Plaquenil / hydroxychloroquine shortage update and a question

[milkwoman]

Hi all -

There's been talk on several of the HU boards regarding the shortage of Plaquenil and hydroxychloroquine. Since I've only been able to tolerate the name brand (generics cause me stomach/GI issues), I was concerned to hear this so I spoke with my pharmacist and also did some research. (The two generics I have tried are by Ranbaxy and Prasco Labs - I cannot tolerate either).

It's important to note that I am in the United States.

Here's some history:

On April 4, 2013, Covis Pharma (a Swiss-based company) acquired full commercial rights for Plaquenil (and 4 other products) in the United States from Sanofi. Sanofi retained the existing rights for Plaquenil in countries outside the United States. Covis is the manufacturer of the name brand Plaquenil tablets I have been taking for about a year with no issues.

In April 2015, Concordia acquired Plaquenil from Covis (this is the manufacturer of the Plaquenil tablets I have been taking and have no issues with). The ASHP (American Society of Health-System Pharmacists) reported a shortage of certain generics manufactured by Ranbaxy and Sandoz. No shortage in the U.S. for the name brand or other generics.

I went onto the Concordia website and they list Hydroxychloroquine Zentiva as the generic for their name brand. I took this information to my pharmacist to day with the hope they could order THIS SPECIFIC generic for me to try. If I can tolerate it, my medication costs would be significantly lower. The pharmacist didn't see it listed for her to order, but she was going to look into it and get back to me.

QUESTION: are there any folks, in the U.S. or otherwise, who have tried the Zentiva generic? Does it work for you (when other generics did not)? Anyone in the U.S. been able to get the Zentiva generic?

Thanks!

p.s. I've crossposted this information across several boards so everyone gets the information.

[milkwoman]

I have an update since I have spoken to my pharmacist.

The Zentiva brand is NOT available in the U.S. (That actually makes sense to me since the sister company (Sanofi) stopped making it for the U.S. in 2013 (that is when Covis took it over). Concordia is the new manufacturer of Plaquenil for U.S. (since Apr 2015)).

The pharmacist could not tell me which U.S. generic is the equivalent (and to be quite frank, I doubt ANY generic is an EXACT equivalent to the name brand since the manufacturers do not disclose the percentages of inactive ingredients in their formulations. All they are required to do is disclose a list of inactive ingredients, which you can find on sites like Drugs.com or via the actual drug inserts).

So I did some "comparison shopping". Those of you outside of the U.S. are actually quite lucky since it "appears" (based solely upon ingredients list), that the Zentiva brand of hydroxychloroquine sulfate is indeed identical to the Sanofi name brand. I do hope that is true!!

Just so you all have the information I found, here is the inactive ingredients list for Sanofi Plaquenil (white round film-coated tablet imprinted with HCQ 200):

Lactose monohydrate

Maize starch

Magnesium stearate

Polypovidone

Hypromellose

Macrogol

Titanium dioxide (E171)

And here is the inactive ingredients list for the Zentiva Hydroxychloroquine (white round film-coated table imprinted with HCQ 200):

Lactose monohydrate

Maize starch

Magnesium stearate

Polyvidone

Opadry OY-L-28900 (containing hypromellose, macrogol 4000, titanium dioxide (E171), lactose)

Now, for those of us in the U.S., well we don't appear to be quite as lucky. For my own peace of mind, I created a table of all the generic brands I could locate and compared their list of inactive ingredients to what is in the namebrand Plaquenil manufactured by Covis. Most have all sorts of additional fillers. The only one that is the closest is by Prasco Labs, which I recently tried and already know causes me issues (it's better than the Ranbaxy generic - that one was just awful).

So, I can either play the "let's try all the generic brands" game or I can simply stay with the namebrand and perhaps, switch in the Prasco generic every other day or so, or even, take 200mg of the generic in the am and take 100mg of the namebrand in the afternoon (my dose per day is 300 mg, split, and yes, I have to cut pills in half for the afternoon dose).

At least now I have answers and hopefully, this information will help anyone in the same boat.

Tracy