Azmacort Substitute (Page 18)
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Azmacort has been taken off the market because of environmental concerns (they say). There really is NO substitute. All other steroids do not work. My wife could die because of it. No one seems to care. Do you?

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Dear Dale88:

I have contacted Abbott by phone and got a sympathetic ear from the bottom of the totem pole. I cannot seem to make contact with anyone making the decision to stop production. I suspect Abbott caved in for other reasons as well - like the drug, although expensive to the individual, was not all that profitable to the company.

I also called the National Jewish Hospital in Denver. They are supposed to have a new name but still answer to this one. They are regarded as the number one respiratory center in the US, and one of the best in the world. They gave me a list of alternative drugs to use -
* Asmanex® (mometasone)
* Alvesco® (ciclesonide)
* Flovent® (fluticasone)
* Pulmicort® (budesonide)
* Qvar® (beclomethasone HFA)
* Aerobid® (flunisolide)
* Azmacort® (triamcinolone)

Sounds good, doesn't it? I thought so too until I met with her doctor.

Her doctor is an absolutely superior diagnostician. She already knew about all the suggestions made by the Denver Hospital and had her reasons for choosing Azmacort. It would (and did) work for her. Apparently, the suggestions made by Denver are canned responses to the question of alternatives that most knowledgeable practitioners are trained to give.

I suppose a canned reply works in many cases where people can tolerate a range of options that my wife cannot. Her body rejects most medications.

In desperation, the doctor has my wife on Pulmicort but is rightly dubious. We have an appointment coming up and we will tell her that my wife is having a lot of trouble tolerating the drug - something we knew would happen. Sometimes she tries alternatives just to see if her body would get used to it or not. It never has.

Her doctor also had a comment about discontinuing the drug. She expressed disbelief that any company would unilaterally do such a thing. When I told her why they did it - to comply with the Montreal Accord reached on December 23, 2007, - her jaw dropped. There is no way that inhalers could possibly effect the ozone layer to such a degree that, if ceased, would make any difference at all. Even if it could, it would be so minuscule as to be non-existent.

We all suspect that the driving force behind it is politically driven. If they are successful, they stand to make a lot more money than Bill Gates ever could. Some of them have already made more than 1000 million! And it is still a hotly debated subject.

I found this out about CFC (chlorofluorocarbons) emissions: they were invented in the 1920's by Thomas Midgley for use in Air Conditioners (Freon). This man, along with the famous Charles Franklin Kettering, are the major (though dead) targets of the environmentalists. They are also credited with inventing leaded gas for cars and other disasters.

Our doctor does not think puffs on medical inhalers should factor into the case against CFC's. However, we do not have either the political clout nor the ear of those who are in power to make a difference.

Although we may disagree on some aspects of the work being done on CFC's, we can live with whatever the results may be - except where it concerns total elimination, and where it endangers the life of an individual.

What I am going to suggest in desperation is this:

Azmacort is generically called triamcinolone acetonide. It is a steroid that also comes in another form - a topically applied cream for various skin disorders. I wonder if it could be applied to the nostril and inhaled that way and, if so, how such a method could be regulated?

I told you, we are desperate. I love my wife and I want her to be able to live her full life. I do not want it to be cut short.

Jack

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Jack, so sorry to hear about the impact that Abbott's decision is having on your wife. It is sad that companies can create products which help individuals (and make individuals rely on them) and then just make such a decision to withhold it on a whim. Surely something can be done about this. I'd start by contacting Abbott and/or consulting with an attorney to see what can be done. Has her doctor recommended any substitutes yet? I know you said that nothing else works for her, but I would be curious to know what the doctor is recommending be done. Good luck and keep me posted!

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