Do prescription medicines finally stop being manufactored as newer version are created?
I am thinking about really old medicines…an example might be Placidils, an old pill for sleep. And are medicines that have been abused heavily been taken off the medical market?..An example might be Quaaludes. Also I remember a diet pill called eskatrol that I haven’t seen in 20 years. Come to think of it I haven’t seen any seconals or tuinols ( use to be called reds and yellows) in some time.
What happens to these medicines, are they just discontinued?
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I would VENTURE a guess to say that the companies take them off the market. Then they go back to their labs, alter the recipe a tiny smidgeon, and come back with a new patent so they can force me to sell my remaining kidney to afford their new snake oil.
But for the most part, I would imagine that companies DO improve on existing drug technology, and are able to engineer drugs with less side-effects and such.
Sala, can’t you count?!? I said NO camels! That’s FIVE camels!
The key point here is patent life on a prescription drug. When you have established a compound as a possible drug candidate, before you spend millions testing it in preclinical (animal testing) and clinical (human testing) trials, you patent it…and a host of molecules remotely similar to it. That, however, starts the patent clock of 20 years. On average (figures from the PhRMA.org page if you want to check) getting the drug to market will take 13 years, leaving 7 to recoup R&D costs and make a profit. Once the patent expires, the market is flooded with generics.
A generic is the EXACT SAME DRUG, and what sucks for the pharmaceutical company is that the comapnies selling these drugs don’t have the R&D costs. They merely need to prove their drug has equivalent performance to the name brand product in terms of safety/ efficacy. End result is that they can sell the drug cheaper which usually eats away a good 90% of the innovator’s market share. It’s especially a problem since managed care organizations will preferentially purchase the generics when available.
So the short answer is, old drugs often disappear because the ‘name brand’ can no longer compete against the generic. Some of the smarter companies are starting to genericize their own products when patents expire (look what SmithKline Beecham did with Tagamet). The other issue, as you already guessed, is that better drugs come out that have the same or better efficacy with a lower dosage and less side effects, destroying demand for these older compounds.
Also, since this topic will likely start the age old question of “I thought generics didn’t work as well as name brand drugs sometimes”. That’s true, but it’s because the formulation of the generic is sometimes different. That is, the active ingredient is the same, but because of the ‘inert’ suspensions they use, sometimes you end up with a drug that is stronger or weaker than the original at the same dosage. Also, on occasion, the generic may be a different dosage all together (i.e. name brand was a 40mg pill and the generic is a 50mg). It sounds like no big deal, but certain drugs have a very narrow index. That is, at the right dosage they work, but if slightly higher, nasty side effects occur – such as with certain cancer and cardiovascular medications.
This is all very well, but what happens to old drugs? For example, what happened to the tranquilizer that preceded valium? What happened to the cough supressants that preceded codeine cough syrup? (sorry, I can’t think of any good recent examples)
In general, they are gradually removed from the market. Sometimes they are shifted into generics, sometimes they are just allowed to run out. It’s like any other product once a new model has been produced; you don’t think Microsoft is still selling Windows 2.0, do you?
Depending on the drug, a lot of them become OTCs (over the counter) drugs. An amazing number of prescription meds that I took as a child I can buy over the counter now – Antivert, Dimetapp, Benedryl.
This way, the companies still get mileage out of all the effort it took to get the drug approved.
I heard on the radio (Clark Howard Show) that the expiratrion sate on OTC meds is all but meaningless and that, more than anything else, it is there to get you to throw away medicine and buy more.
Bullshit. These are organic compounds, no matter how well foiled, vacu-wrapped and bottled they may be, their efficacy deteriorates over time. Plain and simple. I will do that every year or so, go through the stuff. Especially the kid’s over the counter remedies. Now, the really GOOD hijack is this- what happens if you feed a kid generic cherry tylenol that is 13 months out of date? I am NOT trying to be a snotmouth here- I do truly believe that they deteriorate- but…how badly, and how fast? Me, I buy into this. I’ll gladly spend the dinero to have properly dated stuff in the house. I mean, shit…these are my KIDS- what’s a few dollars? I’ve spent the rough equivallent of 250,000 gallons of liquid Tylenol, just on Poke’mon cards in the last year… ( I know that kind of analogy is brilliant and incisive.)
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The Wall Street Jouranal had a page-one article on the subject a month or two ago. In general, OTC drugs are good for a year or more after the expiration date. Among prescription drugs, psychotropic medications and antibiotics are among the most unstable and should be used by the expiration date. Aspirin is still safe and effective decades after it’s manufactured.
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Snotmouth is kind of new to me, we use snotface and liver lips, maybe we could cut back and save a little time by swapping over to snotmouth.
The “dammage” to medications is supposidly either moisture (keeping your meds in the bathroom or over the sink) or sunlight (keeping your meds on the window shelf). I don’t know how sunlight degrades but can guess that moisture might interact with some meds and alter them.
I keep meds in a cabinet in the closet and try to toss everything I’m not using on a regular basis.
Oh, yes I do have a bottle of some ear ache medications (dropper) from the dark ages and will never throw it away - it’s N.F. antipyrine and benzocaine solution. A short term pain killer for ear aches until antibiotics take over and start working. It’s beyond price.
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Dr. Dean Edell answered this question on the air at one time, I think he said the medicines are removed from drugstore shelves when they reach the expiration date and are shipped overseas, possibly to be given to the poor or something, the medicines are still good for a few months after the expiration date.
Drugs are taken off the market when (1) they are ordered off the market by the FDA because they are found to be dangerous, or (2) when there is no longer a profitable market for them as happens when better drugs become available.
Drugs do deteriorate over time. How fast they deteriorate depends partly on storage conditions (temperature, moisture, light) but more important is the chemistry of the drug itself. Some drugs are unstable unless dry and cold. When mixed with water for use they can lose their potency in just hours at room temperature. Other drugs, like some antacids, should retain their potency forever.
The expiration date on drugs is just like the expiration date at the supermarket, it is the latest date on which the manufacturer guarantees the product will be good. (I understand that sometimes, when a warehouse has a huge stock of drug from an about-to-expire lot, the manufacturer will test a sample and, if it’s good, assign a new expiration date.) Just like you can eat a box of cereal months or years after its expiration date, you can use most drugs for long after their expiration date.
The important issue that nobody has mentioned is that although most drugs just lose potency as they age, some drugs turn toxic.
Loss of potency is not usually very important. Most drugs do NOT have a narrow therapeutic index. (Have you ever noticed that for most drugs the prescription is the same whether you weigh 50 kg or 100?) The toxic business is something else again. The most notorious “dangerous when old” drug I know of is tetracycline. Perhaps Yarster can give some other examples.
Yeah, tetracycline supposedly gets really evil as it ages. Aspirin may stay effective for decades, but I wouldn’t use it: it deactylates, making it much harder on your stomach.
Back to the OP: a good example would be the recent removal of Seldane from the market due to cardiac concerns. Once they had a worthy successor (Allegra), Hoechst dropped Seldane to avoid future problems.
As for abused drugs: many of the “classics” were simply replaced by drugs utilizing newer chemistry, with fewer side effcts, lower cost, etc.
I lead a boring life of relative unimportance. Really.
