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Ondansetron/Zofran

PostPosted: Apr 28, 2006 5:07 am
by inkykiwi
it seems no matter what causes nausea and vomiting, Doctors/Hospitals struggle to prescribe this medication. I found this article online from New Zealand, and thought it may be of interest.

What a battle we have, and others with other conditions who need this medication, have to do extreme things to get access.
Mad!

http://tvnz.co.nz/view/page/425826/704503

PostPosted: Apr 28, 2006 9:54 am
by bibliojo
It's so sad and frustrating isn't it? I know what a battle I went through to get Ondansetron prescribed for me this pregnancy and what a difference it made! Have you been able to get it?

Joanna

PostPosted: Apr 29, 2006 1:21 pm
by Trudy
Hey, I just saw your ticker, congratulations!

My mum told me about this women the other day, I had missed the news that night. It really doesn't make sense to why Zofran is so hard to get. Especially as I got it so easily during my last pregnancy. I did have a great pharmacist and midwife who worked for me. I had prescribed and subsidised.

My 1st pregnancy I got it at home through the hospital at home programme. The 2nd the Dr in the hospital got sick of me living there so gave in and prescribed it for at home, I did pay for half. This time it cost me nothing and my midwife prescribed it.
New Zealand Dr's really need to catch up I think.

Though I do know that NZ only imports a limited amount of Zofran so whether that makes a difference I don't know.

PostPosted: Apr 30, 2006 12:44 pm
by inkykiwi
Crazy business this, isn't it.
Joanna, I'm not on it, haven't been at deaths door enough for the NHS to part with any of it, but I'm surviving on Phenergan and Stemitil, and it's working, sort of, working enough to give me some time during each day to get some fluid and food into me. So no need for Zofran for me.
I'm just amazed at how tight some countries are with it, and how freely available it is in other places.
I meantioned to my Doctor that it was avaialbe in America, and they basically said well they are a lot more free about prescribing drugs in that country. So according to one medical professional in the UK Americans are a bunch of pill poppers.
That I can't comment on, but I have to say when families have to go to extreme lengths to get the right medications prescribed it's a sad state of affairs.
Still if it's all about the mighty dollar, then that makes a bit more sense, I know the NHS is cash strapped, and so is health department in NZ, maybe that's the difference between insurance based medicine (USA) and Government funded (UK and NZ).
Just a thought.

PostPosted: Apr 30, 2006 3:22 pm
by bibliojo
Canada is government funded too (but they refuse to cover the cost of Zofran. The patient has to bear the full cost of it unless they have health insurance) and I've often thought because the way it is set up in the US, doctors are a lot more willing to prescribe drugs and do procedures such as PICC lines and NG tubes than in other countries.

I just finished reading a book yesterday on Nausea and Vomitting in Pregnancy written by Denise Tiran. It's quite a technical book written for doctors and midwives - especially in the UK - as the author is from there. But she spent the whole book talking about alternative approaches and that medication is the very last option and even then it isn't great. Well, yeah, but do they have any idea how much we are suffering??? Could you imagine the outrage if say chemo patients were not allowed to have drugs - that really they should just tough it out and that they are really only as sick as they perceive themselves to be (one of the author's arguements :roll: ) It just makes me so angry and frustrated!

Joanna

Zofran

PostPosted: May 01, 2006 4:39 pm
by Hurlygirl
Hi

I am in the UK and I am being prescribed Zofran. So it can, indeed, be done. I am under a Professor of Obstetric Medicine (medical disorders in pregnancy) who actually knows HG. And he is a Professor, so in the hierarchy of the crappy NHS he gets listened to. The point I am making is that if you can get the right practitioner, you can get the meds you need even if they are expensive.

Joanna, I agree with your frustration. Obviously a chemo patient gets appropriate antiemetics. His or hers is considered a REAL medical problem as opposed to vomiting in pregnancy which is just the way it is. It is outrageous! I think it is indicative of deep sexism within the NHS. Its why instead of seeing a OB/GYN like you would in the US, you tend to see a midwife. Nice people and trained, but not medical doctors. Can you think of a male medical problem that is dealt with in that way?

L

PostPosted: May 02, 2006 6:45 am
by inkykiwi
That is a very good point Hurlygirl, maybe there is a huge issues of gender issues here, or maybe we choose to be pregnant, and other don't choose to have cancer? Maybe there is a stigma because we 'got ourselves into this mess'? I don't know but it seems very strange to me. I guess there is massive fear over reserched drugs in pregnancy, and doctors are butt covering not prescribing them. Or maybe it's as simple as, it's not that common an illness (HG) and Doctors are just not aware of it enough, or educated on it enough. Yet because of the title they hold, they put on an air of knowing best when reality is they are not informed enough. I don't know, it's a hard one...

Here's a tease, my Midwife back in NZ is in contact with me as we are returning to NZ for the birth, and she is telling me that she can prescribe all the medicines required including Zofran....and yet I'm over here in the UK, struggling on Stemitil, because my doctor is not willing to prescribe anything else, or even up my doseage of Stemitil...which annoys me greatly. But thems the breaks! We will just have to continue to envy those of you living in America.

I agree that you can get it here, you just have to get in with the right doctors, however I live in a small town, so have little options, but I'm surviving, i shoudn't complain, i've found some mineral water that my body tolerates, I don't like it but it works, so I can stay hydrated, so I'm fine really! I know others are not so fortunate.

It is certainly interesting to discuss theories as to why it's like pulling teeth to get doctors to prescribe around the world.

PostPosted: May 05, 2006 1:35 am
by aussietwirler
Hi, just thought I would add to this topic.

I am in Australia and am 25 weeks with twins. I have been having Zofran since the early days and still on it. My ob/gyn prescribed it to me when I was in tears in her office at about 8 weeks. I had HG for 9 months with my 5 year old and never even heard of the drug back then.

Can't believe that it's so hard to get for some of you. The only complaint I have about the drug is that is it does not take away the nausea feeling. I truly hate being pregnant and can't wait for this hell to be over, but am grateful that I am not throwing up regularly.

Good luck and hope your pregnancy journey goes well.

Mara - Melbourne Australia

zofran

PostPosted: May 05, 2006 2:25 am
by Hurlygirl
Hi Mara

We are the lucky ones. It is very difficult to get here in the UK. And in the US it can be tough depending on insurance or it can carry a very high co-pay.

I think the reason it is not prescribed more readily in the UK is cost. It is relatively expensive and the NHS has disincentives in place to discourage GPs from prescribing expensive drugs. Combine this with ignorance about hg and you end up with a lot of women suffering without...

Like you, the Zofran doesn't touch my nausea. (Unisom + B6 does help briefly before knocking me out.) And I can't wait for this nightmare pg to be over.

Lisa

PostPosted: May 06, 2006 8:22 pm
by aussietwirler
Hi Lisa,

Definitely lucky to be able to get Zofran when others can't, but gotta say it's quite expensive here too. It's normally over $68 for 4 tablets here, but my pharmacist manages to fudge it somehow. As long as I don't have a repeat prescription and it's only 4 tablets at a time it only costs me $30. Of course this means I am constantly needing new prescriptions and making regular trips to the chemist.

Fortunately I am only taking 2 mg twice a day, so it last a bit longer now (and the constipation isn't quite so bad).

I know it's wrong but I pray for this pregnancy to end earlier, so this can be over. I swore I'd never get pregnant again last time, but after 5 years I was talked around.

Believe me, there is no way I'm gonna ever consider this again!! Don't know how others have the strength to do this multiple times. I'm not that strong.

Mara

NEVER, EVER AGAIN

PostPosted: May 06, 2006 11:16 pm
by Hurlygirl
Hi Mara

I have woken at 5AM with overwhelming nausea. I have just taken a 4mg Zofran (which indeed causes constipation, but not as bad as for me as for some ladies) and a Unisom and 50mg of B6. Should conk out in about 30 minutes.

It seems awful that the Zofran is so expensive -- the drug company is milking it. Glad you have found a way to get it in some way that is sort of affordable. It seems wrong that when it doesn't even provide total relief, it is priced like gold. I'm still vomiting / retching most days. But at least I have been able to put on weight and I have only been hospitalized 3x.

My hg eased off a bit in T2 but it is back with a vengeance in T3. The nausea and headache are just debilitating.

I'm with you. I will NEVER do this again. I am opting for a tubal ligation with my c-section. I am 39. I have 2 children now, Myfy 10 and Alec 7. They were supposed to be it. Our Bonus Baby was an accident and I seriously considered
termination. That may sound awful, but we had just moved when I got pregnant and have no support. It is very, very hard to look after the kids adequately if not properly. And I was deathly ill in T1.

In addition to coping with horrible hg and a new and unfriendly place, I am trying to get my head around another international move (next summer because that is the earliest I think I can manage with the hg and a new baby) and reinventing myself again (I was supposed to go to grad school this year, with both the kids in school, but that has gone completely on the window.) Normally I would say, "Don't think about the future. One day at a time." But as all the days until the July birth of this baby are clouded by hg, that is not a good option.

Roll on the birth. Even tho I am not excited about the baby and actively not looking forward to the sleep deprivation, I just can't wait for the hg to end.

Lisa

PostPosted: Jun 20, 2006 4:19 am
by sarahkate
Hi,
I'm in the UK and also muddling through on prochlorperazine (stemetil) and cyclizine. When the two failed last week, whilst I was in hospital, it was like, 'well there's nothing else'. There is, and maybe I should have asked for it.

I think what has been said about it being a self inflicted situation is in the back of health care professionals minds. Also that uncure-able means 'let's not do anything'. But the cost motivates all of these. Mostly in the UK you'd see a junior dr in hospital. I am a junior dr so I hope I can see this from both sides. If as someone a long way down the pecking order you start prescribing something expensive such as ondansetron it will not look good for you. Colleagues, seniors, will be unimpressed. Fine if you get to see the prof, but most ordinary people won't in the NHS. I also don't think people believe how bad it is, they think that they might have to prescibe ondansetron to every pregnant woman which would have cost implications. There is a misconception that hospitalisation is a failure to cope not an overwhelming illness process. Therefore not deserving of the fancy expensive stuff.

Rant over. Phew. Just my twopenny's worth.

PostPosted: Jun 20, 2006 4:50 am
by Natalie
Sarah,

That's a really helpful contribution to this thread. It's good to be able to hear it from the medical professional's perspective too.

Natalie, x