Amicar: Shortage, Availablility & Alternative. Update Post 1

[macoduck]

The information here in post#1 is for those trying to find Amicar.

Dr Couto has recommended Amicar (Aminocaproic acid) to prevent and control excessive bleeding in greyhounds post surgically and especially for amputations. Generally, the dose is 1000mg every 8 hours for 5 days. Editing to add: per Dr Jen in post #3, "for greyhounds under 75 lbs the recommended dose is 500 mg instead of 1000 mg."

As of the end of July 2015 the manufacturer of Amicar, Akorn, sold out to Versapharm. At that time they stopped making Amicar in the 1000mg dose AND they stopped making it as a generic. It appears they have also stopped making it in a liquid as well.

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

 

Greyhound owners had been able to utilize coupons from www.GoodRx.com to purchase Amicar at a discounted price.

 

With the discontinuance of the 1000mg (15 tablets), the 500mg (30 tablets) may still be available in some areas of the country.

 

Current price in my local chain pharmacies for 30 tablets of Amicar 500mg starts at $636.32 because Amicar is no longer available as a generic.

 

Per Dr Couto a substitution of Tranexamic acid 500mg every 8 hours for 5 days is acceptable. Note that this medication only comes in a 650mg tablet. The current GoodRx price in my town is $65.27 with coupon and $149 cash price. It is also not an item kept in stock at local pharmacies.

 

Tranexamic acid should be ordered by a compounding pharmacy that will grind the 650mg into 500mg gelatin capsules Editing to add: or a liquid, making sure non xylotol is used in the suspension. I paid $35.

 

My compounding pharmacy is local and small and does not accept GoodRx coupons. Editing to add: per Dr Jen in post #3, Also, I believe Dr. Shelley Lake has recommended getting compounded aminocaproic acid from a mail order veterinary compounding pharmacy called Meds 4 Vets. http://www.medsforvets.com/

 

I have been emailing with Dr Couto over the past few days and he too was unaware of the very recent price hikes and shortages of Amicar.

 

I will update Post #1 if I learn of additional information. If you think I may have posted incorrect information please let me know and I will check on it. Disclaimer: I am not a vet nor vet tech.

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My search for Amicar started in another thread with great suggestions from our fellow members. http://forum.greytalk.com/index.php/topic/314722-amicar-questions-important-update-post-32/

 

My frustration in dealing with CVS, the only chain who actually had Amicar in their warehouse, grew when they refused my GoodRx coupon. After emailing GoodRx I got a speedy response and explanation of the mystery. Here's their response to my email. (Bolding is mine)

 

Thank you for bringing this issue to our attention, and I apologize for any inconvenience this has caused.

In this case, the coupon you printed on GoodRx displayed an incorrect price. While the pharmacy is under contract to provide a discount and the coupon is legitimate, the price shown on the coupon was simply wrong – we were provided an incorrect price, and we did not know it was incorrect at the time you printed the coupon.

It looks like the rights to Amicar were recently purchased by a new company, and the generic was discontinued within the last few weeks. This medication is now brand name only, which means the prices have increased substantially. It also looks like the 1000mg is coming out, but it hasn’t been launched yet. (Note I was trying to get the 500mg since 1000mg wasn't available.)

This issue is rare, and we sincerely apologize for the error. We have taken measures to make sure this does not happen in the future, and we understand that pricing errors on our website are unacceptable.

We have updated the prices for your prescription on our site, and they should be listed correctly within the next 24-48 hours. We are removing pricing for the generic, since it is no longer available, and prices for the brand name should be available once the site updates.

Because your experience using GoodRX means so much to us, we would like to show our apologies by offering you a $20 Amazon gift card. Would this be a good email address to send the gift card to?

We are doing everything in our power to ensure you receive the lowest prices available and that those prices are listed correctly on our website. You can have faith in the prices and coupons that we list, and we hope that you will enjoy using our site in the future to save on your prescriptions.

Please let us know if there is anything else we can do for you, or if you have any other questions or concerns.

 

This is a second email from GoodRx:

Thank you so much for your understanding, and I am so sorry for the difficult time you had with the discounts. I’m so glad to hear that you were able to find an alternative medication for Percy, and I do apologize that we were not able to be more helpful in this case.

We are always here to help if you run into any other issues in the future.

We truly appreciate your continued support, and we look forward to helping you and other greyhound owners save!

 

Finally, I am amazed that Dr Couto responded to my questions multiple times while he was out of the country. I needed assures for my vet that Tranexamic acid could be substituted. Thank you Dr Couto!

 

Please support the Greyhound Health Initiative! http://greyhoundhealthinitiative.org/

Aminocaproic Acid

Edited September 1, 2015 by macoduck

[seeh2o]

Thanks for sharing this, Ducky. This is really bad news.

 

But hey, I'll bet their stocks are soaring - that's ALL that matters in this world isn't it? $$$ Grrrrrrrrrrrrrr

 

ETA, that last comment was not aimed at you, but at what a messed up medical/big pharma system we have.

Edited August 30, 2015 by seeh2o

[JJNg]

Just wanted to add that the typical course of Amicar is every 8 hours for 5 days (not times - I imagine that was a typo?). For greyhounds under 75 lbs the recommended dose is 500 mg instead of 1000 mg.

 

Also, I believe Dr. Shelley Lake has recommended getting compounded aminocaproic acid from a mail order veterinary compounding pharmacy called Meds 4 Vets.

http://www.medsforvets.com/

 

I asked Dr. Couto a while back if he'd had experience with compounded Amicar, but he said he hadn't, so I'd stuck with using the commercially available generic. With this recent shortage, this may be an option to look into.

[macoduck]

JJNg, yes, it was a typed, now corrected. Thanks for pointing that out.

[MaryJane]

Thanks for providing this information - much appreciated.

 

I've been finding that drug shortages followed by price increases is also happening with other drugs too. Just happened with my dog's thyroid meds.

[macoduck]

I just checked the GoodRx site for my area and it currently states that there is NO Amicar available at all.

[tbhounds]

Just checked my area --#30 500mg tabs =over $600. Thank goodness I have a supply.

[seeh2o]

#30 500mg tablets in my area = $631.82

 

There certainly is no comfort in that.

[macoduck]

I just checked the GoodRx site for my area and it currently states that there is NO Amicar available at all.

I'm in NC so I just rechecked but entered a zip code for Virginia. It's available there for over $600.

 

So varying availability across the country but at outrageous prices.

[macoduck]

Compounded to liquid, the Tranexamic acid cost $35. I also purchased the Amicar that CVS had ordered last week at a cost of $503.

[Guest OPointyDog]

I got 30 tablets of the generic version (500mg) the 2nd week of August for my grey's dental - it cost $90. I guess I was lucky?

 

Thanks for posting this - he will need a 2nd set of dental extractions in a few months and we'll be sure to plan ahead.

[Wendie]

If my greyhound is over 75#, could he use the 650 mg of the Tranexamic acid in a tablet form? Or would it still be recommended to have it compounded down into the 500 mg size?

[Wendie]

Second question - the compounding pharmacy we use at my vet clinic doesn't have the tranexamic acid but DOES have aminocaproic acid available in 350/375/400 mg capsules. Would this be equivalent to the generic of Amicar then?

[macoduck]

Wendie, let me see what I can find out for you.

[kikibean]

I've used the compounded Amicar in both liquid and capsule form and it has worked well in both cases. I don't think the shelf life of the liquid is very long from what I remember.

[macoduck]

Kikibean, I was told the compounded liquid was only good for a week. I also let the pharmacist know it was for a dog so there would be no artificial sweeteners added.

 

So your compounding pharmacist was able to convert the 650mg tablet Amicar to 500mg in a capsule? I presumed that's would happen with my order. I'd never used this pharmacy before and the pharmacist picked was what easiest for him to do.

[kikibean]

I'm not sure what they did, but the capsules I got were 500mg. I can get the name of the pharmacy if you want. The one that did the liquid is different than the one that did the capsules. They made the liquid chicken flavor and the dog I gave it to didn't mind.

[tbhounds]

I personally know that Wedgewood Compunding Pharmacy can compound Amicar.

[kikibean]

Just FYI on the Tranexamic Acid, I just had to get a prescription of it for myself for an issue I was having. I didn't realize it was the same drug we'd been discussing. I was able to get it at the pharmacy at the local grocery store and they did have it in stock. My co-pay on it was $10 and the total cost was $130 for 30 pills. They were 650mg pills.

 

It did stop the bleeding pretty much immediately.

[macoduck]

Dr Couto recently said the 650mg of TA was OK. I'd had mine compounded down to a 500mg liquid and it cost $35.

 

Since it would be an off-label use for our greyhounds, GoodRx.com might not be able to offer a discount. Worth a try though.

[kikibean]

They gave me 10 refills on it, even though I only needed it the one time, so I think I might get it filled next month just in case. Especially if the 650mg would work.

[Fruitycake]

Thanks for posting this and keeping it up to date. Poor Monty needed a tooth extraction, and this information has been very helpful. I read the info to our vet, and since their compounding pharmacy doesn't 'do' the tranexamic acid, my vet called Dr. Couto's office, he was paged and took the call and gave her some other suggestions 'from the Dr's mouth' as it were.

 

I can see why so many say Dr. Couto is so wonderful, and I am so happy he is out there for us (all dog owners)!

[greysmom]

bumping to the top

[Guest OPointyDog]

Just picked up Tranexamic acid for my boy's surgery on Monday - paid $53 at our local animal pharmacy. They do compound it and will ship, too, if anyone is looking for it: http://www.animalpharmacy.net/

[macoduck]

Just picked up Tranexamic acid for my boy's surgery on Monday - paid $53 at our local animal pharmacy. They do compound it and will ship, too, if anyone is looking for it: http://www.animalpharmacy.net/

Did you get it in capsule form or into a liquid? The liquid is only good for 7 days before expiring and has to be refrigerated. In hindsight I should have gotten it in capsules.