Parkinson's Disease Support Group
Parkinson's disease is a movement disorder often characterized by muscle rigidity, tremor, a slowing of physical movement, and in extreme cases, a loss of physical movement. The primary symptoms of Parkinsons are due to excessive muscle contraction, normally caused by the insufficient formation and action of dopamine, which is produced in the dopaminergic neurons of the...
Hello Everybody,
I've been on the Neupro patch for a couple years, starting at 2 mg and increasing as needed (with Dr. supervision, of course). This last increase in November put me up to 10 mg, which is higher than the company makes and requires an 8 mg patch plus a 2 mg patch. I had to pay the copay twice. I've asked the doctor's office to write the script out to cover both under one prescription. They said they'd try, but didn't know if it would work or not.
So, I'm wondering if anyone on here is using the higher doses of Neupro? If so, how are you getting around the double copay? And out of curiosity, how high of a dosage could I expect to get to before I have to switch to something else? The package insert has maximum dosage at 8 mg.
Thanks,
I've been on the Neupro patch for a couple years, starting at 2 mg and increasing as needed (with Dr. supervision, of course). This last increase in November put me up to 10 mg, which is higher than the company makes and requires an 8 mg patch plus a 2 mg patch. I had to pay the copay twice. I've asked the doctor's office to write the script out to cover both under one prescription. They said they'd try, but didn't know if it would work or not.
So, I'm wondering if anyone on here is using the higher doses of Neupro? If so, how are you getting around the double copay? And out of curiosity, how high of a dosage could I expect to get to before I have to switch to something else? The package insert has maximum dosage at 8 mg.
Thanks,
The dose recommendations made are in nominal dose.
Dosing in patients with early stage Parkinson's disease:
A single daily dose should be initiated at 2 mg/24 h and then increased in weekly increments of 2 mg/24 h to an effective dose up to a maximum dose of 8 mg/24 h.
4 mg/24 h may be an effective dose in some patients. For most patients an effective dose is reached within 3 or 4 weeks at doses of 6 mg/24 h or 8 mg/24 h, respectively.
The maximum dose is 8 mg/24 h.
Dosing in patients with advanced stage Parkinson's disease with fluctuations:
A single daily dose should be initiated at 4 mg/24 h and then increased in weekly increments of 2 mg/24 h to an effective dose up to a maximum dose of 16 mg/24 h.
4 mg/24 h or 6 mg/24 h may be effective doses in some patients.
For most patients an effective dose is reached within 3 to 7 weeks at doses of 8 mg/24 h up to a maximum dose of 16 mg/24 h.
Neupro treatment initiation pack contains 4 different packages (one for each strength) with 7 patches each, for the first four weeks of therapy.
Depending on the patient's response, not all of the following dose steps may be required or additional higher doses may be needed after week 4, which are not covered by this package.
On the first day of treatment the patient starts with Neupro 2 mg/24 h. During the second week, the patient takes Neupro 4 mg/24 h. During the third week, he or she takes Neupro 6 mg/24 h and during the fourth week Neupro 8 mg/24 h. The packages are marked with Week 1 (2, 3 or 4).(Last Updated on eMC 26-Jun-2015 View changes | www.medicines.org.uk)
Procedure:
1. Copay Reimbursement
If the member goes to the pharmacy to obtain a dosage of a medication that can only be
obtained by using 2 different strengths, the member will have to pay the copays at the point of
sale and submit a receipt for reimbursement for one of the copays.
Hope this helps..
Brer Terrapin
stay strong
BT
BT
If the max dose is 16, and I'm currently at 10, I may not have too much longer on this particular med. Time will tell. It works well for now.
BT
Thanks for the tip.
I did call the insurance company. If I needed 12 mg a day, they'd be fine with combining two 6 mg under one RX. I could even get three 4mg for a dosage of 12 mg As long as the med is exactly the same, the quantity can be whatever the doc prescribes. It's just too bad for me at the moment that I only need 10 mg and there are no 5 mg patches.
In all seriousness, thank you also for the note on compulsive behaviors. I did have to laugh though, since it's just following the holiday season and I did overspend (again), overeat (again), and spend too much time in front of the TV (again). Noting that those are all normal behaviors, I think I'm safe for now. As the calendar turns, I am back on budget, back to normal eating, and will soon be back to work (eliminating the TV habit. But I will keep an eye on my habits as I do have compulsive tendencies.
It sounds like congratulations are in order on your DBS. Continued good/better health to you.