Estrodiol Valerate shortage?

[Jessica Merriman]

What I personally don't like about Estradiol Cypionate is that I suspect that it may be somewhat harmful in terms of clotting.

Not according to my Endo who is a M.D. and has treated many other trans patients. She says the risk is the same for both. She is the sole provider for the OKC trans community.

[KayXo]

I'm not sure I personally agree with your doctor. Doctors make mistakes too and sometimes are ignorant of certain things. If you explain it to her how I explained it, she may perhaps consider the possibility. Not saying I'm right either and I'm certainly no doctor but still...it makes one wonder...One way to find out is to test clotting factors and see what the results are. On a large scale would obviously be ideal.

As always, follow your doctor. I'm simply sharing here.

[Newgirl Dani]

What I personally don't like about Estradiol Cypionate is that I suspect that it may be somewhat harmful in terms of clotting. The reason being that... (and, no, I'm not a doctor, BUT)

at the same dose of EC (Estradiol Cypionate) and EV (Estradiol Valerate), they yield about the same levels of estradiol and yet EC doses prescribed for the same condition in ciswomen compared to EV doses are 10x less which would suggest EC does not only affect estrogen receptors through converting to estradiol after the ester is cleaved (cypionate) but that EC acts unchanged with its ester still present on estrogen receptors, therefore potentially overstimulating receptors, much like ethinyl estradiol does. Not good. 

I've read this same information back when I was investigating my best route for hrt.  Unfortuneately I cannot remember where I found this info, should not be hard to reestablish the link though.   I still use EV.   Dani

[Eva]

Strange, I looked high and low for anything I could find on the difference between EC and EV and I never found much on the differences between EV and EC... Ive tried both though and Ive felt better and feel like EV is more effective for me but thats just my opinion not backed by much  If EC works for you I see no reason to worry about anything...

I just wish they would get busy making my Delestrogen again

[Jessie Ann]

To follow up to my post earlier this month, I submitted my request for my Estradiol Valerate to my Insurance Company's on-line pharmacy company (I can get 3 months supply for a single co-pay through them) and they called me back and said that it is not being manufactured any more.  I called Costco yesterday to get a renewal on the prescription I had filled with them earlier in the month and picked it up on the way home tonight.  Something weird is going on with the supply. 

[Rachel]

I picked up delestrogen today at Walgreen's.

[Eva]

OK Im assuming those that are getting Delestrogen scripts filled are getting the 40mg/ml concentration??? Has anyone been able to get it in 10 or 20mg/ml???

[Rachel]

Yes. It is 40 mg/ml.

[Mallory]

I tried several places in Anchorage and no one has 10mg/mL. The wholesaler that distributes to Carrs, Walgreens, and Bernie's have a supply of 20mg/mL, but has said 10 is on backorder due to the manufacturer having issues with production.

That's as much info as I've been able to squeeze out of everyone after being on the phone all day. If you cant get 10mg/mL ask the pharmacist if they have 20 or 40; if they do its still easy to get the right dose in a syringe.

[Sydney_NYC]

I recently found out that Delestrogen Brand of Estradiol Valerate is now only available in the 20mg/mL variety as they have discontinued the 10mg/mL and 40mg/mL varieties. I believe the generic version from JHP Pharmaceuticals is still making other varieties since a friend of mine just got her 40mg/mL vile.

[Eva]

I tried several places in Anchorage and no one has 10mg/mL. The wholesaler that distributes to Carrs, Walgreens, and Bernie's have a supply of 20mg/mL, but has said 10 is on backorder due to the manufacturer having issues with production.

That's as much info as I've been able to squeeze out of everyone after being on the phone all day. If you cant get 10mg/mL ask the pharmacist if they have 20 or 40; if they do its still easy to get the right dose in a syringe.

Hmm Im gonna have to try again then, my script is for 20mg/ml but I haven't been able to get it since last fall    I have it custom compounded but my insurance refuses to cover any compounded meds

I wasn't aware there was a "delestrogen" brand, I thought it was just what they called generic EV  

I was getting it through JHP pharmaceuticals and my old insurance at least covered a lot of it but with a pretty big copay.... 

Id have a hard time getting my prescribed dosage every five days at 40/mg/ml and I prefer 10mg/ml but the 20mg/ml works...

I get the compounded EV here, its good stuff 

http://www.stroheckersrx.com/estradiol-valerate-compound.php

It's 111.00 for a 5ml 20mg/ml vial and injection supplies shipped to my door... The 40mg/ml 10ml vial for $59.00 looks like a hell of a deal though so Im thinking Im gonna ask my doc if we can do an increase in dosage and try that and look into getting the 40 mg/ml Delestrogen covered by my insurance

[Eva]

Well I was at the pharmacy today and I checked and they said they can get only the 20mg/ml Delestrogen no 40mg/ml or 10mg/ml...  Gonna get my doc to call it in tomorrow and see if my new insurance will cover it

[Mallory]

Well I was at the pharmacy today and I checked and they said they can get only the 20mg/ml Delestrogen no 40mg/ml or 10mg/ml...  Gonna get my doc to call it in tomorrow and see if my new insurance will cover it

Hope you hear some good news tomorrow! It took me from last Wednesday until this afternoon to find 20mg/mL. I was fairly persistent with phone calls, emails, and everything else too. I just hope the manufacturer doesn't quit making it altogether.

[KayXo]

There are always compounding pharmacies

[- Rachel -]

I'm having trouble getting my script for Estradiol Valerate 40 mg/ml filled here in Seattle. The pharmacy says it's out of stock and can't order it. I have enough left for one injection and I'm starting to panic. My doctor says there are chronic shortages.

[frances_larina]

I'm having trouble getting my script for Estradiol Valerate 40 mg/ml filled here in Seattle. The pharmacy says it's out of stock and can't order it. I have enough left for one injection and I'm starting to panic. My doctor says there are chronic shortages.

Consider asking your doctor to switch it to Estradiol Cypionate.   Same estrogen, different carrier, no shortages.  The most noticeable difference I've found is that with EV, about a day later it would hit me all at once.  While the euphoria was sometimes nice, it was distracting and the end of week crash was just as abrupt.  EC releases more slowly; for me that means a much more steady delivery. 

[Rachel]

My pharmacy has been out for a little while. I switched to 20 mg/ml. I was told the 40 MG/ML will be in production in 1/2016.

[Jessie Ann]

I guess I got really lucky. My insurance company's mail order pharmacy was able to fill my prescription and sent me 3 vials of the 40 mg/mL Perrigo EV for only a $10 co-pay.  That is more than enough to last me over 6 months.  So I should be ok until production picks back up.  I also got enough progesterone to last that same time frame. 

Good luck ladies.  It should not be this hard to get the medication necessary for our treatment.   

[frances_larina]

Google:
estradiol valerate shortage
and one of the first results is ashp dot com, which states this:

Estradiol Valerate Injection
[17 June 2015]
Products Affected - Description

Estradiol Valerate Injection, Perrigo
40 mg/mL, 5 mL vial, 1 count (NDC 00574-0872-05)

Delestrogen Injection, Par Sterile Products
40 mg/mL, 5 mL vial, 1 count (NDC 42023-0112-01)

Reason for the Shortage

    Par states the reason for the shortage is manufacturing delay.
    Perrigo states the reason for the shortage is manufacturing issue.

Available Products

Estradiol Valerate Injection, Perrigo
20 mg/mL, 5 mL vial, 1 count (NDC 00574-0870-05)

Delestrogen Injection, Par Sterile Products
10 mg/mL, 5 mL vial, 1 count (NDC 42023-0110-01)
20 mg/mL, 5 mL vial, 1 count (NDC 42023-0111-01)

Estimated Resupply Dates

    Perrigo has estradiol valerate 40 mg/mL 5 mL vials on back order and the company estimates a release date in August 2015.
    Par Sterile Products has Delestrogen 40 mg/mL 5 mL vials on back order and the company estimates a release date in January 2016.

-------------------------------------

And according to a SF Chronicle article from June, it is implied that despite manufacturers claiming production difficulties, for some reason it is the lower profit generics (vs high profit proprietary drugs) that remain perpetually or cyclically on the shortage lists.  I'm guessing drug companies like to keep the factories at capacity with the high profit stuff and although estradiol valerate is important to some people and saline IV bags to others, neither provides as high a return on shareholder investments as some of the newer customized drugs...

[Cindy Stephens]

tried to renew my compounded prescription at Stroeheckers today.  They do not have the generic compounded product, only the brand name item at a much higher cost.  The pharmacist said that they had been asked not to compound estradiol until the state gives some sort of OK.  Bummer.