Medications

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Medications

Postby Sammy76 » Wed Oct 10, 2007 11:23 am

Hi,

I was on Rebif for 2 months, but was taken off because of allergic reaction. 1 month later I started Copaxone, but was allergic to that too.

I saw an allergist and my Neuro, no one knows what to do for me next. Apparently Mannitol is in all of the CRAB's and that's what I seem to be allergic to.

Has anyone ever heard allergies to all meds? Do you have any recommendations?

Any help would be appreciated.

Thanks,
Samantha
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Postby gwa » Wed Oct 10, 2007 1:14 pm

There is a special purpose in the mannitol that the companies are using. I can't remember the exact thing that the sugar alcohol does, but it gets the meds past the blood brain barrier.

Exactly how mannitol does this is the part that I don't remember.

So for any med going to the brain, it may be necessary to continue with the mannitol. You could probably get more info by googling scholar.google.com.

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Re: Medications

Postby NHE » Wed Oct 10, 2007 2:35 pm

Sammy76 wrote:Apparently Mannitol is in all of the CRAB's and that's what I seem to be allergic to.

Has anyone ever heard allergies to all meds? Do you have any recommendations?

Any help would be appreciated.

Well, it could be that mannitol is used only in the prefilled syringes. I don't know about Rebif or Copaxone, but mannitol is not in the powdered form of Avonex. The ingredients listed for Avonex are 33 µg interferon-ß1a, 16.5 mg albumin human, 6.4 mg sodium chloride, 6.3 mg dibasic sodium phosphate, and 1.3 mg monobasic sodium phosphate, no preservatives. Note that the sodium chloride and dibasic and monobasic sodium phosphates combine to form a buffer solution that's known as phosphate buffered saline or PBS. This buffer is commonly used in laboratories for cell tissue culture. Thus, it's likely that it may be more physiological than the buffers used with the prefilled syringes.

It takes about just an extra minute or so to mix the powdered form and it's really not that much of a hassle. Moreover, many people have noted less side effects with the powdered form of Avonex than with the prefilled syringes. If I remember correctly, Biogen was planning to switch everyone over to the prefilled form but then chose to make both available.

One other benefit of using Avonex is that it's an intramuscular injection so you don't get the injection site reactions that are seen with the other forms of interferon-ß which are injected into subcutaneous tissue.

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Postby Lyon » Wed Oct 10, 2007 3:37 pm

Despite my wife long being in the Tovaxin IIb, we still have a Rebif pre-filled titration pack in the fridge that we couldn't bear to throw away because it was so expensive.....despite the fact that it probably went bad long ago!

The 0.5 ml pre-filled syringe contains 27.3 mg of Mannitol USP, although I have no idea what Mannitol is or what it does.
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Postby gwa » Wed Oct 10, 2007 7:33 pm

Mannitol is a sugar alcohol that is many times sweeter than sugar. I don't remember seeing it in sugarless foods, but it may be used and I just have not come across it.

Normally sorbitol, malitol and xylitol, all of which are sugar alcohols, are put in foods that are made without using sugar. They have less calories and less carbs than regular sugar.

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Postby Lyon » Wed Oct 10, 2007 7:47 pm

Hi gwa,
In addition to what you mentioned, Wikipedia also said the following:
Mannitol can also be used to open the blood-brain barrier by temporarily shrinking the tightly coupled endothelial cells that make up the barrier. This makes mannitol indispensable for delivering various drugs directly to the brain (e.g. in the treatment of Alzheimer's disease).

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