference I noticed was the box & slightly different syringes.

If you exhaust all options close to you it might be an idea to do as I did & ask your Rheumy nurse if it'd be possible for your hospital's pharmacy to supply you. If it's like mine who had multi dispense bottles they may have quantiful supplies in large containers of the tablets (not packets). I was offered the option to instead of trying to find mine to go have my injections at hospital, not that it came to that.

Good luck.

Angela123 profile image
Angela123 in reply to nomoreheels

Many thanks. I'll mention it at my next appointment. I've noticed my other meds come from various suppliers, depending on where I get the prescription done and it doesn't bother me - it's just that this is the BIG one!

Kathyfitz12 profile image
Kathyfitz12 in reply to nomoreheels

Re reducing costs of prescribed drugs...I asked the pharmacy how much my drugs were .& was told I would pay £25 for a Privste prescription, but the NHS cost would be £52! If I understood her directly surely some action should be taken to ensure tH NHS get better value for money rather than paying so much over the Odds?

Kathy

nomoreheels profile image
nomoreheels in reply to Kathyfitz12

That does seem odd doesn't it? Was it a specialist drug or a commonly prescribed one?

Kathyfitz12 profile image
Kathyfitz12 in reply to nomoreheels

It was Leflunomide!

Go Figure....I have to pay because I saw the Condultant privately & the GP says it is what is called a Red Drug.....& muttered something about not prescribing it until he knew I was " safe" on it. I don't know if it's the cost to the Practice or if they are just being ultra careful. I know £25 a month isn't a vast sum but as an OAP every penny counts!

Angela123 profile image
Angela123 in reply to Kathyfitz12

Hi Kathy. I had the same issue with Methotrexate. I see my Rheumatologist privately because when I first started I had private health insurance through work, but not now as I'm retired. For about a year I was getting my prescriptions from him, and yes it costs! My GP receptionist said no, I couldn't transfer my private prescriptions to my GP because the rheumatologist was responsible for the monitoring and blood tests, but at a routine GP appointment the GP said rubbish and put all my meds on NHS repeat prescription. Try getting your Rheumy to write to your GP with a list of the drugs you are taking and that you are doing fine on them. He should then be able to do your repeat prescriptions. As a fellow OAP I agree - we are entitled to free prescriptions now having paid our way and contributed to the system all our working lives! Good luck. Angela

Kathyfitz12 profile image
Kathyfitz12 in reply to Angela123

Thanks Angela...I had Mtx for 7 years on nhs...now new GP I have been allotted is making waves. For the sake of £25 a month I am keeping quiet & trying to change HP!

I read up on The position of Private & nhs treatment & it can be combined...after all if the patient pays to see a Consultant privately is saves the practice budget every time.

At least when I was in USA I paid my insurance & knew exactly what I was entitle to, but here they seem to make it up as they go along! Plus I only take the one drug so it all seems a bit of a drama for that doesn't its?

I'm sure I'll get it sorted, but I can do without the agro!

Kathy

nomoreheels profile image
nomoreheels in reply to Kathyfitz12

I'm a tad confused here Kathy. I understand what a red drug is, it's a drug prescribed by a specialist & the prescribing responsibility rests with him or her. Probably what your GP means is he wouldn't be able to prescribe it or add it onto your repeat prescription until he receives confirmation to do so from your Consultant. It will remain on you acute prescription list as a private prescription until then I would think, or maybe until you change to the NHS, if tthat it the case. What isn't clear is what you were told 're the cost to the NHS of leflunomide. According to the NHS drug tariff a 30 day supply of 10mg is £13.73 & 20mg is £14.50. I'm not sure about private prescription costs, perhaps it's flat payment of £25 charged by your Practice? I'm unsure what the pharmacy meant by saying the NHS cost would be £52

I would question If he could transfer all your RD or any other Specialist prescribed meds onto you repeat prescription, alongside any he, your GP, prescribes then you wouldn't need to pay as you're an OAP.

Kathyfitz12 profile image
Kathyfitz12 in reply to nomoreheels

It's like walking through treacle at my GP practice. Unfortunately my named GP left the practice &'the new broom is questioning everything on my file including drug allergies. I just relayed what the independent pharmacist quoted me on the cost.

Of course the Leflunomide has been prescribed by a Consultant ....I don't think the new GP which way is up as he has never heard of the type of RA I have.mjust keeps banging on about how expensive the drugs are.

I just pay up & keep quiet!

Sorry about spelling ....can't backspace & no time to repeat all.

Kathy

nomoreheels profile image
nomoreheels in reply to Kathyfitz12

It'll all settle he/she will soon get fed up doing that! It is good though that your allergies are noted!

RichardG profile image
RichardG

My chemist did the same thing about a year ago now. What I did find though was that the alternative supplier mtx made me feel much more nauseous. I now take the repeat prescription and walk a bit further to boots and then check on the supplier before handing in the prescription.

Did mention this to the chemist that changed supplier and said I would be going somewhere else for all my medication but their response was that was the only mtx they could get.

G111 profile image
G111

I also came across a shortage of Methotrexate tablets, but there are other forms than tablets. All the information of the possible forms of this immunossuppressant you can find here: pipelinepharma.com/methotre...

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