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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by liliths on May 30, 2006, at 12:13:06
hi all..
I'm planning on switching health plans and am having difficulty dealing with 'formularies'.
2 of my staple drugs, klonopin and hydrocodone are excluded and I am trying to find suitable replacements.
the closest things that are covered:
meprobamate for the klonopin
oxycodone for the hydrocodoneI've written a lot below about my situation and current cocktail for those who want more information before rendering an opinion but basically my question is:
can I take oxycodone instead of hydrocodone and meprobamate instead of klonopin?
so if you can give information about that without knowing anything else, you probably don't need to bother reading the endless babble below
I haven't discussed this with my pdoc yet as I want to make sure before I ask him
so for reference, if interested, my total current cocktail is:
• concerta - 108mg a.m.
(totally different problem will be getting that dosage approved - seems they don't want to cover more than 72mg)• klonopin - 1mg a.m. / (sometimes 1mg mid-afternoon as needed) / 2mg p.m.
• buspar - 22.5mg a.m. & again mid-afternoon
• wellbutrin - 100mg mid-afternoon
I seem to experience word finding difficulty and general stupidity with this drug and so try to keep the dosage as low as possible. I've wondered about trying something else but haven't a clue what might be comparable. And now of course, I have this 'formulary' to think about• hydrocodone - 7.5mg a.m. and again mid-afternoon
I know the subject of 'painkillers' as antidepressants is a hotly debated one but for some reason, they work for me... more focus, some energy - or to put it better - I am less likely to just 'sit there' (a major problem for me)I also occasionally take sleeping pills when needed - usually ambien or lunesta - (whatever samples my pdoc gives me since my insurance stopped covering them)
any suggestions would be greatly appreciated
I am currently in the midst of a major depressive crisis - seems nothing I do or take really balances my basic inability to live.
I have been diagnosed as ADHD, PTSD, DID, and severely depressed LOL - sorry I have to laugh at myself or I'd just have to give up. I'm one of the many who has always had to keep suicide in their back pocket - just to know I have a choice.
But I've always said it's not about wanting to die - rather just not being able to tolerate the fact that I just don't know how to live. I'm so very, very tired of being me. Suicide has always appeared to be a very inevitable conclusion to this failed lifeI recently had the lovely experience of inadvertently missing my morning meds and was shocked at what not taking the concerta (the only 'major' med there) did to me. I spent the day totally abandoned, couldn't concentrate, couldn't think, ate all day for absolutely no reason and was weepy to the point of hysteria at times. I didn't know I had forgotten to take my meds until later that day when I noticed my morning pill container for that day was full and remembered 'remembering I need to take my pills' but obviously never did. It was a day I woke up particularly early and was waiting to take them. Usually it's just 1st thing, along with a million vitamins, my morning coffee and breakfast. So the thought of having to take a lower dose of concerta is horrifying.
I also have major issues about weight - won't take any medication that even hints of possible weight gain
I'd love to feel better than I do now. Have been on this regimen or a variant of it for a few years now. Dosages for wellbutrin used to be much higher but I went back to school last year and cut down on anything I saw as potentially threatening to my ability to learn - being in school was hard enough. After taking the wellbutrin down, I also cut out the mid-afternoon klonopin and went off the hydrocodone for awhile. I even entertained the idea of going off all my meds (my missed med experience answered at least part of that!)
I've since graduated (probably part of the reason I've fallen into the black hole though I felt it gathering below me during my last semester).
I'm pretty much being forced to switch as my current insurance is exorbitant - goes up approx. $150 every birthday (gee, do you think they're trying to get rid of me? LOL I was grandfathered in under a cobra plan they no longer offer. I am a middle aged 'uninsurable' female - really that's what every insurance company has told me the past couple of years)
If I weren't on meds I wouldn't have medical insurance at all as I can't afford it but I'm about to become eligible for medicare and it's new drug coverage. I've been on disability for the past 18 months. Though giving up my health insurance means admitting I will always be on disability as I am simply unable to do dailiness. I only got through school because there was a definite beginning and end in sight.sorry this post is so long. I thought it might be more helpful to give as much information as possible rather than just ask the question about substituting one drug for another
but that's the bottom line
if you got this far, then I thank you deeply and sincerely
namaste,
vness de psycho (my lastest moniker :)
Posted by ed_uk on June 2, 2006, at 17:32:12
In reply to substitutions?, posted by liliths on May 30, 2006, at 12:13:06
Hi
>meprobamate for the klonopin
Surely generic benzos are covered by your health plan? If not, I suppose you could just pay for it yourself. Generic benzos are very inexpensive. Perhaps I have misunderstood.
Ed
Posted by liliths on June 3, 2006, at 6:09:30
In reply to Re: substitutions? » liliths, posted by ed_uk on June 2, 2006, at 17:32:12
hi ed... thank you for replying. I take generic benzos now and according to the pharmacy receipts, mt $7 prescription would cost over $180 without insurance.
I haven't a clue why this insurance company excludes benzos and codeine. My main reason for looking at them was that they were the only insurance company that wouldn't make me pay a fortune for my concerta
I'm still unsure what to do - I guess I need to see my pdoc and ask him about the switches.
thanks again... it means a lot that someone out there heard me. I'm in quite a quandry over this. I have to get rid of the burden of my current plan but it won't be very effective if I end up spending just as much getting my meds
I hate even having to take the damn things - wish at least they gave me that "full" life the commercials all promise LOL
namaste,
lilith> Hi
>
> >meprobamate for the klonopin
>
> Surely generic benzos are covered by your health plan? If not, I suppose you could just pay for it yourself. Generic benzos are very inexpensive. Perhaps I have misunderstood.
>
> Ed
Posted by ed_uk on June 3, 2006, at 19:19:04
In reply to Re: substitutions?, posted by liliths on June 3, 2006, at 6:09:30
Hi again
Some generic benzos are cheaper than others. Could you ask your doctor about switching to a different benzo? Meprobamate is unlikely to be a suitable alternative.
Ed
Posted by liliths on June 4, 2006, at 6:55:29
In reply to Re: substitutions? » liliths, posted by ed_uk on June 3, 2006, at 19:19:04
hi ed... as always, thanks for your help
I don't know what alternatives there are. What else is classified as a benzo? The only one I am aware of in klonopin
sheesh... I feel like such an idiot
perhaps it's the dosage? I take 4 - 1mg tablets throughout the day though currently am only using 3 regularly and the 4th is my emergency one :)
thanks again
namaste,
lilith> Hi again
>
> Some generic benzos are cheaper than others. Could you ask your doctor about switching to a different benzo? Meprobamate is unlikely to be a suitable alternative.
>
> Ed
Posted by ed_uk on June 4, 2006, at 15:53:58
In reply to Re: substitutions? » ed_uk, posted by liliths on June 4, 2006, at 6:55:29
Hi
>What else is classified as a benzo? The only one I am aware of in klonopin
There are a lot of different benzos. Clonazepam (Klonopin) is a long-acting benzo. Diazepam (Valium) and chlordiazepoxide (Librium) are also long-acting benzos.
Does the formulary include diazepam?
Ed
Posted by liliths on June 5, 2006, at 6:31:39
In reply to Re: substitutions? » liliths, posted by ed_uk on June 4, 2006, at 15:53:58
hi ed,
well, I finally figured out what else is in the benzodiazepine family. Thanks for your help
I've been looking into other formularies as well, it seems no one covers ANY benzos anymore. The one I was looking at doesn't cover any - others cover some, but at the highest Tier (payment / authorization / limitation) level.
And from my experience, clonazepam is still my best bet
I'm going to have to put an awful lot of work into finding out what I can get from whom and for how much
sheesh
there was a rant on the board recently that has really hit home.. about being on all these meds and whether I can say I'm actually worse for the wear. I think I am in so many ways more damaged than ever. Yet I know if I were to go off them, I'd easily curl up and give in. But where's all that happiness the commercials promise? LOL I absulutely hate the health care (or lack thereof) system in the U.S.
I'm tired, disgusted and sick of being tired and disgusted.
thanks again for all your help. Right now, I'm clueless about what I'll do. I understand that some formularies allow you to petition for a drug - I may look into whether that option is available even before I signed on - otherwise, there'd be no point
namaste,
lilith> Hi
>
> >What else is classified as a benzo? The only one I am aware of in klonopin
>
> There are a lot of different benzos. Clonazepam (Klonopin) is a long-acting benzo. Diazepam (Valium) and chlordiazepoxide (Librium) are also long-acting benzos.
>
> Does the formulary include diazepam?
>
> Ed
Posted by ed_uk on June 6, 2006, at 16:52:20
In reply to Re: substitutions?, posted by liliths on June 5, 2006, at 6:31:39
Hello
I think your best bet is to find out which generic benzo would be cheapest if you had to pay for it yourself. It sucks, I know :(
I can't believe they cover meprobamate but not benzos. That's crazy. I guess they are relying on the fact that hardly anyone still takes meprobamate.
Ed
Posted by liliths on June 7, 2006, at 6:22:28
In reply to Re: substitutions? » liliths, posted by ed_uk on June 6, 2006, at 16:52:20
hi ed,
what do you think is the closest benzo in the class? I mean, they have diazepam listed as a benzo and I know personally how different it is.
I'm also looking into other plans, some cover some benzos - funny though, no one, it seems, wants to cover clonazepam
it's very weird... this same plan excludes hydrocodone but will allow me oxycontin or morphine I'd actually like to try Buprenorphin but good luck finding that covered!
the benzos are a biggie for me - I'd say along with the concerta, they're possibly the mainstay of my current cocktail. Getting concerta coverage is difficult as well, which is what drew me to the plan I'm stuggling with to begin with.
anyway, sorry for rambling
I appreciate your helpnamaste,
lilith> Hello
>
> I think your best bet is to find out which generic benzo would be cheapest if you had to pay for it yourself. It sucks, I know :(
>
> I can't believe they cover meprobamate but not benzos. That's crazy. I guess they are relying on the fact that hardly anyone still takes meprobamate.
>
> Ed
Posted by ed_uk on June 9, 2006, at 15:20:47
In reply to Re: substitutions? » ed_uk, posted by liliths on June 7, 2006, at 6:22:28
Hi
>I mean, they have diazepam listed as a benzo and I know personally how different it is
Do they have any other benzos listed? You have tried diazepam before? You might find it similar to clonazepam if you find an 'equivalent' dose.
Ed
Posted by liliths on June 12, 2006, at 10:16:27
In reply to Re: substitutions? » liliths, posted by ed_uk on June 9, 2006, at 15:20:47
hi ed... actually, it looks like I might be 'stuck' with the insurance company that only had the meprobamate listed. I plan on asking if they would consider accepting drugs based on my doctor's recommendations. All the other companies have caps on what you're allowed to spend before you pay for most meds yourself. Not very helpful for someone on chronic daily medication... sigh
thank you so much. Diazepam may be easier to get than clorazepam so I will keep your suggestion in mind when asking
you've been great!
I really appreciate all your help..
now if only the insurance company complieshope all is well in your world :)
let me know if you want me to keep you posted - it might be awhile before I know anything (maybe 3-4 weeks!)namaste,
liliths> Hi
>
> >I mean, they have diazepam listed as a benzo and I know personally how different it is
>
> Do they have any other benzos listed? You have tried diazepam before? You might find it similar to clonazepam if you find an 'equivalent' dose.
>
> Ed
This is the end of the thread.
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