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Testosterone shortage


Testosterone shortage

Delatestryl users urged to speak to their doctor
A manufacturing delay that has created a shortage of the injectable testosterone drug Delatestryl has left many trans men scrambling to find alternatives.
A registered nurse with the Sherbourne Health Centre’s LGBT Primary Care program says users should not wait for the drug to reappear.
“They should be coming in to see their physicians or nurse practitioners because they can be switched to a different compound,” says Mary Potter. “The issue is when they don’t come to see us . . . they’re told by the pharmacy that they just don’t have it and people are waiting without the medication.”
Potter says waiting, rather than finding an alternative drug, can result in a lapse of the medication’s effects.
She says this is the second shortage this year.
Xtra spoke with five Toronto pharmacies which all had Delatestryl on back order.
However, another injectable testosterone, Depo-Testosterone (testosterone cypionate), is available. The concentration of the active ingredient is lower in Depo-Testosterone, so injections may be more uncomfortable.
A topical gel and patch are also available, although they are significantly more expensive, says Adam Silvertown, pharmacy manager at Pace Pharmacy. He says the transdermal patch, known as Androderm, can cost users as much as $160 a month.
A month’s supply of Delatestryl is cheaper, around $60.
Theramed, the former manufacturer of Delatestryl, recently sold product rights to Valeant International, another drug distributor.
Carine Remolien, a pharmacological coordinator for Valeant Canada, says the product is unavailable because of a “manufacturing delay.”
“The product might be available January 15,” she says.
Jeff Morrison, director of government relations and public affairs for the Canadian Pharmacists Association, says, “there’s no requirement on the part of manufacturers or industries to disclose why a particular drug is in short supply.”
He says a new reporting system for shortages will allow pharmacists to anticipate problems in advance.
Morrison thinks government should pressure drug manufacturers to maintain a steady supply of their products. “Provincial governments . . . are big purchasers of drugs for their public drug plans. A lot of the contracts provinces have with manufacturers, there are clauses that mandate [drug companies to] maintain certain supply levels,” he explains. “The problem is a lot of provinces just don’t enforce those.”
A 2010 Canadian Pharmacists Association report found that 91 percent of pharmacists said drug shortages “inconvenienced” their patients, while 70 percent said patients’ health outcomes were “adversely affected” by shortages.
“In a lot of cases, patients are the ones sort of having to run back and forth between their doctor’s office and their pharmacy to get a new prescription and they’re saying it’s a huge inconvenience,” Morrison says.
Benjamin Vandorpe was lucky. He filled his prescription before learning the medication was on back order in Toronto. The Nova Scotia native says he first heard about the shortage from friends in that province. When he learned many Toronto pharmacies were also out of stock—and could be for about another month—he decided to call the suppliers to ask what was causing the hold-up.
Vandorpe thinks Valeant and Theramed should have notified users of the drug about the hiccup. “Even just a note on the website explaining the situation would have been great, especially since there is only one person who deals with inquiries about medications, and she's out of the office until January,” he says.
“A lot of people depend on this medication for physiological, mental, and emotional well-being,” he adds. “There are so few doctors who are willing to prescribe it to trans-identified individuals that it's a serious inconvenience to have to seek out another medication.”
Potter agrees. “It is quite disruptive,” she says. “Trans people have to fight so hard just to get that medication in the first place . . . putting people through these gaps or making them struggle to get a medication is just kind of unreasonable.”
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Held hostage
So if I understand correctly, Canadian production is stopped because of an American problem? Because somehow the FDA is questioning Canadian plant quality? How can that be? Sounds more like an excuse to postpone production for another nefarious reason. Come on! How can another country impose that just like that? The Canadian plant could at least continue production for Canadians and simply exclude exporting to the States.
CBC story on Sandoz Canada
Further to Joshua's last post, the CBC website has a story on how Sandoz Canada announced Sunday it was temporarily suspending production at its Boucherville, Que., facility and how this has led to fears that there will be a critical shortage of injectable medicines nationwide.
Sandoz Suspends Production
The situation for Canadian men on testosterone got worse today with the news that Sandoz is suspending production due to FDA warnings about their facility in Quebec. There are now just two brands of injectable T in Canada and neither are available. Rumor has it that Pfizer will be back on the shelves first, hopefully by mid-March, but no one knows for certain.


If you've run out, pick up a phone book and start calling every pharmacy in your area. You may need to look out of town too. That's what I had to do to find a single vial.
lost the battle
i was taking 2and 1/2 cc every two weeks,im 54yrs old and was given a cowboy boot,right in the testy area,you want to talk pain,even after this happened my i noticed that something was not right,i saw a urallagest he put my on delatestryl at that dosage now i get two shots from that bottle,then i need another.were am i going to get this drug when they dont make it anymore,even a shortage put me in a bad way that meens that i have to take with old stuff two shots 2&1/2 in each check
Just got a call last night from my pharmacy, they can't fill my Delatestryl order until unknown.

Now I roam Ottawa trying to find somewhere that has a vial. Or I've got to go back to Andriol (12 pills a day at nearly two bucks a pill... ugh).
Your pharmacist and your GP sound clueless. Depo is half the concentration of Delatestryl, so the dose is simply double the volume of what you were taking.

1cc of Dela = 200mg
1cc of Depo = 100mg
2cc of Depo = 200mg

Sorry you got such a run around. And what a waste of health care resources. The doc's and endo's input is not required for this simple math.

By the way, Delatestryl and Depo are still out of stock. See:
increase testosterone in men." Unfortunately, while that headline and the opening paragraph are likely to grab readers' attention, it's an overstatement of the actual published research, in which the authors were careful not to draw any such conclusions. www.1wallmart.com/product.php?id_product=370 Instead of saying that BPA causes increased testosterone levels, the coverage would have been more accurate had the reporter stuck to her later statement that "men who had high levels of the chemical bisphenol A also had higher testosterone levels compared to men with lower levels of the chemical in their bodies. Bisphenol A (BPA) is found in polycarbonate plastics, epoxy resins, some carbonless papers and other products. It is estrogenic, which means it can disrupt hormone levels, and may contribute to myriad health concerns ranging from metabolic disorders to fertility issues.
I just got my pharmacies last vial today!
None available in Ontario since before Christmas
I went to refill my Delatestryl prescription just before Christmas and was told that my pharmacy (Shoppers) was out of stock, so I asked them to call around to to some of their other outlets but none had any in stock and said that the earliest they were expecting to get any was January 20. They did have an old prescription on file for Depo-testosterone from the last time they had a shortage of Delatestryl but it was over a year old, so they required me to go back to my Doctor to get a new one. Then, because the Delatestryl was 200g/ml and the Depo was 100g/ml, I got into a biut of a discussion with the pharmacist as to what the correct dosage would be (he wanted my Doctor to tell me what the correct dosage was but my GP only gives me the shot (usually 1 ml of Delatestryl) and issues my refill prescriptions, whereas it's my endocrinologist who determines the correct dosage of a given supplement. Unfortunately, my endocrinologist's office was closed until Jan 9 (nearly 3 weeks later). Eventually, I got my GP to fax a new prescription for the Depo-testosterone at 2x the dosage (2ml) of the Delatestryl (1ml) but when it came time to give me injection, he was reluctant to administer it at that dosage, saying he would rather err on the side of caution, inject me with the Depo-testosterone at the same dosage (1ml) that he had been injecting me with the Delatestryl until I could confirm with my endocrinologist what the correct dosage should be.
Yes, problems in Van
@Lincoln: I tried to refill my prescription at London Drugs in Vancouver about a month ago, but they were already out then. I called around to several pharmacies before I found one that still had Delatestryl in stock. When I filled my prescription there, I got their last vial. Depo-T was available, but I didn't want to switch if not absolutely necessary.


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