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Background:
In 2002 the FDA made a ruling that changed the guaifenesin protocol substantially. The many brands of generic prescription long acting guaifenesin were taken off the market. A more expensive (but over the counter) product, Mucinex (Adams Labs) was approved in their place. Although Mucinex is considered a replacement for what had been on the market for so long it really isn’t quite the same. Mucinex is actually a bi-layered tablet with a short acting layer as well as a timed release component.
We were suddenly faced with a dual challenge: trying to figure out how this might be different from what we’d been using and what to do for the people for whom this higher price was a real hardship. Many of Dr. St. Amand’s patients were able to stock up on the older prescription brands. But now those supplies are gone and countless new and old patients have helped us learn what follows.
We’re finding it’s no longer necessary to use the high doses of guaifenesin we often utilized in the past. To our surprise, short acting guaifenesin when added to long acting has proven a very effective delivery system. We believe this is due to the action of the cytochrome system.
We start patients with 300 mg twice daily guaifenesin. This should NOT be a short acting (or quick release) product. Use Mucinex (or the Pro Health 600 mg. product) or one of 600 tablets listed below. Only 20 percent of patients respond at 300 mg. twice a day. We do not use lower doses than that.
Patients remain at 300 mg. twice a day for ONE WEEK. If the patient doesn't feel worse, we ask him or her to increase the dose to 600 mg twice a day. 600 mg. twice a day is the correct dose for one month.
If the left thigh has not cleared after one month, or a patient notices no change in symptoms, the dose needs to be raised again. If a patient is taking Mucinex or Pro Health, he or she should go to 3 tablets a day. (can be taken as 1-2 or 1 1/2 twice a day.)
If the patient is taking a single layered guaifenesin the dose can be raised by adding a 400 mg. short acting twice a day to the 600 mg. or by adding another 600 mg. tablet.
However, if a higher dose is needed we use short and long acting (2 each, twice a day). This combination is working very well and seems to be handling between 90-95% of our patients. If money is not an issue, 2400 mg. of Mucinex with its two layers accomplishes the same thing.
Available Guaifenesin:
OVER THE COUNTER GUAIFENESIN SUITABLE FOR THE GUAIFENESIN PROTOCOL. USE THE SOLOGUAI SIX TO BEGIN WITH:
FROM CLEURE:
Only Cleure guaifenesin sales benefit The Fibromyalgia Treatment Center. Order with the link below or on the homepage. If ordering by telephone mention The Treatment Center. 888-883-4276. Cleure also carries salicylate free dental products, personal care items, make up, etc.
SOLOGUAI SIX:
600 mg. guaifenesin. Ingredients: stearic acid, dicalcium phosphate, croscarmellose sodium, microcrystalline cellulose, silica.
www.cleure.com/ftc
SOLO GUAI FAST ACTING —
400 mg guaifenesin calcium phosphate dibasic, magnesium sterate, microcrystalline cellulose, Poridene K-30, prosolv, stearic acid.(www.cleure.com/ftc)
Cleure guaifenesin is latex exposure free.
CLEURE SOLOGUAI SIX IS CURRENTLY ON BACK ORDER.
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MARINA DEL REY PHARMACY COMPOUNDED GUAIFENESIN
IF YOUR DOCTOR WILL WRITE A PRESCRIPTION FOR GUAIFENESIN YOUR INSURANCE MAY COVER IT IF YOU HAVE COVERAGE FOR COMPOUNDED DRUGS OR IF YOU HAVE FLEXIBLE SPENDING BENEFITS. YOUR PRESCRIPTION SHOULD READ: GUAIFENESIN 6OO MG. DYE FREE. CONTACT MARINA DEL REY PHARMACY FOR MORE INFORMATION.
IF YOU LIVE IN THE UK YOUR IMPORT DUTIES WILL BE SUBSTANTIALLY LESS IF YOU HAVE A PRESCRIPTION FOR GUAIFENESIN AND ORDER IT THIS WAY.
THESE PRODUCTS ARE ALSO AVAILABLE OVER THE COUNTER AS OF MAY 2008.
GUAIFENESIN—DYE FREE 600 mg
Microcrystaline Cellulose, Stearic Acid, DiCalcium Phosphate, Magnesium Stearate. (www.fibropharmacy.com)
FAST-ACTING- FIBROPHARMACY GUAI 400 QA- Stearic Acid, Dicalcium Phosphate, Croscarmellose, Sodium and Silica. (www.fibropharmacy.com)
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PRO-HEALTH (IMMUNE-SUPPORT)
ProHealth product sales always benefit fibromyalgia and chronic fatigue research and awareness.
COMBINATION LONG ACTING/SHORT ACTING IN ONE PILL
Pro Health 600 mg. Extended Release Formula.*
Inactive ingredients: carbomer 934P, dyes, hydroxypropyl methylcellulose, USP, magnesium stearate,, microcrystalline cellulose, sodium starch glycolate. (for ProHealth: www.immunesupport.com)
*this is the same product as Mucinex, the FDA approved bi-layered guaifenesin
FAST ACTING: Pro Health Guaifenesin FA 400 mg
Inactive Ingredients: Collodial silicon dioxide, maltodextrin, microcrystalline cellulose, povidone, sodium saccharin, sodium starch glycolate, stearic acid, talc and vanillin.(www.immunesupport.com)
Local Pharmacies/Online Pharmacies (e.g. drugstore.com)
COMBINATION LONG ACTING/SHORT ACTING IN ONE PILL
Mucinex 600 mg. Extended Release Formula.
Inactive ingredients: carbomer 934P, dyes, hydroxypropyl methylcellulose, USP, magnesium stearate,, microcrystalline cellulose, sodium starch glycolate.
COMBINATION LONG ACTING/SHORT ACTING IN ONE PILL
Humibid 1200 mg Extended Release bi-layered tablet. Inactive ingredients: carbomer 934p, NF, Green lake blend, hypromellose, USP, magnesium stearate USP, microcrystalline cellulose NF,sodium starch glycolate.
Other Products:
LIQUID GUAIFENESIN: These two formulas do not contain mint or menthol. If using any other liquid guaifenesin be sure to check ingredients to make sure there is no menthol listed or as an ingredient in the flavor:
Children’s Mucinex Grape Flavor. 1 tsp contains 100 mg of guaifenesin. Alcohol free. Inactive ingredients: citric acid anhydrous, dextrose, FD&C Blue #1, FD&C red #40, flavor, glycerin, methylparaben, potassium sorbate, propylene glycol, propyl paraben, saccharin sodium, sodium hydroxide, sucralose, xanthan gum, water. Salicylate free
Marina del Rey Pharmacy also carries a liquid guaifenesin. For information please contact them directly: (www.fibropharmacy.com )
For those with stomach upset, Marina del Rey pharmacy carries a gelatin capsule that will fit around their compounded guaifenesin tablet.
JUNIOR STRENGTH Mucinex Mini-Melts (for older kids) –fast acting. Take every four hours
Mucinex Grape Mini Melts: 50 mg of guaifenesin per packet. Inactive ingredients: aspartame, butylated methacrylate copolymer, carbomer, carboxymethylcellulose sodium, grape flavor, magnesium stearate, microcrystalline cellulose, povidone, raspberry flavor, sodium bicarbonate, sorbitol, stearic acid, talc, triethyl citrate. Salicylate free.
Mucinex Bubble Gum Flavor Mini Melts: 100 mg. of guaifenesin per packet. Inactive Ingredients: aspartame, banana flavor, butylated methacrylate copolymer, carbomer, carboxymethylcellulose, sodium, magnesium stearate, microcrystalline cellulose, povidone, sodium bicarbonate, sorbitol, stearic acid, talc, triethyl citrate, tutti frutti flavor. (Salicylate free)
NOTE: Children’s Mucinex Cough (Cherry) is not plain guaifenesin --contains dextromethorthan.
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