Caverject 40 mcg injectable powder prescription

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James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4453
   Posted 12/27/2007 3:19 PM (GMT -6)   
I sit here with a sample package of 2 20 mcg Caverject Impulse injection systems and a prescription for Caverject 40 mcg injectable powder for injection 1 Once per day, Dispense 1 vial, 3 refills. 
 
The Impluse I understand and can use, but the script for injectable powder has me bumfuzzled.  I didn't notice until I got home about the powder part.  I will be going to the pharmacy tommorrow and would like to understand somewhat just what I have so I can seem to know what I doing.  How does the powder reconstitute?  I understand how the Impulse system works, but if all I get is a vial of powder, then how does that work?  Or does it really mean that I get a powder and some type of sterile water to mix.  If so, how is the mixing done?  I notice that the package instructions for Impulse mentions that Caverject is also available  as a "Caverject Sterile Powder packaged in vials, 6 vials per carton" and also as a "Caverject Sterile Powder vials with diluent syringe, 6 syringe systems per carton".  By the use of the word system, I wonder if this is the same as the Impulse system, even if listed seperately as a form of Caverject that is available?  Also, there's "Caverject Injection, aqueous, 5 amplues per carton" available under the same trade name.  All very confusing. 
 
I remember someone here mentioning that the VA adminsters Caverject as a powder.  Someone who gets it from the VA want to describe the details involved in mixing and using it from a powder?  Anyone else get it this way outside of the VA?  Anyone know anything about the various forms of Caverject and can describe their uses.
 
James C.

Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1727
   Posted 12/27/2007 5:12 PM (GMT -6)   
James,

Its a reconstitue. You will need to ask the druggist to show you how to mix the powder and measure the dose you desire. It's a one time use pre-fill. Our insurance pays for 6 pills or 6 (3 of the 2 vial prefills) caverject doses per month for a co-pay of 30 dollars. Be sure the Doc writes what your insurance pays for so ya don't get stuck paying too much out of pocket. 66 bucks a box gets pretty expensive. E-mail me after you see the druggist for a very useful tip concerning your particular packaging. Good Luck...

Swim
 


James C.
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Date Joined Aug 2007
Total Posts : 4453
   Posted 12/28/2007 11:11 AM (GMT -6)   

swimom says:

"It's a one time use pre-fill." 

Does this mean that all I got was a prescription for a vial of powder that reconstitutes into a fluid that I draw one dose from and have to throw away the remainer, like I have to do with the Impulse system?  I can get a 40mcg vial of injectionable Caverject at Walgreen's for 50.19.  That seems very expensive and wasteful.  I thought doc and I had talked about and agreed to getting a bulk supply liquid vial that would allow me to draw off what I needed from a 40 mcg bulk vial, keeping it in the frig and maybe getting 10 doses or more out of it.   
Evidently we didn't understand what we had agreed to. tongue


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1727
   Posted 12/28/2007 11:37 AM (GMT -6)   
JC,

If what you have is the Caverject Impulse in the 2 pack injectors, you are talking one time use for each syringe.
Caverject does come in a multil use vial, yes. It too has to be reconstituted and stored in the frig once it has been opened but you already know that. Don't get all frazzled just yet....we'll talk :>) The Impulse is not impossible ;>)

swim
 


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4453
   Posted 12/28/2007 11:53 AM (GMT -6)   

I have a 2 pack of the Caverject 20mcg Impluse System samples which I understand.  What I am concerned about is the prescription which calls for "Caverject 40 mcg injectable powder for injection 1 Once per day, Dispense 1 vial, 3 refills."  I am hoping you are saying this powder reconstitutes into a multi-injection bulk, that is refrigerated and lasts for 30 days or 3 months, I can't remember which now.  I am wanting to get some info now, so I can maybe bargain with the Pharmacist when filling the prescription to something that is more of a bulk and longer term supply rather than a use and throw away type.  The prescription does say 'substitution allowed", lol....maybe I could convince him I really was to get something different...lol

It's all academic right now as the wife had eye surgery Wed. and we won't be 'testing' it for a while.  tongue   One thing I gots is patience......

Thanks,

James C.


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 1427
   Posted 12/28/2007 12:04 PM (GMT -6)   

Meds sometimes come in powdered form that need reconstitution with a liquid before use.  The powdered form extends the shelf life, which is shortened once the liquid is added to the powder. 

I'm surprised that your pharmacist didn't discuss the med with you and how to reconstitute it.  You may want to see him/her for more detailed instructions on how to use it.

I started out with Caverject ready-to-use syringes after oral meds failed, then switched to a liquid mix made up by a compounding pharmacy. Caverject was painful and expensive and the mix cheaper and less painful. 

Take care and hang in there...Tim

 

 


Age 59 PSA 2.6 (PSA velocity--quadrupled in 1yr) 
Bilateral nerve-sparing open RRP 6/21/06  Gleason 5
Cancer confined to prostate, post-op PSA's non-detectable


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1727
   Posted 12/28/2007 12:11 PM (GMT -6)   
Multi-use vials should come with sterile solution in which you must use to reconstitute. Make sure you ask or they druggist forgets the sterile solution. Powders are difficult to get up into those syringes for sure...LOL! Ours didn't realize she needed to order solution...duh? I sent them back along with one really dumb look the druggist won't soon forget. You use only what is needed at one time...thus, multi-use :>) and it has to be liquid. Oh heck, who needs a pharmacy degree anyway? As for the Impulse...email me (edit)... click here...>>  swimom
Hope the DW is doing well.

swim  
 
 

(Edit e-mail) Click on link and Refresh…once page is opened.

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bluebird ~  Moderator for Prostate Cancer Forum

Post Edited By Moderator (bluebird) : 12/30/2007 11:36:13 AM (GMT-7)


usmc155
Regular Member


Date Joined Mar 2009
Total Posts : 22
   Posted 3/5/2009 11:46 AM (GMT -6)   
Wheras Caverject is on hold, per FDA until July 2010 you can get a script for the PROSTAGLANDIN E1 40MCG/CC and have a compounding pharmacy "make it". It is the exact compound by caverject. I got a 10cc vial (liquid) and I will get 40 shots from it. All roads lead to Rome but use the toll free route.

chipewap
New Member


Date Joined Oct 2008
Total Posts : 1
   Posted 4/13/2009 3:19 PM (GMT -6)   
Since Caverject is on hold til July 2010......I got a prescript from the dr today and he put "Caverject inj" and told me to put the quantity size on it. So I should write on the prescription:
"PROSTAGLANDIN E1 40MCG/CC"

How do I find a compounding pharmacy would Bay Medical Center (hospital pharmacy) be able to make it?

Hope you can answer this....mike chipewap@comcast.net

usmc155
Regular Member


Date Joined Mar 2009
Total Posts : 22
   Posted 4/13/2009 6:12 PM (GMT -6)   
The compounding pharmacies are around. Caverject is the brand name and Edex is also the same. Ask your doctor if he could recommend one. The powder is mixed with bacteriascopic water I.E. a saline solution. The compounding pharmacies are way to go. You will get a 10ml vial that needs to be refridgerated. There is a 3 month exp date that can be pushed a bit. This is a quick reply so I will leave my email. A vial of compounded PROSTAGLANDIN E1 may be frozen up to 1 year. The 40MCG/CC is 40 micrograms per CC. A shot of .25ml is average. (THIS INFO IS NOT A REPLACEMENT FOR DOCTORS DISPENSING ORDERS) A 10ml vial will give you 40 injections. Average price per use is $1.65. This amount should give you wood for 1 to 2.5hrs. A 60mg dose of Sudafed will bring you down, you may need a second 60mg to come down. This is step 1. If you have pain you could ask dr for Tri-Mix. Hope this helps........Google compound pharms and you will find one. Paul. pmassie321@msn.com

Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 4/13/2009 8:13 PM (GMT -6)   

The compounding pharmacy my urologist uses and have been great to work with is Franck's Compounding Lab in Ocala, FL.  Google them and you can get a phone number. 

Tamu


Diagnosed 7/6/06, 1 of 10 core samples, 40%,Stage T1c, Gleason 3+3
Da Vinci on 11/01/06, Catheter out on 11/13/06
56 Years Old
Post Op Path, Gleason 3+3, Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06, 6/25/07, 1/8/08
No more pads as of 1/13/07
Began injections in April '07
 


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4453
   Posted 4/14/2009 11:00 AM (GMT -6)   
We have a list of Compounding Pharmacies used by members here. Go to this thread link to see them. Franck's seem to be the most used.

www.healingwell.com/community/default.aspx?f=35&m=1017774

Hope this is helpful
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
16 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months

Post Edited (James C.) : 4/14/2009 10:03:45 AM (GMT-6)

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