Susan's Place Transgender Resources

So I was just recently prescribed Estrodiol Valerate 40mg/ml 5mg vials.  I'm switching over from Estrodiol pills.  Problem I'm running into now is Walgreens, Fry's, and CVS all do not carry Estrodiol Valerate injectables currently.  Something about their distributors not having the availability anymore.

So.. now what?  Has anyone else run into a non-availability of Estrodiol Valerate at their local pharmacy?

Quote from: Leeloo_Dallas on March 14, 2015, 10:43:55 AM
So I was just recently prescribed Estrodiol Valerate 40mg/ml 5mg vials.

40 mg/ml, 5 ML NOT mg for a total of 200 mg EV.

QuoteProblem I'm running into now is Walgreens, Fry's, and CVS all do not carry Estrodiol Valerate injectables currently.  Something about their distributors not having the availability anymore.

So.. now what?  Has anyone else run into a non-availability of Estrodiol Valerate at their local pharmacy?

Why not try a compounding pharmacy?
http://www.womensinternational.com/
http://www.collegepharmacy.com/
www.anazaohealth.com/

I just had my prescription filled by Costco. It took 2 days for it to come in but I got it without a problem. Hope that helps.

Lol, what doesn't Costco sell!  Didn't think of them.  Ill give that a shot.

Quote from: Jessie Ann on March 14, 2015, 10:59:02 AM
I just had my prescription filled by Costco. It took 2 days for it to come in but I got it without a problem. Hope that helps.

I get delestrogen at Walgreens. 40 mg/ml 5 ml vile for 200 mg per vile. The Walgreens is next to my PCP and a door connects the two. 

Quote from: Leeloo_Dallas on March 14, 2015, 11:17:59 AM
Lol, what doesn't Costco sell!  Didn't think of them.  Ill give that a shot.

Glad to be of help. Just remember it does come in the economy 1 gal size  :o  ........

Not really....

My Walgreens told me just this morning that their distributor no longer carries Delestrogen. :(

Quote from: Cynthia Michelle on March 14, 2015, 01:53:57 PM
I get delestrogen at Walgreens. 40 mg/ml 5 ml vile for 200 mg per vile. The Walgreens is next to my PCP and a door connects the two.

I'm being told by CVS that it (40mg 5ml) has been discontinued.  Just left a message to have my doctor call me.  I've been trying to get this refilled for 2 weeks and beyond stressed out at this point.   /:

Contact compounding pharmacies. ;)

One of the reason I am glad to be on Depo Estradiol (Estradiol Cypionate). Never had a shortage or any other problem. :)

Ok, so as of today I have contacted pharmacists at Costco, Walmart, Frys, CVS, and Walgreens.  All of these pharmacies have told me directly that they can no longer get Estradiol Valerate, or Delestrogen brand in any concentration. 

As far as compounding options go.  Because I live in the state of Arizona, Stroheckers will not ship here.  I also was advised by my endocrinologist that compounding although an alternative is less advised than remaining on estradiol pills for the time being.  :(

I'm curious to hear why the manufacturers of injectable estrogen have halted production.  If major pharmacies are discontinuing the product I would be cautious using them even if they were available elsewhere.   

Quote from: Leeloo_Dallas on March 16, 2015, 06:28:50 PM
I'm curious to hear why the manufacturers of injectable estrogen have halted production

They haven't. Estradiol Cypionate that I am on is still very available. I inject it once a week and have had zero ups and downs seen with the two week injections.

I am in Philadelphia and have no issue getting delestrogen. Although, the pharmacy I go to has thousands of trans customers.

Quote from: Leeloo_Dallas on March 16, 2015, 06:28:50 PM
Ok, so as of today I have contacted pharmacists at Costco, Walmart, Frys, CVS, and Walgreens.  All of these pharmacies have told me directly that they can no longer get Estradiol Valerate, or Delestrogen brand in any concentration. 

As far as compounding options go.  Because I live in the state of Arizona, Stroheckers will not ship here.  I also was advised by my endocrinologist that compounding although an alternative is less advised than remaining on estradiol pills for the time being.  :(

I'm curious to hear why the manufacturers of injectable estrogen have halted production.  If major pharmacies are discontinuing the product I would be cautious using them even if they were available elsewhere.

Estradiol Cypionate is readily available. I switched to it when I couldn't get Estradiol Valerate any more. My Endo had no problems making the switch at my request once we couldn't get a hold of the other. Based on the company that manufactures it I doubt it would ever disappear.
Mariah

Thank you for the Estradiol Cypionate suggestion.  I'm contacting my doctor to see if he can rewrite the script.  Never expected I would run into this issue, it's a bit irritating...

Tell me about it. I was irritated when this happened to me, but it happens and life goes on. You will make it through this smoothly and who knows your body may respond better to the new injection instead.
Mariah

Quote from: Leeloo_Dallas on March 16, 2015, 06:59:22 PM
Thank you for the Estradiol Cypionate suggestion.  I'm contacting my doctor to see if he can rewrite the script.  Never expected I would run into this issue, it's a bit irritating...

Quote from: Leeloo_Dallas on March 16, 2015, 06:28:50 PM
Ok, so as of today I have contacted pharmacists at Costco, Walmart, Frys, CVS, and Walgreens.  All of these pharmacies have told me directly that they can no longer get Estradiol Valerate, or Delestrogen brand in any concentration.......

That is really strange about Costco because I was able to pick mine up last Monday and I am in So Cal.  Maybe they are using a different supplier?  I have placed an order for a 3 months' supply (3 vials) through my insurance company's on-line pharmacy (which based on my actual prescription would last much longer) I should find out about that order in the next couple of days.  If that goes through I will be able to get my E for about $20 for the year.

I'm not sure if this helps, but I've had no issues getting depo estradiol (estradiol cypionate).  It may not be the same as estradiol valerate and different thing work on different people, but I have no complaints with that form of injections.

Anyway, I'm sorry that its been so hard to find your medication.  I'm surprised to read this as I wouldn't have expected for a hormone to be short in supply.  Hope it works out in the end for everyone.

I get my EV 20mg/ml 5 ml vial compounded at Stroheckers, my insurance wont pay for compounded meds though but its still cheaper than the copay I had when I was on EC (Depo Estrogen) >:(  I get my other scripts done at Targets pharmacy and I started on Delestrogen 10mg/ml 5ml vial, then that was "discontinued", then 20mg/ml 5ml vial then that too was discontinued >:( I was there the other day and since I still have script for it I asked if they could fill it in 10 or 20mg/ml.... NO, they had told me months ago it should be available in March 2015... Nada and they couldn't tell me when or even if it would ever be available :'( 

WTF ??? How can such a vital med just be "discontinued", I mean as much as they were getting for it its not likely they weren't making $$$ on it...  Its not some exotic med either so I dont get it literally, It really sucks :'(

Quote from: Jessica Merriman on March 16, 2015, 05:59:29 PM
One of the reason I am glad to be on Depo Estradiol (Estradiol Cypionate). Never had a shortage or any other problem. :)

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.  :(

Quote from: KayXo on March 17, 2015, 04:02:04 PM
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. :)

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. ;)

Quote from: KayXo on March 17, 2015, 04:02:04 PM
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

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  :P If EC works for you I see no reason to worry about anything...

I just wish they would get busy making my Delestrogen again :( :'(

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. 

I picked up delestrogen today at Walgreen's.

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???

Yes. It is 40 mg/ml.

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. :)

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.

Quote from: Nikki G on April 11, 2015, 06:38:08 PM
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 ;)

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 :)

Quote from: Eva on April 13, 2015, 08:45:41 PM
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.

There are always compounding pharmacies :)

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.

Quote from: - Rachel - on August 06, 2015, 10:46:05 AM
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. 

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.

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.   

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...

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.

Just got notified that my prescription auto renewal was shipped yesterday.  I'm going to have to turn that off now because I have enough E to last me into next year.  Apparently it is coming in and out of stock at places because I had received notice a few weeks ago that they couldn't fill the renewal.  Hard to figure out what is happening with all of this.

It seems Estradiol Valerate 40 mg/ml is available again. I just got my refill a few days ago. Yay!

Here's another indicator of what is happening in the world of these random-seeming shortages:

Google:
doctors without borders snakebite anti-venom

Essentially, just like with Estradiol Valerate and plain IV Saline bags, there just isn't enough profit in certain products compared to others (read: proprietary) that might be made in the same factory.  In the case of the article on DWB, it's the most effective snakebite anti-venom.  No one is manufacturing it anymore and stockpiles expire next June.  The one company that was making it stopped in order to make a rabies treatment instead.  Which is having it's own critical shortage and has since 2008.

IMO, this is what happens when governments decide that profits are more important than people.

It's up, it's down, it's in, it's out. Estradiol Valerate injectable, 40 mg/ml is back  on shortage (http://www.ashp.org/menu/DrugShortages/CurrentShortages/Bulletin.aspx?id=1186) again :(

"Perrigo has estradiol valerate 40 mg/mL 5 mL vials on back order and the company estimates a release date of mid-September 2015.
Par Sterile Products has Delestrogen 40 mg/mL 5 mL vials on back order and the company estimates a release date of late-4th quarter 2015 to January 2016."

Here is a method of obtaining your perscription for EV that prior to only a few days ago I did not know was possible.  So this is for those who are in the same lack of info bubble that I was in.

The other day my pharmacist left a message on my phone stating that my 40mg/ml EV perscription could not be filled due to unavailability (he did have 20mg/ml, which I did not want).  After the initial panic  :o I spent a little time spinning my wheels doing searches for reasons as to why this was so, then I decided to make some phone calls.  My own pharmacy being very small (only two locations), I called the last phamacy I used to use, Walgreens.  The lady was VERY helpful and said she was going to check her database to find some for me.  To my surprise she gave me a list of 5 Walgreen locations that actually had vials on their shelves, how many they had, and their phone numbers.  WOW, I called the one fairly close (about 25 miles away) and he said yes we have these and stated he would call my pharmacist to get a transfer of perscription, they would be ready for pick up in an hour.  Needless to say wild horses could not have kept me home  :laugh: and within an hour and a half I was driving home with my EV.  Hope this helps someone.  Apparently back order like Rachel stated above (who also might add helped me with the BO info, bless her heart), so all is not lost, it just takes a little leg work to solve.   Dani

Ok everyone, here's the deal. Delestrogen is the brand-name version of Estradiol Valerate. The concentrate for the formula comes from one or both of the labs who claim to have "difficulties" producing it since April.

Some Walgreens have vials on their shelves, and they will send them to other Walgreens pharmacies sometimes if someone at another WP has a script. Even if they do, ALL 40mg/ml manufacturers - there are only two - haven't been making it since April until a few days ago. According to the latest pharmaceutical update, Perigo now has a "limited supply" available of 40mg/ml Estradiol Valerate available http://www.ashp.org/menu/DrugShortages/CurrentShortages/Bulletin.aspx?Source=Current&Type=Rss&Id=1186#sthash.0PkR0uO2.dpuf (http://www.ashp.org/menu/DrugShortages/CurrentShortages/Bulletin.aspx?Source=Current&Type=Rss&Id=1186#sthash.0PkR0uO2.dpuf), What this means is that hospitals will get those vials, and those of us seeking 40mg/ml will still be taking part in a crapshoot to see whether any old ones are still around our area or not.

Allegedly, supplies will start to be released to pharmacies in early 2016, so we're months away from that still, if it happens at all.

Also, for those that use Strohecker's, they can't compound it anymore because 1) the ingredients they use aren't available, and 2) they're no longer going to be compounding due to releasing a batch of testosterone that contained estradiol - i'm not kidding here
http://www.accessdata.fda.gov/scripts/enforcement/enforce_rpt-Product-Tabs.cfm?action=select&recall_number=D-1088-2015&w=06032015&lang=eng (http://www.accessdata.fda.gov/scripts/enforcement/enforce_rpt-Product-Tabs.cfm?action=select&recall_number=D-1088-2015&w=06032015&lang=eng)

So, basically, *IF* your pharmacy has 40mg/ml on it's shelves, or another pharmacy in that chain locally has it, you'll probably get it. If you're looking for compounded, since they apparently use the "raw" estradiol made by the two companies who are claiming to be having difficulties, again, unless they have the ingredients on their shelf, you're going to be out of luck. And even when supplies are freely available again, you'll not be able to use Stroheckers.

Delestrogen isn't on my insurance plan, so the vials were more than $260 each. From Strohecker's, they were under $60 compounded. My last fill was 2 vials of 20mg from Stroheckers, and it was $300 so I opted for a single vial. I've been completely without estradiol for 4 weeks now, trying to sort this out.

Walgreens *usually* have the 20mg vials, and if they don't, they CAN get them. GoodRX has a coupon that brings each vial down to around $60 give or take:

http://www.goodrx.com/coupon/dispatch/_8EBJXF_6jGWhgZU90EkRw1EMHh1e1gPhdFP-twMNz-_Y-siAFAvzN8Sv5s5mojGav8Mhm9i-9izbkT12FSRxj0hlWZpwRuRcs09Jow= (http://www.goodrx.com/coupon/dispatch/_8EBJXF_6jGWhgZU90EkRw1EMHh1e1gPhdFP-twMNz-_Y-siAFAvzN8Sv5s5mojGav8Mhm9i-9izbkT12FSRxj0hlWZpwRuRcs09Jow=)

I haven't used this yet, but have Googled it and found many instances of people who have, so it appears to be legit. I just had my provider call in a script to Walgreens for me, and they're out of stock, at least in my Walgreens - which means it'll be a few days before I can see whether the coupons really work or not, so YMMV.

HTH,
Kelsie

I went to pick up my first prescription of estradiol valerate 40 mg/ml 5ml and they said they'd have to order it and it'd be there on the 6th. Went back on the sixth and they said they didn't receive it so they'd have to re-order it. At this point, I'm not expecting that it'll actually ever get there. This sucks.

Is there also a shortage of pills, or just the injections?

My doctor told me that Strohecker's problem with compounding was contamination in the oil used for the suspension and that was cleared up and they are once again selling Estradiol injectable.

I had my prescription filled three times now since Oct. 7 from my pharmacy and received Perrigo 40 mg/ml vials exp date 6/2017. I just received my current refill Mon. 11/30/2015

This site  (http://www.ashp.org/menu/DrugShortages/CurrentShortages/bulletin.aspx?id=1186) seems to indicate the  Perrigo 20 mg/ml and 40mg/ml are on allocation.

AFAIK, tablets are not on shortage.