Amicar Questions, Important Update Post 32

[macoduck]

I'm having trouble locating Amicar to have on hand for Percy's dental/teeth removal on 8/31.

 

My vet has a vial of the liquid form but has given me an Rx to get the pills. 1000mg, 3 times a day for 5 days.

 

I went to the GoodRx site and found it for around $140. Dropped the rx at RiteAid - it was in their system but they'd have to order it. But later last night they call saying although it was in the computer their warehouse does not have it. Today I will try Walgreens. All the others on the GoodRx site were much more expensive.

 

How is the liquid form dispensed? Is the dosing the same as the pills? If it required more than one injection my vet *might* let me do it at home.

Edited August 29, 2015 by macoduck

[tbhounds]

I've always had good luck finding it at Walgreens.

[macoduck]

Wgat do you think of the liquid v pills?

[tbhounds]

To be honest I've never had trouble finding the tablets so I don't have personal experience using the liquid form.

I guess I would have to question what suspension is used in the liquid form. That what be a question for your pharmacist.

[greysmom]

The liquid is, I guess, more easily available for the body to absorb. I had to give it to Cash last winter when Toni ripped up her side. It's a straight forward delivery - use the needle to get it out of the vial, pop the needle off, squirt into dogs mouth.

 

Hope you can find some at a reasonable price. Interestingly, when Dude had his osteo amp in 2/2011 the hospital/ER was not familiar with Amicar and had to order it specifically for him. But with Cash, they had it on hand and she got it as part of the routine IVs during her treatment, and I got some to take home.

[macoduck]

Have tried Rite Aid as well as Walgreens. No Amicar in pill form available per the manufacturer.

 

Will ask my vet about the injectable she has on hand.

[macoduck]

I've found this about the manufacturer:

http://www.ashp.org/menu/DrugShortages/CurrentShortages/Bulletin.aspx?Source=Current&Type=Rss&Id=1190

[NeylasMom]

That's regarding the 1000 mg tablets, but it says they released 500 mg tablets. I'm pretty sure I remember getting 500 mg tablets myself. Have the pharmacies you've been checking with been looking for any dosage of tablet? Easy enough to double up on the 500 mg tablets if you can find them.

[macoduck]

That's regarding the 1000 mg tablets, but it says they released 500 mg tablets. I'm pretty sure I remember getting 500 mg tablets myself. Have the pharmacies you've been checking with been looking for any dosage of tablet? Easy enough to double up on the 500 mg tablets if you can find them.

Both RiteAid and Walgreens said neither were available.

[tbhounds]

Try a compounding pharmacy

[NeylasMom]

Might make sense to just go with oral meds then. I just had to administer an oral med to my cat. Mixed it with a few drops of simple syrup to make it taste better and it wasn't that tough once I got the hang of it. Think it would be MUCH easier with a dog.

 

I was also able to find the pills through a compounding pharmacy, but it was $$$. Thankfully that's when someone told me about GoodRx and I was able to get Walgreen's to order it.

Edited August 26, 2015 by NeylasMom

[macoduck]

I'm in touch with Dr Couto. Will let you know what I find out.

[3greytjoys]

We get veterinary prescription (generic) aminocaproic acid in tablet form through Costco's pharmacy.

 

We get compounded liquid form through an independent compounding pharmacy. They add beef flavoring which the hounds love and consider it a treat. I administer the liquid through a plastic syringe into their mouth.

 

Costco's prices for tablets are cheaper than I've found elsewhere, but liquid form is usually less expensive. If time permits, I suggest people order it a week in advance of surgery since many other pharmacies need time to order it from their supplier (could take up to 3-5 days to restock).

 

If any owners need to keep it on-hand for known seriously excessive bleeders, the tablets have a longer shelf life (approx. 1 year) vs. liquid form (approx. 1 to 3 months).

 

We've ordered so much aminocaproic acid over the years that my local pharmacies (including Costco) try to keep it in stock for all the retired racers in the area.

 

If you can't find it, try contacting your adoption group's primary veterinarian/s to ask if they keep an easily administered oral form of aminocaproic acid in stock for owners' home administration. Good luck.

Edited August 27, 2015 by 3greytjoys

[Guest MnMDogs]

Of they order it at Walgreen's you should have it before 12/31. Did they say it would take longer than that? Good luck.

 

Ok nm. You said they don't have it at all. We were lucky recently in that our Walgreen's had it on hand for a person who needed it regularly.

Edited August 26, 2015 by MnMDogs

[macoduck]

None of the major chains had the 1000mg.

 

If we're lucky CVS will have it tomorrow BUT they can only get the 500mg and are not sure if they can get the full number of them. My vet did write a new Rx today to reflect the dosage change.

[3greytjoys]

Just had a moment to read your link in post #7. Thanks for that info. The 500 mg. tablets I currently have on-hand were manufactured by Versapharm (the manufacturer that was purchased by Akorn last year).

 

Several years ago, our compounding pharmacy said they buy a large container of powder (or granular) form of aminocaproic acid from which they compound into the oral liquid, so perhaps a compounding pharmacy could help you better than standard pharmacies(?). It's a human drug used in hospitals too.

 

Three of our hounds are excessive bleeders, our largest male weighs approx. 78 pounds. He's always done well on the 500 mg. dose for dentals, minor surgeries, and home emergencies; however, I understand Dr. Couto now recommends a higher dose for larger hounds, especially if being treated for a major surgery like limb amputation. Prior to our vet using aminocaproic acid, one of our hounds nearly bled out on the operating table during several small body mass extractions, so our vet starts all our Greyhounds on aminocaproic acid at least one day before surgery and continues daily through Day 4 or 5 post-op. (The vet hospital stocks it for surgeries now.) Same hound started spontaneous bleeding 30 hours post-op recovery while at home. Now the largest emergency vet hospital stocks it as well.

 

I'll be interested in your reply from Dr. Couto.

Edited August 27, 2015 by 3greytjoys

[BluegrassGrey]

 

 

We get compounded liquid form through an independent compounding pharmacy. They add beef flavoring which the hounds love and consider it a treat. I administer the liquid through a plastic syringe into their mouth.

 

 

We do this too! There is a veterinary compounding pharmacy here in town...... $15- yes, fifteen dollars, for a large bottle of the liquid formulation!

[macoduck]

No luck with CVS. They got the Amicar in today but will not honor the GoodRx coupon. Their price makes it nearly $600. That was the most uncomfortable pair of pharmacists I'd every been around. Lots of whispering and eyerolling directed at me.

 

A local compounding pharmacy could not locate Amicar from any of their suppliers. They can get Tranexamic acid, which Dr Couto says could be substituted. I am waiting on confirmation from Dr Couto on the dose before getting my vet to write an Rx. The pharmacy can get it here by Monday.

 

I do tend to micromanage my pets healthcare. Of our previous 11 greyhounds none have been bleeders. This time my spidey-sense is tingling and telling me to be prepared.

Edited August 28, 2015 by macoduck

[3greytjoys]

$600.00 is outrageous!!

 

I just called Costco's pharmacy (west coast).

My current price for aminocaproic acid (as a Costco member) is $88.56 + tax for quantity 15 tablets (500 mg. dose).

If I were to need to double dose the 500 mg. tablets, price for 30 tablets is $170.89 + tax.

 

Non-Costco members can use Costco's pharmacy, but price might be only slightly more.

If Costco's pharmacy happens to be out of stock, they said if it's ordered on a Monday, they could fill the order by Wednesday. If a weekend is involved, best to allow one week turn around.

 

Of course, Dr. Couto is the veterinary expert having done surgery on several hundred Greyhounds every year.

If I recall correctly, their recommended dose for Greyhounds post surgery used to be 500 mg. three times per day. Since your vet already has aminocaproic acid for treatment on surgery day, I wonder if 500 mg. tablets might be enough for your follow-up home treatment(?). If there were a problem at home within the first couple of days, you'd have enough tablets to double dose until you got to a vet hospital for further care; or perhaps you could taper dosage down on days 4 and 5. (Just thinking of potential options.)

 

BTW, just to answer your original post question: Oral liquid administered at home is the same dosage and same # of daily treatments as tablets. Oral liquid is given 3 x per day. It's my understanding/my experience that Chris' reply is correct; the liquid solution is typically absorbed faster than tablets. Either type has worked well for our excessive bleeders.

[NeylasMom]

No luck with CVS. They got the Amicar in today but will not honor the GoodRx coupon. Their price makes it nearly $600. That was the most uncomfortable pair of pharmacists I'd every been around. Lots of whispering and eyerolling directed at me.

 

A local compounding pharmacy could not locate Amicar from any of their suppliers. They can get Tranexamic acid, which Dr Couto says could be substituted. I am waiting on confirmation from Dr Couto on the dose before getting my vet to write an Rx. The pharmacy can get it here by Monday.

 

I do tend to micromanage my pets healthcare. Of our previous 11 greyhounds none have been bleeders. This time my spidey-sense is tingling and telling me to be prepared.

Fwiw, I've heard on here that calling GoodRx while at the pharmacy can get them to honor the coupon. If you can't find another option.

[Guest MnMDogs]

Fwiw, I've heard on here that calling GoodRx while at the pharmacy can get them to honor the coupon. If you can't find another option.

Yes, call while you're there. Our Walgreen's wouldn't honor our coupon and we ended up paying then calling after the fact. GoodRx was very helpful, but said they couldn't do anything after the fact, but they could have if we had called at the pharmacy. It can't hurt to try.

[macoduck]

Yes, call while you're there. Our Walgreen's wouldn't honor our coupon and we ended up paying then calling after the fact. GoodRx was very helpful, but said they couldn't do anything after the fact, but they could have if we had called at the pharmacy. It can't hurt to try.

Tried calling the number on the coupon. Got a recording, no human and no way to leave a message.

[macoduck]

I've emailed GoodRx.

 

The coupon I had had a different phone number than the one I just reprinted this morning. The battle continues......

[NeylasMom]

Good luck! So frustrating.

[macoduck]

Dr Couto and I have been emailing. He says that Tranexamic Acid 500mg, given 3 times a day for 5 days beginning the day of the surgery, can bed used as a substitute for Amicar.

This is also not a medicine stocked routinely at pharmacies.

 

It only comes in 650mg but my local compounding pharmacy will grind and put it in gel caps to the specified dose. It will be available for me to pick p on Monday morning.

I didn't get a price on it but at this point I don't care.

 

Regarding Amicar, I also checked today's at Sam's Club - no Costco here. The pharmacist said she wouldn't know if she could get it until she ordered it. Wasn't sure of the price, GoodRx or not, and it woulnd't be in until Tuesday.

 

Once this is all settled I will start another thread with a heading of "Amicar, availability, shortages, & a substitute".

Edited August 28, 2015 by macoduck