Dear NADF Members:
On February 9th, 2006, National Adrenal Diseases Foundation (NADF) headquarters received a report from the concerned sister of a longtime member that Merck & Co., Inc. is not longer making DecadronŽ (dexamethasone).
Investigation by NADF Pharmaceutical Liaison Volunteer, Les Sass, revealed that Merck stopped making DecadronŽ on August 31, 2001.
Merck supplied the name of Roxane Lab (614) 276-4000, as an alternate manufacturer of 4 mg. tablets of dexamethasone. (NADF shows that Roxane also makes a 0.5MG, 0.75MG, 1MG, 1.5MG, 2MG, and 6MG tablet.)
NADF records show other possible manufacturers of dexamethasone as:
Par Pharmaceuticals (supplied in 0.25MG, 0.5MG, 0.75MG, 1.5MG, 4MG and 6MG tablets.)
Organon USA Inc. makes a dexamethasone product they call HexadrolŽ in a 4MG tablet.
Some words of explanation of bioequivalency from NADF's Medical Director, Dr. Margulies (reprinted from NADF News, Vol. 1, 2004):
All of the hydrocortisone, cortisone acetate, prednisone and dexamethasone preparations out there are identical only in the amount of hormone in the pills. The absorption may vary because the different brands or generic versions may have slightly different binders, fillers, coatings, and densities. This creates variations in blood levels and biological potency. I have always been aware of clinical variations that patients have experienced when switching from one brand or generic to another. Basically, a new titration or adjustment in dosage is needed whenever a switch is made. Sometimes there is a need to increase or decrease the dose, and very often there is no need to adjust the dose.
The message for our members: be aware that a change in potency may occur with any brand switch and discuss any symptoms of glucocorticoid excess or deficiency with your doctor so proper adjustments in dosage are made.
For those who were taking DecadronŽ, and feel that generic dexamethasone isn't an option for them, there are other types of replacement cortisol-type medications available to them.
Hydrocortisone
Cortisone Acetate
Prednisone
Prednisolone
Methylprednisolone
Please talk to your physician regarding any medication changes, problems, et al. (Keep in mind that the proper hormone replacement dosages for adrenal insufficient patients vary for each medication, some drastically.)
I have attached to this e-mail an FDA Medwatch form in PDF format for those DecadronŽ users who would like to report medication trouble. Please send it in to keep the FDA apprised of the importance of life-sustaining medications to adrenal insufficient patients. (You can also report on line at www.fda.gov)
Best of health and luck to all,
Melanie Wong
Executive Director
National Adrenal Diseases Foundation
NADF does not engage in the practice of medicine. It is not a medical authority, nor does it claim to have medical knowledge. In all cases, NADF recommends that you consult your own physician regarding any course of treatment or medication.