Generic Buprenorphine 54 411 Vs M 924 (Top voted first)

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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Makes me really weak and tired and I have to do more and don't really do it for me at all. The Roxana 54-411 are the ones I get every month for almost 2 years now and everything in my life has been great. Haven't touched a opiate since. But these m 924s suck

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Do you know if it has the excact same stuff in the M 925 has the 54 411!! I don't like the M 925s at all. Doesn't seem to do the same has the 54 411

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The 924s have more buprenorpin in them,maybe a half mg or so

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I still get the 54 411 to this day

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The inactive ingredients aren't required to be the same, so you could be reacting to one of them.

Are you allergic to anything that you know of? Having unusual side effects, or does it just seem not to work?

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The akorn ones are terrible. They dont look like the roxane and mylans. It took me a week to notice they gave me M 924s so I dont think they are that much different than the Roxane 54 411s

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Agree with Mike. The only generic subutex that sucks is the small one that is made by HiTech/Akorn/Midlothian. I saw no difference between the M924s or 54 411s or Teva B 799 or even back in the day when name brand (B 8)was all you could get.

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The oval ones and the 54-411 are the best all the other ones suck.

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How do I get off these things (Suboxone-Subutex)???

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I just got switched to the Mylan Brand as well which one did you decide that you liked better?? I do like the Mylan is cheaper and pill seems to be harder than the Roxanne Brand which is nice if you are breaking pieces off

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Hello,

Thanks for update on the information from Roxane. I too just discovered that news about the merger /acquisition. It's really unfortunate that the ball was dropped on their end since all pharmacists I visited this past week had no information other than there being a delay, or some said they don't think Roxane would be back. (Partly correct)

Sadly, the Walmart I visited only had the 8mg tablets of the Westward brand (roxane) and their systems did not allow them to even order the Westward 2mg - nor anything else other than the Hi-Tech.

I really wish I had been asking the pharmacists to look into "Westward" this past week, but I only learned of it the other day. Too late for me.

Sadly, it came down to Activas or Hi-Tech for me for this month.

I can put it this way:

If I was out of medication and my options were to either refill with Activas right away, or go 2-3 days in withdrawal until another brand was available, I'd choose going 3 hellish, sick, horrible days to avoid another month of Activas.

Yes, I know people will say how idiotic that statement is and that if that was reality then there is no way I'd opt for 2-3 days without medication.

But having gone 30 days feeling so depressed, so empty, 24/7 headaches, irritated, tired beyond belief (a very different tired), hot/cold hot/cold, and tuly have ZERO desire to do much of anything -- including being around family, then I'd do what I could to avoid that.

I am truly, still amazed even after a month's time of how different that medication was for me. (My own experience)

It even led me to filing with the MedWatch program because I was so taken back by the mental effects of the medication, as well as physical. I really did worry for anyone else who might be early in recovery and was given Activas instead of another generic.

First time I had cravings in years was this past month....still scares me to think about that.

I thought for sure I was going to adjust to the change, but instead I felt like I was on an entirely different medication. Crazy too since I used to never, ever, ever think there could be such a difference between one generic and another.

If my experience with Activas is not unique, then I can see some real serious changes happening down the road with how "easy" it is for pharma to be approved for a generic for this medication.

I read much of their trials/studies since I became so curious about it. Without a doubt, the design of the studies to prove it's efficacy was so incomplete. I'm still amazed that Pharma continues to push the idea that 16mgs is a good starting dose.

It's unfortunate because it's so easy to place trust in our doctors and to also believe that such high doses are exactly what we need. It's only when others drop down to a few mgs that they realize how much better they truly feel -- and that they wish they had known how much better they would have felt long ago on a far lower dose than was recommended.

($$$$$$ why would a sales team for a company -- any company -- ever, ever try to push less product to vendors or distributors..... they don't, ever.)

So unfortunately the same has happened to Pharma and certain medications.

Which medications? Only those where the research into long term effects, efficacy of dosage, reactions to other possible concurrent medications, etc. is still in its infancy....

Just like any other new market, new product, or new change that presents new business opportunities in something where there is little data or not enough, the first ones to the plate with the most resources and influence are the first ones to shape the narrative.

That narrative sets the foundation for good or bad. Then it can takes years, even decades before the data, advancements in tech, and official standards begin to show how the early narrative was flawed...... but it will always be okay because the excuse will always be that there was a lack of quantifiable data to have been able to form better decisions about x,y,z at the time....

Always true, but also rarely the full story since data rarely incorporates greed and desire for power and control into the full picture.

Looks like the makers of Suboxone are right now in the middle of their early narratives being reshaped.

Unfortunately, without the Patients / People / consumers having the ability to play a bigger role in the narrative early on, this cycle will continue and people trying to gain control of their own lives will still struggle.

Sorry for ramble. I just wish there was more equity in all areas of our society. All areas....

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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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Yes, these tablets are just manufactured by different companies, which so very common with generics.

The FDA classifies this medication as an opiate that is most commonly used to treat drug addiction. It has the potential to be habit forming and may cause side effects, such as nausea, dizziness, drowsiness, dry mouth and constipation.

Is there anything else I can help with?

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Does anyone know if the manufacturer Roxane labs discontinued buprenorphine 54 411?!? My pharmacy said they only carry the Mylan's brand now, which in comparison are horrible!! If they are discontinued, does anyone know why? Or has had personal experience to other manufacturers of buprenorphine that you thought were better?

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I've been doing tech for about three years now. I always get the 54-411 but I have gotten the M924 a couple of times. Both pills look identical except the imprint on them. Taste the same, feels the same. I see no difference except the life of the 54-411 seem to last in my system a little longer. I get mine filled at CVS and they always have 54-411. Ask your pharmacy which one they have before you get your pills filled, that's what I've done to make sure I get the ones I want.

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I find that the M924 and 54 411 do the same for me.. Each person is different though.. I prefer the M924 though just do it a bit better; but not much of a total difference..

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Yes you can. I've come off suboxone before. I won't lie, it was awful for 2 weeks. But after realizing how addictive they were I knew this was the drug companies were really trying to turn our pain into profit I was disgusted. I knew I had that poison out of my body. And you can too. You don't have to be a slave to subs.

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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 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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Re: Subzero Subutexn (# 169)

I would try to get him outta there too! If a doctor writes a prescription for you, it is because that's what the doctor says you need, who is a pharmacist to question the Dr? They need to just fill the damn script and stop abusing their authority.

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