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Why is this darn drug so expensive in even generic form?

My best friend has a chronic back problem and needs a muscle relaxant and an analgesic like hydrocodone/APAP (when we first met, I think I blurted out "You're taking HOW MANY Tylenol #4's a day? Can you spell "liver"?) so that changed real fast; most people don't understand the codeine threshhold that converts around 10% or so into morphine in the liver, but throwing more than two grains of codeine at it won't help any more; I forget which system is involved, but it would be interesting to figure some experimental study that blocked that system to see if those theories are true, or at least the basis for them in terms of saturating the pathway.

Anyhow, 5 mg hydrocodone/162.5 mg APAP bid beats a handful of 1 gr. codeine/325 mg. APAP tid. Was it George Cohan that said, (paraphrasing him) "My liver thanks you, my kidneys thank you, my back thanks you, and finally, I thank you."

Is carisoprodol (Soma) being used by drug fiends in some way, or what? Robaxin (methocarbromal) is a derivative of the same root and the generic costs a fraction. Of course the whiner says that doesn't work as well.

I'm tempted to tell him to ask his doctor for meprobamate (Equanil, or more famously, Milltown) just to see what a rise he gets out of him.

Of course meprobamate is C-IV; the others, family relatives, are just Rx. In Canada, Robaxisal (and a ton of other drugs that are Rx or Scheduled here) is OTC there.

Just asking if anyone heard anything peculiar about Soma / Carisoprodol.

Our current problem in Montana is a serious methamphetamine "crystal meth", problem, and the little wannabe pharmaceutical chemists have settled on Actifed and Sudafed and its generics as the preferred feedstock. Anybody with allergies and colds probably wants all those SOB's to go to you know where, I know I do.

Oh on the ridiculous drugs show, Soma Compound has to be the winner. Well, closely followed by Ultracet.

Sorry, I'll stop torturing now, but I am extremely curious about the carisoprodol thing.

Thanks.

RSH.
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rshunter2...if you go to the biotech board with the link below, there are very many well educated bench lab people, many M.D.'s, and those who have worked in the industry...Pose your question there and i think youl'l find some answers...

http://boards.fool.com/Message.asp?mid=17229954

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Thank you so much!

I will indeed do so.

RSH.
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We had a "pain control" doc (translatarion: addiction creation/maintence specialist) when I worked retail. 99 & 44/100% got scripts for Soma 2 tabs QID & Lortab-5 QID. We even had a nickname for all the patients on it : Somites. I think it is hoplessly addicting and a completely worthless drug. Then again, I think all the "skeletal mucle rexlants) are worthless becasue all the do is get you stoned. Relax the muscles, brain, common sense, ....

But that's just my pharmaceutical opinion, but I don't think I'm wrong...

KY Hawkeye, Pharm.D., R.Ph,-Jester
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We even had a nickname for all the patients on it : Somites. I think it is hoplessly addicting and a completely worthless drug. Then again, I think all the "skeletal mucle rexlants) are worthless becasue all the do is get you stoned. Relax the muscles, brain, common sense, ....



Reading that gave me goosebumps. Is it your finding the same is true for methocarbamal as carisoprodol? I've taken both over the years for things like torticollis, or in the aftermath of car accidents, I admit they made feel sleepy sometimes, but not "high". Whatever that means; I can't personally speak to that, I suppose "high" means different things to different people.

The Pt in question generally takes HC/APAP T 1/2 on arising (10/325) and a carisoprodol PRN, perhaps another half tablet during the day PRN of HC/APAP, and a tablet of caisoprodol PRN HS.

I do appreciate your sharing your experience in this matter and your taking the time to do it.

RSH.
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Well it's doubtless HC/APAP is addictive if left unmonitored; how Brett Farve (the QB) ended up taking them like candy, for months and months, until he himself realized he was addicted, and had the courage to kick his habit and warn the public, took a lot of guts.

But this media frenzy hurts innocent patients on a variety of notorious drugs, and their doctors, by making them so fearful the doctor doesn't want to prescribe it and the patient doesn't want to take it.

The Pt. would do much better on OxyContin T. 1 daily in the AM; we all know analgesia on a scheduled, rather than PRN basis is less likely to lead to problems down the road. (Or do we?) Or the lowest dose of the Duragesic patches.

As far as the carisoprodol goes, I can say on my own behalf it does work, as does methcarbamol, but I don't believe I've ever taken either for more than a month. Pt. exhibits greatly improved range of motion, functionality, and less pain and spasm when on the drug than when not taking it; he doesn't exhibit drug seeking behaviors at all, and generally has to be reminded to take his meds.

Every NSAID through the COX-2 inhibitors have been ineffective and poorly tolerated; cyclobenzeprine was the predictable nightmare; tramadol was poorly tolerated and not effective; propoxyphene and Talwin received similarly poor reviews.

SL buprenorphine worked extremely well, and 1 dose in the morning managed the pain all day for the pt; on a very rare day he might need 1/2 T. hs in addition.

So I guess you answered my question- carisoprodol seems to be a prize drug of abuse, and that's why there's some hesitancy to presribe it. Maybe it does work chiefly through CNS depressant effects, but, it does work. It's a shame.

RSH.
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