Intermezzo, another ‘new’ drug that isn’t

I just saw a commercial for a “new” prescription drug. Only it isn’t. Not really. Intermezzo is “for the treatment of insomnia when a middle-of-the-night awakening is followed by difficulty returning to sleep.” There is nothing new about this drug except its name. It is zolpidem — generic Ambien. But because you dissolve it under your tongue instead of swallowing it, it counts as a “new” brand name drug.

Intermezzo_blueThis is the sort of thing Big Pharma does. When the patent on the brand name Ambien expired, for example, Ambien CR, a controlled release form of zolpidem, was introduced. Now comes Intermezzo. The gimmick this time is that it’s administered sublingually — dissolved under the tongue so it will take effect faster. There’s nothing new about being able to take it in the middle of the night. The half-life of zolpidem is 2-4 hours. Always has been. You could take a small amount of zolpidem in the middle of the night and get the same result for a lot less money. (Talk to your doctor before doing so.)

Brand names are more profitable than generics, and obviously easier to market. “Intermezzo” is certainly more euphonious than “zolpidem tartrate sublingual tablets.” And no doubt somewhere right now, some drug company scientist is trying to think of yet another novel way to market zolpidem. Perhaps a liquid (“fast acting, pleasant tasting”). Coated tablets (“easier to swallow”) or enteric-coated tablets (“for sensitive stomachs”). Maybe even suppositories (“when nausea is keeping you awake”). And then there are the combos, maybe zolpidem and aspirin (“when headache keeps you awake”). Or Zolpidem and bismuth subsalicylate (“when indigestion keeps you awake”). Each would be a patentable new brand name drug with a brand name price. Big Pharma is nothing if not creative. Stay skeptical, my friends. .

 

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Categories: Big Pharma, generic drugs, Health

18 replies

  1. Good advice, PT. Skeptical it is.

    Coincidentally, speaking of sleep aids, after years of my having sleeping problems and nightmares our family doctor prescribed a med for the problem and it has been nothing short of life changing. Nightmares gone, at least so far. Sleeping much better, and longer. It was effective from the very first night, and on a low 50mg dose. I feel like a new man.

    Obviously this is a complex subject and people react differently to meds, but the effects were so positive for me and because insomnia is such a common problem, I thought I would share it. The med is called trazodone.

    • I’m glad this works for you. In my book a good night’s sleep is essential to a decent quality of life.

    • Back when I first started my treatment for Major Depression, trazodone was one of the meds I was taking (in addition to Zoloft) for anxiety. I don’t recall the dosage, but it was removed from the list because it didn’t seem to be very effective. Years later, it was prescribed again (100mg) to help me sleep with great effect. It’s so effective that I usually just take a half tablet. Go figure!

  2. I couldn’t believe this when I saw it.
    No wonder self control and self behavior modification is out of style
    People ignore that all meds have side effects/consequences – some not revealed for years
    Wish all drug ads would be banned from media.
    So not helping anyone but the Pharm profits

  3. I couldn’t agree more with your assessment of Big Pharma and the tactics they use to keep the dollars rolling in PT. The thing is that, as despicable as their practices are, and as “unpopular” as the thought of legalizing drugs is, I still think that they could be incredibly useful “allies” in eliminating at least the “crime” aspect of the War on Drugs: Tolerance… Not! Drugs

    • If there’s profit to be had, I’m sure Big Pharma would be all in favor of it. Not sure I understand what you’re getting at, though. Have Big Pharma make and legally distribute/sell coke, meth, heroine, etc? Quantities and availability would still be limited by prescribing physicians, so addicts would still turn to black market sources. Do you mean just let Big Pharma sell those drugs directly to the consumer? The FDA decides if a drug is safe enough and innocuous enough to be sold over the counter; I doubt they’d ever approve OTC distribution of such drugs.

      I think I’m just not understanding what you have in mind.

      • Whether they’re seeking profit, seeking power over their fellows, or just the temporary relief to be found in one substance or another, people are just too firmly entrenched in their way of thinking about things for me to ever expect anything I say to bring about real change. But, as one who’s spent almost his entire life surrounded by it, I know that the vast majority of the violence associated with drug abuse is committed by the drug dealers themselves. How could removing them from the equation by allowing OTC sales of pharmaceutical equivalents possibly be worse than the situation as it exists now?

        Of course, I realize that rational thought is a fleeting concept in the world we live in. The mere thought of pressing the point reminds me of the last song from Pink Floyd’s “The Wall”: 😕

        All alone, or in twos,
        The ones who really love you
        Walk up and down outside the wall.
        Some hand in hand
        And some gathered together in bands.
        The bleeding hearts and artistes
        Make their stand.

        And when they’ve given you their all
        Some stagger and fall, after all it’s not easy
        Banging your heart against some mad bugger’s wall.

        • Afraid I can’t agree with making potent, highly addictive drugs available OTC. Sure, it would take the drug dealers and their violence out of the loop, but the drugs themselves are far too dangerous to be made available OTC. We’d just be enabling current addicts and creating new ones.

          • I must agree, PT, and I would add that the average person has lousy judgement, not to mention education, for medicating. In fact, I have often read that one of the most pervasive medical problems is simply failing to take medicines as prescribed.

            • I’ve heard that too. Noncompliance is a huge problem (an estimated 50% of patients don’t follow instructions). Beats me why anyone with a medical problem would pay to see a doctor, pay to get a prescription drug for the treatment of that problem, and then not follow the instructions to the letter.

  4. Oh, they are the masters of creativity, for sure. LOL.. .my doc prescribed some Ambien for me last September. Having a rough bought of insomnia. I had been saying “no” to his offer for quite a while and finally gave in. After all, just because I have it filled doesn’t mean I have to take it. Well, I gave it a try one night. OMG! I have never done LSD in my life, but if I could imagine what LSD is like, then that’s what I felt like on Ambien. My world literally warped in front of my eyes. Everything was wavy and I was messed up in the head! But I did sleep well that night. I took it one more time, then half a pill. That’s all I’ve taken of it. I don’t really care for feeling that doped up. I have a house full of dogs. If something happens in the middle of the night, I have to be able to take care of it. The one thing I was not expecting when I took it the first time was how rapidly it set in. Within minutes. I took it about 30 minutes before I planned to go to bed, and barely made it there. Had to hold the wall on my way.

    Since then I’ve just been dealing with the insomnia. Since my job change and working out of the house, I have the luxury of not having to adhere to a business clock. So if it’s a rough night, I sleep a little later. For the past few nights, though, my roomie introduced me to Melatonin… and so far I love it! Dosage is one a night, so I tried that. Didn’t really seem to help. Then I noticed for jet lag, it’s okay to take two. Well, I’m not suffering from jet lag, but since it’s okay to take two, I did… and slept like a baby two nights ago. That is the first night I have slept completely through in many many months. And I didn’t feel like I was on LSD either.

    That Ambien is a trip! Literally….

    • Sounds like maybe you were given too high a dose of Ambien, or are extremely sensitive to it, or it interacted with something else. Could have been a lot of things. They’ve recently lowered the recommended dosage for women to half what it was. Maybe a lot of other women reported experiences similar to yours. Glad the melatonin is working for you.

"Opinion is the medium between knowledge and ignorance." ~ Plato

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