Sunday, December 14, 2008

What Forms of Long-Acting Guaifenesin are Available?

Guaifenesin is an old compound that is supposed to help thin respiratory mucus and hence help one remove it from the respiratory tract. Technical term is an expectorant. The evidence in favor of guaifenesin is weak in my opinion. However, when used correctly, there may be benefit without adverse effect and hence it may be worth a try to reduce symptoms. I personally find guaifenesin to helpful about 50% of the time. So remember if now is one of those times that it does not work, then why take it? Aside, interestingly, over twenty ingrediants were marketed with claims as an expectorant until 2/28/89 by order of the FDA. The only compound that remained was guaifenesin.

There are several places for confusion.

Guaifenesin used to be frequently put into OTC and prescription medications until
this directive from the FDA on 5/25/07 [places for confusion #1]. The FDA announced it would take enforcement action against all manufacturers of all timed-release guaifenesin products not approved by the FDA. This means the manufacturers should stop manufacture of those products, which are many (Guaifed-PD, Entex LA, Entex PSE, Profen II). The result of this is markedly less supply for demand and confusion for the pharmacies, physicians, and patients. As of Novermber 26, 2007, all sale of non-approved timed-release guaifenesin products was ordered by the FDA to stop. This completely shuts off the supply to one product.

To further complicate things, the FDA's action does NOT affect products containing guaifenesin in immediate-release form [places for confusion #2], but rather only affects timed-release forms, often described as extended-release, long-acting or sustained-release. The only FDA-approved long-acting formulation of guaifenesin is Mucinex. Regretably, as a disciple of free-market economics, this means they have monopoly on sales with the subsequent result that the prices are certainly not what one would call "low", "inexpensive", or "a bargain." This post should NOT be understood to be a plug for the Manufacturer, whom I think could stand to lower prices as they stand to do very financially in the future.

To further complicate things [places for confusion #3], the maker of Mucinex has several combination products available, all under the family name of Mucinex. So read those labels carefully!! I spend a minimum of 30 minutes every day explaining these differences and urging people to read the labels. I have tried to summarize the products, their differences and approximate prices in the table below.

Note, [places for confusion #4] when you are looking for Mucinex products, the entire Mucinex family of products is available
over-the counter (approved in 2004) but behind-the-counter of pharmacies, meaning patients must ask for the products. They are not stocked on shelves in the normal aisles.

Recall that immediate-release products containing guaifenesin remain over-the-counter and on the normal shelves [places for confusion #5]. A few examples include: liquid guaifenesin in Robitussin, generic brands (e.g. Waltussin); plus tablets Hytuss and Organidin NR. There are MANY more. These are an option, if you don't mind taking the medications more often. Do your math carefully. It may be less expensive, and more convenient, to pay for the time-release products.

A future note, on October 29, 2007, the same manufacturers received an approvable letter from the FDA for the timed-release tablet for the combination of guaifenesin + codeine. This has not been marketed yet [places for confusion #6, for when the ads start]. This will be available by prescription only.
D = decongestant (for nasal-sinus congestion); DM = dextromethorphan (cough suppressant); G = guaifenesin.

IngredientsTrade nameFormCost ($/number of units)
GMucinextablet[CVS only 49.99/100] 23.00/60, 18.99/40, 9.99/20
DM, GMucinex DMtablet19.99/40, 9.99/20
D, GMucinex Dtablet22.99/36, 19.99/24
DM, GMucinex Cough Mini-Melts9.49/12
G, codeineMucinex with codeinetabletnot available yet

Some doctor's offices have $2 off coupons. Ours does. Hey, I always say every little bit helps in life. Some pharmacies have the same coupons. Remember to ask for them. The coupons are not currently available on the internet. Prices above were at CVS as of the publish date and of course could vary from place to place.

Confused yet? So am I. Please re-read this and if you have questions, ask your doctor...

No comments:

This website is certified by Health On the Net Foundation. Click to verify. We comply with the HONcode standard for trustworthy health information: verify here.
My Zimbio Medicine Blogs - BlogCatalog Blog Directory