Remember the issue I had with Sotalol at the start of this year?
The problem had been the milk sugar used as filler, like that's a viable use of lactose with medications for those having heart problems.
Well, when the VA sent my last refill of Sotalol, it was the lactose-containing variety.
I contacted the VA pharmacy.
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9 August 2023
1158
"The new prescription of Sotalol which I received is a different color and consistency than that I had previously. I know from prior experience, when I was receiving this Rx from the Publix Pharmacy, that this new form of Sotalol has lactose as the filler.
I am lactose intolerant.
That means that I will have to take Lactaid, or some other compound with the lactase enzyme, in order to take the recommended dosage of Sotalol. Moreover, I would need to take the Lactaid twice daily to counter any ill effects of the lactose filler in the medicine which I take for atrial fibrillation.
I hereby request Sotalol from a different supplier, such as APOTEX, which does not use lactose as the filler.
Thank you,
Faustina Smith"
"The new prescription of Sotalol which I received is a different color and consistency than that I had previously. I know from prior experience, when I was receiving this Rx from the Publix Pharmacy, that this new form of Sotalol has lactose as the filler.
I am lactose intolerant.
That means that I will have to take Lactaid, or some other compound with the lactase enzyme, in order to take the recommended dosage of Sotalol. Moreover, I would need to take the Lactaid twice daily to counter any ill effects of the lactose filler in the medicine which I take for atrial fibrillation.
I hereby request Sotalol from a different supplier, such as APOTEX, which does not use lactose as the filler.
Thank you,
Faustina Smith"
- - -
Within just a few hours, I had a response, with the conversation going back and forth.
- - -
9 August 2023
1544
"Ms. Smith,
Have you tried taking the sotolol with the lactose filler without taking any Lactase? Generally the amount of lactose used as a tablet filler is so small that it does not cause any symptoms or reactions in people that are lactose intolerant. If it causes any GI upset you should take Lactase with it. Do NOT stop the sotolol! Let me know how it goes without the Lactase.
Regards,
Natalie Kurtkaya, PharmD, BCACP"
- - -
10 August 2023
"Ms. Smith,
Have you tried taking the sotolol with the lactose filler without taking any Lactase? Generally the amount of lactose used as a tablet filler is so small that it does not cause any symptoms or reactions in people that are lactose intolerant. If it causes any GI upset you should take Lactase with it. Do NOT stop the sotolol! Let me know how it goes without the Lactase.
Regards,
Natalie Kurtkaya, PharmD, BCACP"
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10 August 2023
0047
"Will do.
My cardiologist has me on a half-dosage right now, so I have not had an issue yet.
However, when I had this Rx before with this lactose filler and was on the cold-weather dosage of 80 mg twice daily, I was definitely having problems with diarrhea and abdominal bloating. That's what led me to research the med and that's when I found that TEVA USA - the supplier - uses lactose as the filler. APOTEX, the supplier I had at first, did not use the lactose as a filler."
- - -
10 August 2023
"Will do.
My cardiologist has me on a half-dosage right now, so I have not had an issue yet.
However, when I had this Rx before with this lactose filler and was on the cold-weather dosage of 80 mg twice daily, I was definitely having problems with diarrhea and abdominal bloating. That's what led me to research the med and that's when I found that TEVA USA - the supplier - uses lactose as the filler. APOTEX, the supplier I had at first, did not use the lactose as a filler."
- - -
10 August 2023
1050
"Ms. Smith,
Please continue to take the prescribed dose of the sotalol. If you need to take Lactaid with it please do so. If you need more Lactaid let me know and I can send you some. I will reach out to our purchasing department and see if we can get a lactose free form of sotalol. We are often restricted on which brands of medications we can purchase based on contracts between the VA and drug manufacturers, so I can't promise we can get a lactose free form. I expect it to take some time to determine whether we can get a lactose free form of sotalol so please continue to take the ones you have (with Lactaid if needed).
Regards,
Natalie Kurtkaya, PharmD, BCACP"
- - -
10 August 2023
"Ms. Smith,
Please continue to take the prescribed dose of the sotalol. If you need to take Lactaid with it please do so. If you need more Lactaid let me know and I can send you some. I will reach out to our purchasing department and see if we can get a lactose free form of sotalol. We are often restricted on which brands of medications we can purchase based on contracts between the VA and drug manufacturers, so I can't promise we can get a lactose free form. I expect it to take some time to determine whether we can get a lactose free form of sotalol so please continue to take the ones you have (with Lactaid if needed).
Regards,
Natalie Kurtkaya, PharmD, BCACP"
- - -
10 August 2023
1355
"Will do.
Thank you."
- - -
11 August 2023
"Will do.
Thank you."
- - -
11 August 2023
1129
"Ms. Smith,
The purchasing team has identified the reason the sotalol brand was changed. Unfortunately the Apotex brand is unavailable from the manufacturer. I'm not sure if this is temporary or if the Apotex has permanently discontinued making sotalol. The mail order pharmacy has switched to a new brand of sotalol that contains lactose. We are going to change your sotalol prescription so that is not filled at the mail order pharmacy but instead filled at the Charleston VA hospital pharmacy (your refills will still be mailed to you, just from a different pharmacy). The purchasing team is going to work to source a lactose free form of sotalol for the Charleston VA hospital pharmacy on an ongoing basis. If a lactose free form of sotalol is available (may be Apotex or a different brand), we will fill your prescription with it. However, if a lactose free form of sotalol is not available, we will fill your prescription with whatever brand we can get. Please continue to take your sotalol as prescribed. If you experience any GI upset, please take the Lactaid with each dose of sotalol. If taking the sotalol becomes problematic, please speak with your cardiologist about other medication options.
Regards,
Natalie Kurtkaya, PharmD, BCACP"
"Ms. Smith,
The purchasing team has identified the reason the sotalol brand was changed. Unfortunately the Apotex brand is unavailable from the manufacturer. I'm not sure if this is temporary or if the Apotex has permanently discontinued making sotalol. The mail order pharmacy has switched to a new brand of sotalol that contains lactose. We are going to change your sotalol prescription so that is not filled at the mail order pharmacy but instead filled at the Charleston VA hospital pharmacy (your refills will still be mailed to you, just from a different pharmacy). The purchasing team is going to work to source a lactose free form of sotalol for the Charleston VA hospital pharmacy on an ongoing basis. If a lactose free form of sotalol is available (may be Apotex or a different brand), we will fill your prescription with it. However, if a lactose free form of sotalol is not available, we will fill your prescription with whatever brand we can get. Please continue to take your sotalol as prescribed. If you experience any GI upset, please take the Lactaid with each dose of sotalol. If taking the sotalol becomes problematic, please speak with your cardiologist about other medication options.
Regards,
Natalie Kurtkaya, PharmD, BCACP"
- - -
I didn't really expect anything to come of the matter, but at least I had spoken up and spoken out about the matter.
Time marched on, as it does, with me going through the latest batch of Sotalol.
Time arrived to order a refill of that medication, as well as a few others.
The package arrived yesterday while I was at NCG with Barbara for a Tina Tuesday movie, this time being "Bottoms", a fun flick about high school lesbians who start a fight club at their school in order to get close to some cheerleaders.
Very funny!
And, it's another one produced by Elizabeth Banks!
That's right - the emcee for "Press Your Luck"!
(smile!)
Anyway... as I said, the package had been left on my porch.
I didn't bother to open it last night, I just took it into the kitchen.
Today, when I did open it up, there were my three prescriptions I'd ordered.
That was good.
Then, as I was putting them away, I noticed the Sotalol looked different.
The pills were WHITE, not that odd bluish color.
Could it be that they were the lactose-free type???
They were!
They were!!
I was elated!!!
Not only because this batch wouldn't give me GI distress, but mostly because the person I had contacted at the VA had actually LISTENED to this GI!
Wow.
So, I sent another message to the very helpful pharmacist.
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"13 September 2023
1115
Dear Natalie Kurtkaya,
My refill of Sotalol arrived yesterday and I was THRILLED to find it was the lactose-free formulation.
THANK YOU for making that happen.
I cannot tell you how much it means to me that you listened to my concerns and then resolved the issue.
THANK YOU!
Faustina Smith"
Dear Natalie Kurtkaya,
My refill of Sotalol arrived yesterday and I was THRILLED to find it was the lactose-free formulation.
THANK YOU for making that happen.
I cannot tell you how much it means to me that you listened to my concerns and then resolved the issue.
THANK YOU!
Faustina Smith"
- - -
Again I say, thank you Natalie Kurtkaya.
Your help is most appreciated.
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