Oh, Doctor! Encora: Why is this a prescription?

So…I went to the doctor yesterday and she wants me to begin taking Encora. It’s a new thing (I hesitate to call it a drug) and she thinks it is a real breakthrough in women’s health. Two pills, twice a day, address bone loss, promote cardiovascular health and help with the evil mood swings associated with menopause.

So I’m looking at the ingredients, http://www.encoraefa.com/

…and I don’t see anything in it that would indicate this needs to be prescribed. It’s expensive ($50 out of pocket) but as far as I can tell, I could get these ingredients over the counter. Granted, I’d be missing the convenience of the whole pre-packaged thing, but still…what am I missing here?

Also, does anyone know if this is becoming a standard peri- or post-menopausal treatment? Is it just for general good health or is there a real indication that I could get Very Very Sick if I don’t do this? I fall into the dreaded “Skinny White Smoking Female” category, and I know I need to quit smoking, but aside from that…what’s the deal?

Muchos thankos to all who reply.

Did you have a pre-existing condition?

Did she diagnose something new? (You don’t have to say what diagnosis was made)

Or did she suggest it out of the blue for no particular reason?

If it’s the last option, I’m willing to bet she had a visit from the pharma-fairy recently and has either been on a nice trip or been taken out for a nice meal.

Well, I think it’s just standard “menopause concerns” coupled with the “skinny white menopausal smoking female” situation, which is a high-risk group for osteoporosis. I’ve been on the Climara Pro hormone patch for a little over a year, but have experienced periodic bleeding (which isn’t supposed to happen). So in addition to this prescription, I’m also having my hormone levels measured. If that reads the wrong way, I have to get an endomitrial biopsy and a possible D&C. The whole situation is kind of freaking me out, but I don’t think it’s particularly rare.

Well, I can tell you that the prescription is “pre-printed”, but she told me that my insurance company may or may not cover it. So, in light of that, I need to know how essential it is that I take this stuff if I’m going to be forking over $50/mo. out of pocket for it.

Bump. I’m really curious about this. Anyone? Buehler?

How much would the generic vitamin pills cost to match the following:

AM pill:
Calcium 400mg
Vitamin D 200IU
Vitamin C 25mg
Folic acid 2mg
Vitamin B5 25mg
Omega-3 Fatty Acids 650mg
EPA and DHA 550mg
Alpha linolenic Acid 100mg
Linolenic Acid 10mg
Vitamin E 50IU
PM pill:
Calcium 600mg
Vitamin D 600IU
Vitamin C 25mg
Folic acid 0.5mg
Vitamin B5 12.5mg
Omega-3 Fatty Acids 650mg
EPA and DHA 550mg
Alpha linolenic Acid 100mg
Linolenic Acid 10mg
Vitamin E 50IU

IANADoctor, but as far as I can tell all this product does is package a collection of vitamins and supplements in two pills. It doesn’t appear to have any active ingredient that couldn’t be bought over the counter, probably for far less. I was wondering if it was controlled release, but I couldn’t find mention of it in the marketing bumpf.

I’m not going to give you any advice, at all… I’m not qualified to. I would just suggest looking at the cost of possible alternatives and then talking to your doctor (you could even ask her how the meal/trip was).

I don’t know about this product in specific, but shooting from the hip, it smells like the typical “let’s package up a bunch of different vitamins and minerals and pass out ‘pseudoprescriptions’ to encourage folks to think it’s an actual FDA approved prescription medication”.

I seriously doubt there’s any evidence-based studies showing that this product actually works.

Well, I know I need calcium because of the bone loss thing. I’m going for a density test in the next couple weeks to see if I really have a deficiency in that area. The cardio stuff…I have no idea if this remedy really affects that. I know that quitting smoking would have a far bigger effect on that, but that’s another thread.

The mood swings? That’s why I’m on the patch. It works. They took me off it temporarily until they get a read on my hormone levels, but if everything’s ok, I go back on it. Even after a possible D&C I can go back on it. My husband worships the patch and isn’t looking forward to my hiatus from it.

Folic Acid? I thought this was essential for women in child-bearing years and benefits the baby. I’ve never heard of it being an essential element in post-menopausal health. Any takes on that?

Rather than going into the details of this particular company (one can always Google Ther-Rx to find comments by and boards for their employees) I would suggest this:

Several companies have, in recent years, been instructed to remove the standard “Federal Law prohibits dispensing this <medication> without a prescription” warning from the package insert and prescribing information. I would be very skeptical of any “prescription only” medications or “nutriceutical” that substitutes phrases like “RX only”-- evidence that the “prescription requirement” is nothing but a marketing ploy in this case.

Sadly, this test will not catch all medications The inserts are written by the companies themselves, and they are often slow to respond to specific FDA directives, to update inserts, or apply them to often substantial existing stocks (many pharmaceuticals are not manufactured continuously, but in large batches when existing stocks get low; sometimes the production runs can be as much as a year or more apart) . In the end, the company is legally responsible for their content, with FDA guidance, and may not employ commonsense measures, if they feel the legal exposure is small compared to the commercial benefit (e.g. if specifically instructed not to use the standard Federal warning on a given “product”, they may continue to use it on other “products” that are identical, except for dosage or form.) “RX only” may simply mean that the marketing company has made this requirement a part of the contract for their authorized retailers, to create an elite marketing image. Physicians often do, after all, write completely legitimate prescriptions for over-the-counter aspirin, bed rest, and other things that are freely available without a prescription.

To be clear: not all products that (still) display the “Federal Law prohibits dispensing without a prescription” warning are genuine “prescription drugs” in the sense that the consumer might expect, but any product which doesn’t is clearly NOT. Consumers should make their own decisions about such marketing tactics when considering alternatives.

Hey Kal, I’ve got nothin’ on the subject but just wanted you to know that:

I Like You!

Rhonda
~ skinny white smoking female approaching menopause

Okay, Sis…here’s the deal. I send you a carton of smokes, a box of patches, and a five year supply of wine. Call me. We definitely need to talk!

Thanks for this information. I smell a pharma-scam. It really pisses me off, because 1) I have been extremely lax in my female health maintenance. Now that I’m (shudder!) 50, I’m making a concerted effort to keep up with this stuff, and 2) I really liked this doctor. It was my first visit. She was very smart, but I should have suspected immediately when she walked in with the samples before ever having met me. Fuckers. It’s bad enough there’s so much I have to watch out for without adding another layer of paranoia to it.

The manufacturer addresses your question here in their FAQ.

It seems to say that this level of Folic acid requires a doctor’s approval (which, I note, is not the same as a Doctor’s prescription):

It also warns of taking too much Folic acid in their safety page as it may mask pernicious anemia.

All that being said, 100 tablets of 800mcg Folic Acid from the GNC store is $3.99. Add some B-12 & Calcium & you’re most of the way there.

By the way, IANADIAACG (I am not a doctor, I am a computer geek).

They’re using different amounts for the am and pm doses and claiming that it improves bioavailability because of daily rythyms. This is not unreasonable, but it may not be true either. Whether it qualifies as a prescriptable distinction I have no idea; I stay as far away as I can from such things,
Larry