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  • sywi

    Thank you all for confirming what I already suspected, that my pharmacy now having only Aurobindo “Adderall” in stock (they used to carry Teva) is why after 10 years on generic Adderall, which was previously overall tolerable and effective at curbing the worst of my ADD to warrant staying on it for a decade, suddenly what Aurobindo is claiming is real generic Adderall is all pronounced, unbearable, untenable side effects and less-than-zero medicinal value.

    If I wanted to alternately be constantly exhausted, so anxious I’m afraid to leave my apartment, randomly mentally though not physically homicidal, so oversensitive to stimuli that I can no longer shower, only bathe with a washrag and no-rinse shampoo because being pelted with water is suddenly unbearable, and depressed and less able to focus than taking nothing–oh, and newly plagued by severe lower abdominal pain, mouth ulcers, and a general sense of being poisoned, it’s perfect. But, given that I neither want nor can afford any of those things, because I not only have to function, I used to quite like showering regularly (esp. in August in the Midwest, but efficient personal hygiene is really an all-weather boon), and I find hours-long panic attacks nerve-wracking, exhaustion tiring, severe gut pain uncomfortable, and the sense of being systemically poisoned, disturbing. I also was happier when not compelled to randomly scream at my mother; because she’s my mom, 80, and already nervous that her circle of acquaintances has suddenly expanded to include a number of gynecological oncology surgeons arguing about whether she’s more apt to die of invasive abdominal surgery or an ovarian tumor growing like it’s on the pharmaceutical-grade amphetamine mix that I very seriously doubt I am, I’m really grateful to hear others’ accounts that so match mine, I feel I have id’d the culprit and overcame my new phone phobia to find a different pharmacy that stocks Teva instead.

    Not that Teva hasn’t been caught by the FDA violating acceptable mff. procedures for its drugs bound for the US, but Aurobindo has managed to collect 11 FDA reports of violations in 3 years, some of them addressing problems caught earlier and unfixed.

    FDA regulation of offshore drug-mff. plants is so spotty that US. drug mff. are outsourcing generic production to such plants just because they’re “unburdened by regulatory inspections.” Still, a single inspection of one Aurobindo plant in May 2019 found unignorable issues like using known carcinogens as binding agents at about 4 times the acceptable levels in life-critical cardiac medications, the presence of rodents, insects, visible dirt, rust, and 5 buckets of water from leaking air conditioners sitting in plain view in the manufacturing areas, safety technicians not trained for their jobs, and obviously faked data representing the amount of active ingredients at much higher levels than the products actually included when tested by FDA inspectors. And supposed capsules of drugs shipped to the U.S. totally empty. The actual report is heavily redacted, but understandable. URL given below.

    Notably, the conclusion reached by the FDA in its folo-up letter to Aurobindo in June, AFTER AB was given time to address the issues noted in May, was that Aurobindo’s 3 main plants are not capable of meeting basic safety standards for drug manufacturing, and that there’s been a notable absence of anything being done to make them so. (Direct quote: “These repeated failures at multiple sites demonstrate that [Aurobindo’s] management oversight and control over the manufacture of drugs are [still] inadequate.”) The full text of the june folo-up letter from the FDA to Aurobindo is here:

    Aurobindo’s response to media inquiries about how its stock/price/revenues would be affected by the FDA letters were rosily optimistic: It literally said that the FDA warnings would not affect its revenue stream at all (the FDA fell far short of closing the plants), and its recent acquisition of the mff rights to a huge number of drugs formerly made by, or in the pipeline of, Novartis, still leaves it positioned to become the second-largest producer of generics for the US market. I’m glad to report that its stock price was and remains dinged, at least.

    Actual FDA report on one Aurobindo plant inspected in May 2019 (heavily redacted and requires attention to the implications of what was observed; also noteworthy that the plant is still pumping out drugs for the US market):

    Examples culled from the FDA report:

    Ask before you fill your scrip who the mff. is for what you’ll be given. If the answer is “Aurobindo,” take your scrip elsewhere; call around to local pharmacies and find one that has what you’re prescribed mff’d by pretty much anyone else. (I’ve personally had OK results from Teva, a common supplier.) If you just submitted a scrip, don’t know who the mff. is, ask, and if it’s Aurobindo and they offer no other options, take your scrip back from that pharmacy and get it filled elsewhere, as noted; you can probably get it electronically transferred to another pharmacy, though I’m not positive about that bit re: meds scheduled as tightly as Adderall. I just got my physical scrip back from the CVS and plan to take it Walgreen’s, which I called and which thankfully has my 15 mg. pills made by Teva. If they already filled it, I’m pretty sure that as long as you haven’t picked it up and/or taken it out of the pharmacy, you can get them to put the pills back and, if Aurobindo is all they have, and they won’t order your dose made by somebody slightly more reputable, still retrieve your prescription, or transfer it. Don’t accept medication that was mff. by Aurobindo. Or at least not their “mixed amphetamine salts, i.e. generic Adderall. (Who the mff. is, is in tiny print on the bottle. Hard to spot but it’s there. Or just ask the pharmacist.) It is in my opinion both medically useless and dangerous. If you simply can’t find a pharmacy that can fill your scrip with pills made by other than Aurobindo (seems unlikely, but just in case), contact your prescribing doctor and try to get her to give you a scrip marked “DAW,” assuming your insurance will cover non-generics. Or if you can afford to, bite the bullet and pay OOP. If your insurance doesn’t cover non-generics & you can’t afford to buy the, see if you can get the same total amount of medication using, say, in my case, 3 10-mg. tablets per day rather 2 15-mgs. For some reason, my CVS’s 10-mg tabs are mff’d by a couple of suppliers that aren’t Aurobindo. It’s just the 15s that they offer no other choice for. Maybe Aurobindo has more market dominance in 15-mg. tablets? Anyway, I didn’t need to go through the whole rigmarole of getting hold of my p-doc and explaining the problem and getting a new scrip, because while it’s refill time, I’m not out of the 15 mgs–I haven’t been taking much, because too nasty–so I’m not going through acute withdrawal, I can just take my scrip to Walgreens tomorrow.

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