Because I’m lacking a large portion of my bowel, I don’t absorb a sufficient amount of B12. I found this out because I began to have nerve problems with my legs. Because of this I have to give myself monthly injections of B12. I’ve been doing this for several years now.
I posted about this on here back in 2011.
The insufficiency was diagnosed through blood tests and the nerve problems were confirmed by a nerve conduction study. (I think that’s what it’s called. They attached wires to my legs and took some measurements.) The symptoms improved with the injections and a second nerve study showed near normal functioning.
So I thought the problem was solved, albeit with the inconvenience of monthly injections.
But recently, I tried to get a refill of the injectable cyanocobalamin (B12). The drugstore was not able to fill the prescription and informed me that there was a supply shortage. I used my last dose last month. My doctor still had some in his office so I was able to get this month’s dose there, but the nurse tells me that their supply is dwindling and that she’s been trying to order more with no success.
Apparently the shortage has been caused by the closure of a plant in Quebec along with an increase in demand.
The next release date on that page seems to keep changing.
This is frustrating as hell. It’s a simple thing; an injectable vitamin. I need it to prevent nerve damage to my legs and eventully even worse things. But there’s not enough being manufactured (or none at all?).
According to that FDA page, this was first reported January of last year. I would think that the market would have corrected this by now. I want to be angry about this, but I don’t even know who to direct the anger towards. I can’t sue everybody that doesn’t manufacture B12, that doesn’t even make sense.
What’s the answer to this type of thing? How can we assure that necessary things like this are available? More immediately, what are my options?
You could take a sub lingual dose? Little tablets that dissolve under your tongue . The vitamin is absorbed straight through the skin into the bloodstream. Arent those available OTC in a health shop or by mail?
Amazon sells it. Failing that, you could take oral vitamin tablets with a crazy high vitamin b12 dose, like 1400 times normal. I take those cause I had gastric bypass surgery.
I’ve been considering something like that. Either sublingual or very large oral doses. My concern is that I won’t absorb enough that way. The injections are much more certain. But given the lack of the injectable form, I’ll obviously try it. It’s just frustrating that I’m being forced into a less certain way of treating a potentially very serious problem.
BTW, there is no evidence that sublingual doses are more easily absorbed than oral doses. It is surmised that, even with sublingual doses, most of the absorption happens in the digestive tract.
There is a nasally administered B12 prescription medication.
It’s apparently very expensive.
My insurance wouldn’t cover the injectable, but it was cheap. The nasal spray costs between $300 and $400 dollars. I don’t know how many doses that is.
While there is a shortage, some pharmacies seem to have better luck getting it than others. While I usually try to support small pharmacies, this is one medicine you may have better luck at one of the Big Guys - they place so many orders so frequently that I suspect they are bumped up in the priority list when meds go on back order. Money talks.
So call around and see if someone else can get it for you. I’ve been able to get it pretty consistently from Osco Pharmacy here in Chicago (although the pharmacist will only fill it 4 1mL vials at a time, instead of the 1 30 mL multidose vial the doctor ordered.)
Sorry to hear about your situation. Unfortunately drug shortages and becoming increasing problematic. I was on a hospital IRB and many new research protocols included restrictions about enrolling patients in trials unless the hospital could prove a they had an adequate supply of certain drugs used in the protocol.
I use the local CVS. They’re definitely one of the big guys. I’ve gone there for years and am friendly with the pharmacist. She’s aware of the problem and trying to get it for me.
I also called my insurers specialty pharmacy, but they said that they don’t carry B12. Maybe I will call around to some other local chains. I know that there are local Walgreens and Rite Aids, I’m not sure about Osco.
Hospital pharmacies are another option; it’s worth making phone calls. Drug shortages are an interesting phenomena. Often the initial report of possible future shortages leads to panicked stockpiling by people, leading to a worse situation.
I actually still have an unfinished multidose vial still in my refrigerator. The problem is that the expiration date is last month, so I’m not sure if I can safely use it or not.
You might want to check Costco. When I was price-shopping for an expensive drug (over $1,000 for a course of treatment in the U.S.), they were the cheapest, and the other pharmacists (Walgreens, CVS, Target) acknowledged they would never be able to beat Costco on price. I’ve heard that you don’t need to be a member to buy federally regulated things like prescription drugs, but at $55/year for a basic membership, it might be worth it anyway just for this one item.
You might also try asking your pharmacy if they can get Hydroxocobalamin as an alternative to Cyanocobalamin injections. It doesn’t appear to be on the FDA shortage page (at least, not at a cursory glance). If they can, ask your doctor if he’d be willing to write a prescription for that.
I guess the factories are busier churning out Viagra, Cialis and the other patent drugs endlessly advertised to the public. Just ain’t no money in USP generics…
We had to wait two weeks for a refill of a fairly ordinary and USP-generic rash cream.