Warning: Oxycodone from Caraco Pharmaceuticals (imprint: 223)

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cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 917
   Posted 6/30/2013 1:38 PM (GMT -7)   
Caraco Pharmaceuticals (subsidiary of Sun Pharma) has had a long history of FDA violations: inconsistent potency, poor quality control of base ingredients, etc.. (google "caraco violations")

Due to these violations, the FDA shut down their Michigan plants for about 3 years. Only in late 2012 did they pass inspection (for two specific non-opioid drugs), and I presume began manufacturing oxycodone again a few months later.

Well, it has been a terrible month for me -- my worst ever. This was very likely due to other factors (stopping tramadol, starting cymbalta), but I have been concerned about my BT meds. I had assumed that my baseline pain was why they weren't helping as much. Today, though, I happened to use an oxycodone that was in my briefcase (something I put in there months ago)... and WOW. It made far more of a difference than the Caraco crap.

Thus, let me encourage all of you to look at your pills and see if they are made by Caraco (the 5mg is tiny, white and round with "223" on it). If you don't have the bottle, you can use an imprint search such as:
www.webmd.com/pill-identification/default.htm.

If anyone else has noticed a lack of efficacy with these Caraco "223" oxycodones, please let me know -- as I'm not sure if it is a fluke, due to my other med changes, or if the company still isn't making reliable meds.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Cymbalta 30mg (waiting for it to kick in), Oxycodone 5-7.5mg for BT. .25-.5mg xanax as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 6/30/2013 2:05 PM (GMT -7)   
So are you saying that the ones you are prescribed now are being recalled? I don't understand the "Warning" part in the title of the thread as that seems to mean some sort of "danger" for people.

It sounds like you just don't think this particular generic works as well for you than another. What was the laboratory/manufacturer of the one in your briefcase?

I have been on generics for as long as I have been taking medications and personally have never found any difference in one to the other minus a bit of nausea or headache the first day or two due to the inactive ingredients that can be different from med to med.

I am on the OxyIR 5mg and it's made by KVK Tech...but I have been on Watson, Mallinckrodt, and a few others...They all work the same for me. Same thing with my generic MSContin.

I know that other people say that they can "feel" a difference and if it's really important to you, then just ask the Pharmacy if they carry another manufacturer or call around to other Pharmacies to see if they carry what your prefer.

I didn't see you answer on your other thread but are you off all the Tramadol now or are you still taking the same amount?
SB (Snowbunny) and the pup that snores (my yellow lab:))

3, two-level, cervical fusions over the past 11 years. The last one was anterior and posterior with lots of fun titanium!
Still have active herniations along with knee problems and another Morton's neuroma in left foot.
I try to find joy in each day even with chronic pain:)

Linds_
Veteran Member


Date Joined May 2013
Total Posts : 853
   Posted 6/30/2013 5:17 PM (GMT -7)   
My 15 mg oxycodone this month is by Caraco (187 imprint) and they work just fine for me... I'm sorry you are having an issue. Talk to your pharmacy about getting a note in the system that you prefer this month's pill's company.

Good luck!
Chronic Pain Warrior since 2007
Diagnosed in 2007 - Chronic Pelvic Pain and Stage 3 Endometriosis
PM Patient since 2009
Current Tx Plan - Oxycontin 15mg 3xday, Roxicodone 15mg2xday for BT, Elavil 50mg 1xday, Depot Lupron 2xyear (injectable)

My daily Goal - to make at least one person smile a day. Smiles are contagious and create a ripple effect... that one smile may lead to a miracle! :0)

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 917
   Posted 6/30/2013 7:58 PM (GMT -7)   
Sheesh.... "So are you saying that the ones you are prescribed now are being recalled? I don't understand the "Warning" part in the title of the thread as that seems to mean some sort of "danger" for people."

No. If they were being recalled I would have said that. Likewise, if there was a "danger" I would have said. The point is that this is a manufacturer that has had years of problems with the FDA for quality control and were shut down until recently for that reason.

As an analogy: let's say that your local IHOP was shut down for 3 months because of health and hygiene violations, then someone you know ate there shortly after they reopened and got food poisoning. Would you eat there? Would you not think a "warning" was apt?


While many other generic manufacturers provide consistently reliable medication, that has not been the case with Caraco. They were shut down for 3 years because of FDA concerns (google "caraco fda")

In 2008 they received warnings from the FDA due to quality control issues. In 2009 their inventory was seized and their facilities were shut down. They are now manufacturing again. However, if you trust my judgement, I found their oxycodones to be far less effective than the pills I have from other manufacturers (Mallinckrodt pharma made the others I have). Hence, it strikes me that members of this board would share my concern about this company's shaky history and my (albeit) anecdotal evidence that something still may be amiss.

Members may, thus, want to ask their pharmacies to not use Caraco when filling their scripts. On the other hand, Snowbunny, if you think "warning" is too strong, please recommend to the mods that they edit the post.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Cymbalta 30mg (waiting for it to kick in), Oxycodone 5-7.5mg for BT. .25-.5mg xanax as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 6/30/2013 8:13 PM (GMT -7)   
It was just a question...LOL...Sorry that it seemed to upset you..I truly was asking if there was something dangerous about the meds now.

We always appreciate information on the boards so that people can make a decision about their healthcare.

I hope that you can have your Pharmacy order the type of meds you need....
SB (Snowbunny) and the pup that snores (my yellow lab:))

3, two-level, cervical fusions over the past 11 years. The last one was anterior and posterior with lots of fun titanium!
Still have active herniations along with knee problems and another Morton's neuroma in left foot.
I try to find joy in each day even with chronic pain:)

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9657
   Posted 6/30/2013 9:50 PM (GMT -7)   
Edited ....

Cognito, so very sorry this happened to you, hope you can get the better medication for you and Thank you for letting others know about this and its good that your staying on top of that! Make sure to let your doctor know this information about your medication as your doctor can thenn put a specific brand on yoir prescription and I hope this will help you get better pain controls soon.
Many many well wishes to you and keep us posted how your doctor visit goes tomorrow..

Post Edited (Chartreux) : 7/1/2013 11:00:54 AM (GMT-6)


Lynnster
Regular Member


Date Joined Nov 2012
Total Posts : 264
   Posted 7/1/2013 6:33 AM (GMT -7)   
Thanks for bringing this to our attention. I don't take that medication but if I did I would definitely find this very helpful.

This was just a post about a medication made by a company that had shady practices in the past and they are now manufacturing the meds again and they don't seem to be as effective as other brands. Now the op did not say in any way that everyone was having this outcome with this brand, just stating about personal experiences and wanted to make others aware.

Lynnster, I went in & edited some of your post. I was going to send you an email & ask you to edit it, but could not find an email listed here at the forum. Thanks, Susie....

Post Edited By Moderator (straydog) : 7/1/2013 3:49:38 PM (GMT-6)


Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 7/1/2013 8:49 AM (GMT -7)   
I will apologize again about my delivery of the way I wrote the questions...I did not mean for it to upset you in any way. They were truly all at face value with nothing negative in my intent.
 
I certainly hope this is easily resolved with getting the medication that you prefer:)

Post Edited (Snowbunny21) : 7/1/2013 11:50:55 AM (GMT-6)


straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 15534
   Posted 7/1/2013 9:27 AM (GMT -7)   
Well, I too thought this was going to be a recall on the meds from the style of the heading. I did not feel the need to ask the same questions since Snowbunny had already asked. Once again, it goes back to different companies producing meds some of us react differently to them. A good example is the Fentanyl patches, lots of problems with those for different people, then some folks have no problem with them. Sorry the meds did not work well for you Cogito.

I do not feel there was anything out of line in Snowbunny's post. She did not attack anyone, she asked questions. I will suggest that if anyone has a problem with another member at the forum, why not simply send this person an email rather than a group of people making comments as the ones above did. You can also email one of the mods if someone writes something you do not like. I do not feel it is fair for a member to be called down as she was.

Lets refrain from anymore comments like those on this thread or any other thread for that matter please. Since these comments have nothing to do with the actual thread, I am going to ask you folks to go into your posts & delete your comments please. This is not what this forum is about. If you do not know how to edit a post any of us mods will do it for you or help you do it. Thanks for your help.....Susie
Moderator, Chronic Pain Forum & Psoriasis Forum

Post Edited (straydog) : 7/1/2013 10:55:13 AM (GMT-6)


Blessedx8
Veteran Member


Date Joined Aug 2008
Total Posts : 3193
   Posted 7/1/2013 10:31 AM (GMT -7)   
I have to agree w/ the other mod here.... calling someone (anyone) out on the board is not what we want to be promoting here....

If I got on here - and saw that several people had made negative comments about me - I would be hurt and frustrated.

I'm not defending anyone.... I would feel this way about each and everyone of you here. I don't want to see anyone called out by multiple people.

The moderators here all have their e-mails available if you have a problem w/ a member.

Let's remember that we are all different.... all have different styles....

As I said, if anyone has an issue pertaining to anything on the board -- I'm available via e-mail.

Thanks --Tina
Moderator - Chronic Pain Forum

momtofourangels
Veteran Member


Date Joined Apr 2010
Total Posts : 2261
   Posted 7/1/2013 10:33 AM (GMT -7)   
Thank you for this information cogito. I take oxycodone, and thank goodness it's not the one that you are talking about. I take 5mg twice a day as needed, and I feel that it doesn't do much. I am scared to ask my pcp to increase it, because she isn't a PM doctor. Take care.

I hope you're having a low pain day.

love and hugs
Loretta
Dx: osteoarthritis, bursitis in left hip, Osteoarthrits in right hip, compression fracture in thoracic spine due to falling on frozen ground March 2001 , ddd, spinal stenosis, bone spurs, osteoarthritis in spine, osteoarthritis in both knees
Meds: Fentanyl patch, oxycodone, otc: BenGay, Tylenol Arthritis on occasion

Splashdancer
Veteran Member


Date Joined Aug 2009
Total Posts : 928
   Posted 7/1/2013 1:09 PM (GMT -7)   
Thank you Cogito, for mentioning this - I thought I was the only one! I will not accept the Caraco brand anymore. I know there is a difference between this brand and others - I've lived it. I would get a new scrip, start taking it, and I could feel the difference (or lack of!). At first I didn't think much about it - just thought it was due to my usual pain level fluctuations. However, after a period of time I realized the connection between what I was experiencing and what generic I had received that month. So no, you are not imagining it - there IS a difference! And if there is poor quality control at the manufacturer, that could account for the fact that not everyone notices a difference - different batches can equate to varied quality.

Mercy&Grace
Veteran Member


Date Joined Jun 2013
Total Posts : 1705
   Posted 7/1/2013 2:05 PM (GMT -7)   
I searched the FDA website for "oxycodone" and all I came up with was from 2011 and it was regarding Endo Pharmaceuticals for a Voluntary Recall on certain bottles of Endocet due to higher amounts of tylenol than it should be.
http://www.fda.gov/Safety/Recalls/ucm260826.htm

But, I was wondering if it could be the new formula for oxycodone that isn't suppose to be as addicting. It may not make much sense, but it was a thought.

Splashdancer
Veteran Member


Date Joined Aug 2009
Total Posts : 928
   Posted 7/1/2013 5:08 PM (GMT -7)   
As of right now, the new formulation is only for the oxycontin. I remember reading a journal article about the new formulation awhile back (it was actually pretty interesting!). From what I read, I don't think that the short-acting oxycodone products will be given the new 'anti-crush' formula any time soon - mainly because of the cost. Apparently, it's an expensive process. Oxycontin is expensive and the extra cost is more easily 'absorbed' than it would be in the fairly inexpensive short-acting products.

Generally, I don't notice a difference between generics or generics vs. brand - but there have been several that I have definitely noticed a difference - some more than others.

Post Edited (Splashdancer) : 7/1/2013 8:39:07 PM (GMT-6)


Mercy&Grace
Veteran Member


Date Joined Jun 2013
Total Posts : 1705
   Posted 7/1/2013 5:50 PM (GMT -7)   
Sorry I forgot about it being just the oxycontin and not the oxycodone.

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 917
   Posted 7/1/2013 8:14 PM (GMT -7)   
Thanks Splashdancer for mentioning your similar experience with Caraco. One can find a few others also raising the issue online. It may be time to contact the FDA.

I spoke with my PM today. He never heard of Caraco but suggested that I request generics from Mallinckrodt in particular. He also noted that he's had far more patients than usual calling in this month -- we joked that they're all using the Caraco meds, but we're just kidding about it.

At my CVS pharmacy, they told me that they had no control over what is in stock. They will order more, but don't know if they will be Caraco or not.

So, I have a practical question, assuming that CVS can only get in Caraco and I've already handed over my script, what should I do? As a schedule II drug, I presume they can't transfer it. I suppose my only option would be to have the script cancelled and ask my PM for a new one, and switch to another pharmacy.

I won't hear from CVS until Wed or Thurs, when they get their shipment in, but I thought I would look into other pharmacies in the area. As a last resort, I'll take the Caracos and have them as an emergency supply. I still have enough Mallinckrodts left for a few months.

My wife and I plan on moving as well this summer (and have even made an offer on a house). So it may be prudent to wait to change pharmacies until then (otherwise, I may have to change twice in as many months -- which might seem fishy).

Also, is there still a branded version of oxycodone? That is, can I just have my pharmacy fill using Purdue or some other major company. They didn't know of any "brand" version and stated that all oxycodone IR is generic.

Thanks.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Cymbalta 30mg (waiting for it to kick in), Oxycodone 5-7.5mg for BT. .25-.5mg xanax as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Mercy&Grace
Veteran Member


Date Joined Jun 2013
Total Posts : 1705
   Posted 7/1/2013 8:29 PM (GMT -7)   
Schedule II's can't be transferred, refilled, etc. If your insurance company or you will pay for the name brand and the rx if for the name brand, I can't think of any reason why you couldn't get it. Although you may have to try another pharmacy.

This is Purdue's website-
http://www.purduepharma.com/

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9657
   Posted 7/1/2013 8:43 PM (GMT -7)   
Cognito,
Hope the med manufacture changes help you and that you get better pain control! Many well wishes on the move, sure hope the move is easy on you! Keep us posted on the move and if the medication is working better for you.
**********************************************
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...
********>^..^<********>^..^<*******

LexiRae
Veteran Member


Date Joined May 2012
Total Posts : 828
   Posted 7/1/2013 11:20 PM (GMT -7)   
My pharmacy is fond of Watson, and I've never heard nor had an issue with that brand of generics. I'm pretty sure that since the FDA has already closed down the Caraco facility once, if they hear a decent number of complaints, they wouldn't hesitate to look into it and close them down again.

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 917
   Posted 7/5/2013 2:08 PM (GMT -7)   
Howdie All,

An update...

When I dropped of my new oxycodone script to CVS on Monday, they only had Caraco in stock and didn't have control over what came in if they ordered more oxycodone.

I contacted CVS corporate about my issue with Caraco and a more general concern that for various reasons (binders, etc.) stores should be able to give customers more than one option for a generic.

Either through that contact or good fortune, CVS filled my script today with Qualitest pills. I've not used them before and so decided to use one of them vs. the Mallinckrodts I also have.

Well, again this is just my personal experience, but the Qualitest also seem to do much better than the Caracos.

Whether this is because there's something wrong with Caraco (as may be the case given their history of FDA violations) or if for some reason they just don't work well for me, I can't say definitely one way or another.

I remain tempted to contact the FDA about the Caraco pills. Any opinions?
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident in 2004. Also, supraventricular tacycardia and mitral valve prolapse.
Current meds: Cymbalta 60mg (not sure if it is helping), Oxycodone 5-7.5mg for BT. .25-.5mg xanax as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

olhippy
New Member


Date Joined Aug 2013
Total Posts : 1
   Posted 8/7/2013 12:53 PM (GMT -7)   
This is first time using Caraco 5mg oxycodone. I've used Roxy since 1998 for massive spine problems. Not any problems with usefulness of medication till this month. the refill for 5mg oxycodone made by caraco, is useless. it either does nothing, of a roaring headache and almost a overdose feeling comes over me. This medication is useless. I called my Pharmacy and they said they couldn't get the usual Mallin, so this is what was sent. I need consistancy with my medication and this stuff is useless. I informed my Pharmacy CVS that I wouldn't accept another refill made by caraco. Call my MD and to my surprize, he had received the same complaints. He is not a "pain Specilists" but the few patients he does prescribe "Pain Meds" to are saying the same thing. Whats up with this company. I'm tempted to give some of these tablets to the Food and Drug administration to see what is really in them.

Pandorasbox
New Member


Date Joined Aug 2013
Total Posts : 18
   Posted 8/7/2013 3:32 PM (GMT -7)   
Cogito,
Thank you so much for the useful information. I have taken oxycodone for years and I have periodically had problems with consistency in the way I feel from one PX to the next. I just checked my bottle and it is nor Caraco. I will definitely heed your warning and check each time I get a refill. Thanks again.

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 917
   Posted 8/8/2013 2:35 PM (GMT -7)   
Hi olhippy...

I agree that the FDA should be contacted. Given Caraco's history and the apparent problems with this recent batch of oxycodone, they should be investigated yet again.

I was going to phone them last month, but just got sidetracked and didn't. IF you do contact them, let me know. I have a couple Caracos put away just in case I did get around to filing a report.

My CVS has been filling with other brands since I told them about my issues with Caraco -- and the others have been fine.

BTW, if you google Caraco and oxycodone, various other complaints can be found. Mind you, some are from discussion boards that have more to do with getting high than pain. For example:

http://forum.opiophile.org/showthread.php?26683-Anyone-used-the-Caraco-Oxycodone-IR-%28imprint-224%29
http://www.topix.com/forum/drug/oxycontin/TOHANHHDHM2CC007I
http://www.medschat.com/topics/caraco-oxycodone-224/
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident in 2004. Also, supraventricular tacycardia and mitral valve prolapse.
Current meds: Back to Tramadol ER for now, Oxycodone 5-7.5mg for BT. .25-.5mg xanax as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

KQ
New Member


Date Joined Nov 2013
Total Posts : 1
   Posted 11/20/2013 5:16 AM (GMT -7)   
Thank you so much for your information. My husband is having a difficult time managing his pain with his last prescription of Caraco oxycodone filled on 11/18/13 by CVS. He has taken Oxycodone 5mg for about a year now to help minimize his level of pain and his prescriptions were all from Mallinckrodt. His last prescription is from Caraco and he has complained since taking the first pill that they don't work, which is what prompted me to research this company. He has to take more medication than what is prescribed to try to manage the pain to the same level as he was able to do with the oxycodone by Mallinckrodt. At this rate he will go through this prescription quicker and our concern is that the doctor won't write a new prescription but with all of the posts here I think she will understand that there is a problem with Caraco.

nvrthesame98
Forum Moderator


Date Joined Jun 2008
Total Posts : 6706
   Posted 11/20/2013 5:39 AM (GMT -7)   
Hi KQ and welcome to HW! If you would please be so kind and start a introduction thread of your own so everyone can welcome you to the forum!

That allows us to get better acquainted and everyone will see your a new member!

I would really find all the information you can about this and print it off and let your husband's Dr know today that the meds not working like it should. Its possible you can return the meds and if all's ok he may rewrite the script so you can get a different brand.

Again welcome to HW.
Vickie
Chronic pain moderator
"At the end of the day all you need is HOPE&STRENGTH! **Hope that it'll get better,**
**Strength to hold on until it does**

Disabled 98 (multiple spine issues , multiple knee surgeries)
CP meds--Butrans 5,lexapro, lyrica, Indocin, Voltaren gel.
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