Generic Buprenorphine 54 411 Vs M 924 (Page 3)
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I've been going to a clinic for almost a year now and each time I get prescribed 8mg Subutex. When I would fill my prescription I would receive 54 411 white tablets. Today when I picked it up I got M 924 white tablets. The only difference I've found is the manufacturer. The manufacturer for the 54 411 is ROXANE and for the M 924 is MYLAN. Are they pretty much the same pill just different imprint/manufacturer?

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Re: Roxanne56 (# 172)

I'm around Charlotte NC and get the 54 411 monthly, have for over a year. Have no problems around here.

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I'm doing research on the new buprenorphine that apparently everyone is now getting. I was told that my pharmacy can't even special order the roxanne ones. So I'm now getting the 460s. Why is everyone complaining so much? Technically, they all have the same ingredients. They don't split easy that's for sure, and don't taste that great, but I really think it's all in people's heads about side effects. I think the side effects that are being felt is just the adjustment to the active ingredients. What i want to know is there a pharmacy out there that CAN get the roxanne ones ordered in?

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Re: Illymae (# 20)

The Mylan 924s work wonderful for me. I used to be on the suboxone strips. The 924s seem much stronger than the strips.

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Re: Subzero Subutexn (# 169)

I had a similar issue where I had called up more than 3x in a day to check on the status of my order being filled. The third time the fill-in pharmacist picks up the phone and proceeds to tell me that my prescription is NOT ready and the world doesn't revolve around me. Anyways long story short, the store manager actually is above them and I didn't know that, even if they're a pharmacist at Walgreens or Walmart. BUT please be careful - he knows your address, name, phone number & everything!!! I'm in Oklahoma and there was a case here where a little old lady pissed her pharmacist off so he posted an ad on Craigslist advertising her as a prostitute and gave out her address inviting men over. Just keep in mind who has ur entire life's info at their fingertips!!! People these days u never know.

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There is no difference at all between the 54-411 and the m-924. It's all in your head. They switched me to the 924's and they seem to last much longer.

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Re: Darryl (# 175)

I've been worried about illicit drug use picking up as well.

The first time in years I had cravings for my previous drug of choice was when I was switched to the manufacturer Activas when the Roxanne was no longer available.

It's been a couple months since I was on Activas, but I still think about how crazy of a difference I felt that entire month. I was so depressed, agitated, fatigued beyond belief, and had zero motivation to do anything. Suffice to say, it scared me is a major way.

Even though my dose was not working like I've been accustomed to, I feared that increasing it would only make matters worse when I would run out early and then be without it.

So I only increased the dose one time to see if it improved how I felt or made things worse.

It most definitely made things worse.

It felt as though the Activas brand is far stronger on the sedative end, but without the feeling of even taking your dose. The sedation felt more like a 24/7 hangover from taking nothing more than a Tylenol PM and a string dose of Melatonin. Literally.

So I realized increasing my dose only meant things got worse. That month I also tried to take a smaller dose to see if "less is more" with Activas.

Haha. Nope. Taking less only slightly improved the 24/7 fatigue feeling, but all other negative effects remained.

One of the scariest, biggest thing that stood out to me while on Activas for a month was THE CRAVINGS. Wow. I mean, wow.

I was in shock to have been feeling such strong cravings since I hadn't experienced that feeling in years. The cravings were daily, every day that month.

I do not have any contacts for getting illicit drugs these days, and I have been extremely happy with my success in the last few years.

I don't drink, I don't smoke anything, and I have never really even craved drinks or smoking in years until that month. It scared me it in a serious way.

It opened my eyes just how powerful a chemical imbalance (or sudden inconsistencies in chemicals/medicines) can be on someone - no matter how long you've abstained from illicit drugs, no matter how strong you think you are mentally, and no matter what promises you've made to yourself or others.

I still think about if others experienced a similar situation, but did end up going back to illicit drug use because of it.

Worst part is that the change in medication (.... or generic vs generic) won't be a factor in any research or news about how or why someone would give in to cravings all of a sudden. The fact that generic vs generic can cause such a significant difference in someone physically and mentally, even though legally the meds are identical, won't be given any merit whatsoever.

It will always come down to the individual being too weak, or not trying in recovery, or any number of possible explanations for going back to illicit drug use.

So any rise in illicit drug use will very likely not factor in the influence leniency in chemical makeup of generics had on individuals who depend on CONSISTENCY of what goes in their body.

CONSISTENCY is so important for diets, and it's so important for medications.

Suddenly disrupting that by forcing people to change what they take - despite generics legally being claimed "identical"... or within a few % points -- is so dangerous. So dangerous.

I hope research brings this more to the forefront so positive change can happen.

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That's going to make the illicit drugs come back strong. They're already making a come back. So sad, the world we live in...

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Re: Meghann (# 17)

They still make 54 411. I've been on them for years but this time the pharmacy gave me m924 and I don't like them very much.

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Re: Roxanne56 (# 172)

Yes I just had the Roxanne brand last month the 54/411's. And the month of September I got Mylan. Actually 2 pharmacies where I'm from had them last month. I go again on the 12th so we'll see what I get this time but the Roxanne and Mylan are hard to find. At one pharmacy in my town they order them because I've been a customer 15 years and the other does it because I was their first customer ever. There's a lot of people in my town near Pittsburgh Pa that are having major issues finding them. Roxanne Laboratories was bought or merged with West Ward Laboratories so I'm sure that has a major factor why pharmacies are not supplied with them at the present time. I know that my last pharmacy normally carries Mylan and ran out of those and ordered the Roxanne. I think the pharmacy companies make less money on these brands and that may also be a factor.

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Re: Stacey Butto (# 167)
You we're able to still find the Roxane brand? Not Wentworth but the tables actually have,54/411? I ask because these no longer exists. Other than some friends I have in California it's impossible.Please let us know!

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Re: Subzero Subutexn (# 170)

Find somewhere else to talk smack! Everyone else in the world has pain too. You're right that's how the Subutex companies make money because people get strung out on pain medication. This is for discussing those issues. It's not a smack talking website. Find something better to do!

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Re: suffering 63 (# 21)

Well let's see here special one, while u are screaming at 4 in the morning because of pain, is the same reason 90% of this epidemic even took place in the first place. So get over your fragile egg mother goose s***.

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Re: Please no more Activas (# 163)

Bro, where are u from? Bcuz the whole deal about pharmacists being part of my team is about the funniest s*** I've heard in a long time, matter of fact they treat me as if they are more like my enemy. But I'm glad I heard your message for the fact that's actually how it needs to be and there's a couple of them for whatever reasons just don't have that kind of heart or soul, cuz I see it as I did last time after the talk and argument I had with this younger guy at Texarkana tx, walmart on new Boston road told me he can make it where I can't get any of them filled anywhere at all because I wanted to get my prescription transferred to his pharmacy. Well after going up there in person and talking to the first pharmacist I saw like a man and no longer on the phone then got some proper responses but I didn't know who the young man was, but I did find out and it wasn't from someone telling me it was from him eyeballing me and looking at me out the top of his eyes on to the side of his eyes like I was crazy and like he could not stand me. Okay now all because he told me that I couldn't he can make it where he I couldn't get any of my prescription filled anywhere and I told him you're full of s*** dude, you don't have that authority. When I went up there in person he was like a little coward and he ran to the other side of the store because he was right next to the woman that I was talking to and I was explaining the situation and when he heard me talking about that he took off. So there are pharmacists out there that are not in our best interest and I would like to know who I would report that to because people in that field need to be more dedicated to our personal well-being our health and what works for us and not exactly like what you said, you know exactly how you said it, and so that just gives me the confidence to know that this is for me not for him and I'm going to work on that. I'm going to try to have him removed anyway I can or at least for his negative behavior. Thank you.

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I get mine from super one grocery store. They always have them. I live in Shreveport La.

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They do still make the Roxanne ones. I just had them last month. Roxanne labs just merged with West Ward Labs and they are hard to find at the moment but not impossible.

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Yes I have to agree Mylan just released a better generic subutex. It rates equal to Roxane brand. I'm curious I've read some posts that their Dr. Specified Roxane brand and they received it. I'm lost with that because they don't make them anytime.

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How do u get them filled? I've been looking for them? CVS no longer gets them. I love these 54 411 by mylan. All the others are s*** and everyone I know is complaining.

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I hear this story over and over again. I've gone to 4 funerals in the last 3 months due to patients committing suicide - due to their chronic pain. Pain management clinic doctors are no longer prescribing any controlled substances, opiates especially (pain meds) to their new patients and sending all their existing patients to detox and for those who cannot afford that, they are left without their meds suddenly to suffer in severe withdrawals. There are some that are not willing to go on the streets to obtain illicit pain meds and those are the 4 friends and former patients who I've known that are no longer around. It saddens me because I can't do anything about it, other than dispense what is prescribed by a physician, but I do care about them. I am the middle person, as a pharmacist and its very upsetting. Because of some people who are abusing opiates with alcohol, and other drugs, now millions of legitimate patients are paying the price by being under/un-treated. Even emergency rooms at all area hospitals have signs that state they are not treating anyone for any pain, and to see your private physician(s), which they too have posted "no pain meds prescribed". So what does one do? I guess the funeral business will profit and that is okay with some.

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I am so happy to report that Walgreens in Illinois is able to once again order Bi-Roxane Buprenorphine after I faced a very challenging last 2 months / 2 refills with them only able to get the Activas.

The difference between Roxane, Hi-tech, and Activas is profound, and also worrisome at the same time.

It's worrisome because of the opioid epidemic.

More and more patients may be reaching out for help and opting to try to Suboxone or Subutex very soon.

If anyone new to a Suboxone program and is put on Subutex for whatever reason, and reads this, please please please be extremely open with your doctor about how you are very serious and committed to recovery -- and that you have learned how different the main 3-4 generic's *might be* for your personal health.

Please let them know that you are just as committed as your doctor is to finding the RIGHT dose, and now a days, the right manufacturer, that works for YOU! For your genetic makeup, your other medications, your social, mental and behavioral health, and your environment.

You respectfully don't want to hear that "others have never complained about generic abc, so it's all in your head...."

I don't care if the FDA or knowledgeable bio-chemists, geneticists, Pharmacists, etc. say that the "active ingredients are only within a couple percentage points" (1%, 5%, 10%, whatever) between generics and that the generics are "equal" in terms of the therapeutic effects they'll deliver.

Absorption rate, bioavailability, yada yada yada. What it comes down to in 2017, is YOU! We are finally entering the era of personalized medicine where health decisions are going to increasingly be less about "what works for most", and more about "what works for you!"

We're about to experience an unbelievable change in medicine with the advancements in genetics and genomics.... truly, a significant change.

Your genes, medications, family health history, behavioral health, social health, and environmental health are 100% UNIQUE to you.

Not even the most intelligent professionals in medicine and research can stand by the claim that, "with generics, it's technically the same medication, so the effects and therapeutic benefits will only differ slightly, if at all, from the general population that takes this medication. So one generic is the same as another...."

Actually, the most intelligent professionals in all of medicine and research would never make that statement. They are smarter than that. Only those who think they know it all will make such statements.

So be extremely open, honest, dedicated, and motivated in your recovery. Don't place blame on anyone for anything -- including pharmacists -- since as a whole, substance abuse treatment is still very much in its infancy. Instead, always view your doctor, pharmacist, and others as your team.

.......So The Point Is......

Ask your doctor about first trying a specific generic for 1 week or so instead of being given a full month script. Most, if not all, clinics will already do this for new patients since they are committed to you being on a medication that works for YOU, not "the majority".

Without a doubt buprenorphine (generic subutex) has been the right choice for me instead of Suboxone. I suffered daily headaches, stomach issues, lethargy, lack of motivation, etc. on Suboxone years ago.

Then I switched to Subutex and the difference in how I felt was almost immediate. I even reduced my dose after 1 month of the switch, and it felt great.

However, patents now are expiring, or have expired for these meds, and in my personal opinion it seems there is quite a bit of leniency in approving generics to go to market. The studies I've read by 1 particular manufacturer to prove it's efficacy was mind blowing. It was so poorly modeled, did not represent the patient base very well, and was so "small / short" for such a serious medication and a company will $ billions.

So now we, the patients, are faced with an additional hurdle at the very start of our recovery. We have to now do *our own personal, clinical trials on ourselves* to find which of the generics is right since they're so far from being equivalent.

TRIAL AND ERROR: So discuss with your doctor the option to try a week on one generic. Of that seems to work for YOU, then awesome. Don't even bother with more hurdles, expenses, anxiety, etc. with trying the others.

But if you feel "something's not right", then ask about trying a different generic for 1 WEEK. Do not get stuck with a month. I am so serious about how different these generics can be -- at least they have been for me.

You will 100% know if there is a difference between them. Personally, I could care less about taste, the size, time to dissolve, or other minor differences. I'm talking about differences that truly hinder your recovery or daily routine/health.

Actavis hindered my life for a month (2 months ago) and I'm still amazed at the difference. It was that significant and scary.

Hi tech is also absolutely different (again, my own experience), but no question about it I'd take Hitech over Actavis even if Hitech cost 5x the price. Very serious.However, it's therapeutic effects are still roughly 50% of what I get with Roxane.

Plus, you will also notice that with one generic you can feel great in your recovery at ××mg, but on another one that dose might be 1/2 less or more.

And that's what is going to continue to cause a TON of issues for EVERYONE INVOLVED IN THE SUBSTANCE ABUSE WORLD. I'm talking about doctors, patients, pharmacists, manufacturers, FDA, etc. Everyone is negatively impacted by this inconsistency and most won't even realize this until 5 years from now. And that's worrisome.

WHY? Because the data is going to be TERRIBLE!!

EXAMPLE: If you have 100 patients taking generic A at 4 mg and have been for 6 months with positive reports, and then you have 100 patients taking generic B at 4 mgs with positive results, and 100 patients taking Generic C at same dosage and same period, all will LOOK, SOUND, and read on paper that "All is Equal..."

But then the change..... Maybe it's a shortage of Generic A, or maybe generic B is discontinued, or any number of things that can, and will happen.

What happens? If Generic A is on a shortage for 2 months or even discontinued, those 100 Patients are now taking Generic B or C, possibly for the first time ever.

85 of the 100 patients notice a difference right away, but assume it is "all in their head" since they're told that the active ingredients are the same and any difference is due to bioavailability, or something else very minor and that you should not notice much of a difference at all. "Your body and mind will adjust "....

But those 85 patients don't adjust. They are confused, delicate, and naturally will seek to fix the change. They will up their dosage (or even lessen it), or take it a couple times a day instead of once... they do this because they are human.

At the end of the month they tell their doctor that they ran out early because 4 mg of generic B felt more like 2 mg of Generic A so they had to up their dose to achieve the same therapeutic effects.

Many times the patient may be seen as "exhibiting drug seeking behavior since they are trying to fill more often than they should, because they took more than they should."....

Sadly, the legitimate excuse of the change in generic manufacturer causing this behavior is something that won't be taken seriously, YET.

Because of there not being enough data or time/ experiences to back the fact that generics for buprenorphine are NOT equal.

Thus, it is sooooooo important to be honest, upfront, and dedicated to your recovery by viewing everyone as team. Don't try to sneak anything and outsmart anyone, if that actually is your goal. It truly will only bite you and everyone else in the ass....

All because the patient voice in substance abuse, and really many areas in health, is not even a whisper. It's often more like an unwelcomed odor.

Doctors, pharmacists, and the Gov naturally shy away from odors and take anything said with a grain of salt. But ONLY because of those who actually do try to take advantage of things or lie, cheat, steal, etc to get their fix or whatever they want.

So fast forward the scenario. After even just 1 year of patients taking 3-4 generics of buprenorphine, as a whole, and the patients noticing and reporting the vast differences, you now have a serious problem for all.

Reason being is the data is bad and it is NOT accurately telling the true story of how this medication works, at which dosage is best, for how long, what medications conflict, what ones dont, and the 100 other variables that come into play here but no one will even think about or realize.

Now doctors don't have good data, or pharma, or the patient.

Because.....1mg of A is more like .5mg of B. Or 1mg of C is like 2mg of A, but the negative reactions are too serious. Etc.

At the end of the day, these drastic of differences in generics that the FDA approves only comes back to bite us all in the ass, except for those at the top: the ones making and selling....

A doctor won't be as informed as they could be since the data will he all over the place, and I'm sure at times even fudged.

Patients are faced with the need to trial and error more medications now, which costs the more more money, more time, more stress, and can be very dangerous early in recovery.

Pharmacists have to put up with complaints and have to spend more time researching a patients prescription history and calling doctors to see if this patient truly just had an awful experience with a generic and ran out early, or they truly are exhibiting drug seeking behavior.

Pharmacists will not know which is which, and may accuse an honest individual of something that is actually a result of manufacturers cheating on ingredients or the FDA being way too lenient in approving generics to help with the opioid epidemic.

Doctors will get blamed for not helping the patient, and the patient may actually be very dedicated to recovery and truly did just experience the consequences of the cheap manufacturers or others.

It's a scary cycle, but everything is very positive and optimistic as long as you speak up, are 100% honest and open, and are dedicated to sharing your experiences with your recovery so that the *Patients Voice can become something more than a whisper or an ignored odor.

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I just decided I cannot tolerate the suboxone. I forgot yrs ago when I was started out on suboxone the horrible swelling in lower extremities, nausea and a general since of malaise. I have tried all generic brands of subutex. Now since the Roxane branf is obsolete I have good news. I honestly can't tell you the difference. Praise God. I'm going to switch over.

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