Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Corgard discontinued

The manufacturer of nadolol (Corgard®) has confirmed that this product has been discontinued. The product has been discontinued for commercial reasons.

Nadolol, a beta blocker, is licensed for use in hypertension, angina, arrhythmias, migraine prophylaxis and adjunctive treatment of thyrotoxicosis. Supply chain stock will be limited and there is no generic alternative. Treatment should not be stopped abruptly and therefore patients who are currently being prescribed nadolol should be identified, reviewed offered an appropriate alternative.

Action: Clinicians should be aware of this product being discontinued. It would be prudent to run clinical system searches to identify any patients who are currently prescribed this product to allow a review and an alternative to be arranged.

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22 Comments to “Corgard discontinued”

  1. I just found out 2 May 2017 when trying to refill my Nadalol that the co-pay went to almost $200. I have been taking this medication for 25 years and have never paid more than $30-40 for 3 month supply. I can in no way afford the new co-pay.

    Upon looking the medication up on line I find out it has been discontinued altogether, and not made any more (?) -- so then, how can I still get it at the exhorbitant price? Something wrong with this picture.

    I am greatly disappointed in this development. How can a medication so helpful to so many patients for decades be discontinued just like that with no warning or notification to patients? Looks like our dollars count but we don't.

    Thank you,
    Jean Chabre

    Comment by Jean Chabre — May 4, 2017 #
    Reply

    1. @Jean

      Supplies do seem to be getting hard to come by and this is being reflected in the increasing price.

      It's not easy to contact patients when things like this happen. The manufacturer doesn't know the names of individual patients on their medicines as that private information held by your healthcare provider. And your healthcare provider may be unaware that this product is in short supply or discontinued. No system is ever perfect.

      Comment by Matthew Robinson — May 4, 2017 #
      Reply

      1. I learned last February that Corgard was no longer available, but was able to get a large supply from Safeway and had to pay $799.00 for a six month supply until I could get an appointment with my cardiologist to discuss what should I now take. It would seem to me that physicians offices should be alerted or yet the Doctors offices should know when a medication is discontinued so that they can alert their patients that they would need a new prescription for a different beta blocker. This is a very serious issue. I am not taking it lightly. As far as I am concerned, if I knew that Corgard was discontinued, my physician should have known. He did not know that Corgard was discontinued until I had my appointment with him, and he was astounded when I told him that it was no longer available. He is the physician he should have known. Surely, he has staff who should stay on top of the medication status that he is giving to his patients. When a drug is discontinued his staff could alert each patient who is taking that drug that it has been discontinued. It is the obligation of the physicians to make certain that the patient is taken care of. That is why we are going to him and do expect him to stay on top of his practice. He is a physician with a large medical practice in Palo Alto, Ca. They have the staff to monitor all of their medications that has been prescribed to their patients. No excuses.

        Comment by L. Scott — June 12, 2017 #
        Reply

        1. @L. Scott

          I understand your frustrations and agree that product discontinuation does cause issues due to poor communication. I'm not sure how things work in your part of the world but here in the UK doctors prescribe and pharmacies dispense. It is pharmacies that conduct the medicines procurement and supply so only they know of the current stock situation. Doctors rely on mailed notification from drug companies to learn about products that are discontinued and sometimes these letters don't arrive or are missed. The system can certainly be improved but it would take a drug regulator (like the FDA) to start that process I suspect.

          Comment by Matthew Robinson — June 13, 2017 #
          Reply

  2. I have Long QT and I am on 80mg of Nadolol.
    I live in Italy. Corgard became unavailable here two two years ago but recently I have been able to get it as Nadololo and the cost is low. Same goes for Switzerland.
    It may be easier for those in the UK to get it from here as its within the EU.

    Comment by Amanda — April 29, 2017 #
    Reply

    1. HI Amanda,
      Where is it you are able to get Nadolol from?
      I'm in the UK and so many pharmacists and doctors are not aware of it's discontinuation so I'm going to have to find a source as it helps me so much.
      Many thanks

      Comment by Katherine — August 16, 2017 #
      Reply

  3. I have been taking Nadolol 40 mg for 30 years, and now since the drug is not covered on Part D, my GP placed me on Metoprolol tartrate 25 mg twice a day. I am reluctant to start the Metoprolol Tartrate, as the Nadolol works so well. If I were to pay monthly, the cost is close to $140.00. If I had the money, I would pay. I do not want to jeopardize my life, so might call the doctor and tell him about this.

    Comment by Bonnie Etter — March 21, 2017 #
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  4. I'm on 320mg of Nadolol a day, I'm heavily dependent on this medication. It is ridiculous that the only place that it can be sourced from in the UK is New Zealand.

    Comment by Dan Bexon — January 5, 2017 #
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  5. Effective 05 October 2015, the NDA for CORGARD Tablets has been transferred to U.S. WorldMeds, LLC.

    So does this mean that this company will be making Corgard and the generic Nadolol? Many of us depend on this drug, I have been taking it for two decades and I have allergies to certain drugs. I am so afraid that if my medication is changed I will have an allergic reaction which could cause death. How can a company just stop making something that so many people need? For money? God help us if that is the reason.

    Comment by Rosemary Martin — November 29, 2016 #
    Reply

    1. @Rosemary

      Given that your quote is from 2015 and we are at the end of 2016, and also given that the company named in that transfer do not list Corgard as a current product on their website today it doesn't look to hopeful.

      Unfortunately, money is a factor in the world of medicines. When a company isn't making money from sales of a medicines, or worse still is losing money, the obvious decision is to stop making it or sell the rights to the product. That's what seems to have happened here and as yet no other company has seen a market to manufacture and sell this medicine.

      Comment by Matthew Robinson — November 29, 2016 #
      Reply

  6. I'm on 80 mg nadalol twice a day and have an ICD. Sotalol does not manage my arrhythmias. My pharmacist currently makes a liquid solution for me. This costs an absolute fortune. I don't care how much it costs as I pay my taxes. Can somebody within the NHS take it upon themselves to source this drug in tablet form? It would save so much money!

    Comment by Sam Gibb — November 16, 2016 #
    Reply

    1. @Sam

      The NHS can only source what manufacturers are prepared to manufacturer. At the moment nobody seems too keen to make nadolol in tablet form.

      Unfortunately, the disassociation between health costs (which from a patient perspective are often unknown) and the taxes we pay in the UK leads to statements such as you made above. Perhaps if we all took a little more interest and made a more personally responsible value based decision on the cost of the treatment we might all pay a little less tax while putting pressure on drug manufacturers to price the offerings more reasonably. You occasionally hear of a pill that 'costs just £3 per day' but work that out yourself and that's over £1,000 per year. Consider then whether you are willing to pay that much for the benefit yo get (or may get in time).

      If you are genuinely interested in looking into this further explore the other alternatives with your GP or consultant. There are more that 2 drugs in the group of beta-blockers (nadolol and sotalol being two you named) but there are others that might be worth considering.

      Comment by Matthew Robinson — November 16, 2016 #
      Reply

  7. I have been taking Nadolol for over 20 years due to mitral valve prolapse. It is the only thing that has given me the relief that I needed. I take 20 mg once a day and am told I will have to pay a 500% increase as a co-pay. I did not know it was discontinued altogether. I think it is a travesty that, like the Epi Pen situation, that drug makers can discontinue drugs or jack up the prices "for commercial reasons" who have no concern for the health and safety of patients. Something has to be done about the drug situation in this country of USA. I no longer trust any of the manufacturers and wonder about fraud, payoffs, price gouging for profits, etc. I'm going to keep investigating this situation. There is another drug I use that has gone up even further, also "not available anymore", but I will do without that altogether. I'm convinced something is going on with the drug manufacturers.

    Comment by Donna — October 13, 2016 #
    Reply

    1. @Donna

      I can understand your frustrations, it might be worth seeing a doctor and investigating different options, there are several other drugs in the same group and one of those may be suitable for you and far less expensive. For people living in the UK, drugs are funded through taxes and are either free or charged at a flat rate. This makes drugs more affordable for individuals but also means that patients have no concept of the cost of their treatment.

      Comment by Matthew Robinson — October 14, 2016 #
      Reply

  8. Hi my son got long QT. He now going to be 13. He was diagnosed since birth. I only found out today that this medication, nadolol has been discontinued. Wasn't it a consultant job to let parents know of the changes and to review people who are taking these medication.

    Comment by S.Aziz — July 28, 2016 #
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    1. @S.Aziz,

      I don't agree that this falls to consultants to sort out. Patients may have been discharged many years ago and have moved house since. This is also presuming that they are aware that nadolol has been discontinued. I would argue that the healthcare professionals making your regularly supply of medication (so usually your pharmacist or GP) would be best placed to advise that this medication is discontinued and offer a review.

      Comment by Matthew Robinson — July 29, 2016 #
      Reply

  9. I'm in the US, my daughter was diagnosed with long QT in December 2014, and started on nadalol 80mg. Currently on same dosage, so my guess is you can get it from US.

    Comment by Kimberly — July 26, 2016 #
    Reply

    1. @Kimberley,

      Thanks for the information, however it might prove difficult for UK patients to access the medication directly to due importing restrictions and the way our healthcare system works.

      Comment by Matthew Robinson — July 26, 2016 #
      Reply

  10. Is another uk company going to manufacture nadolol? My daughter who was diagnosed with long qt syndrome in October 2015 was prescribed nadolol 40 mg and has had to go through the side effects of being uncomfortably hot until the 3 months was up and then the drug levelled out, so she would have to go through the side effects of the next drug. Should we look for different companies even in the USA or has it been withdrawn because it is unsafe for diabetics type 2 or for anyone with a heart condition. Any information would be greatly appreciated. Anne D'Wilton(RGN)

    Comment by Anne D'Wilton — April 26, 2016 #
    Reply

    1. @Anne,

      The product was discontinued for commercial reasons - there are no safety concerns. However, I am not aware of any current alternate provider. So unless one pops up in the next few weeks your daughter will need to get reviewed for an alternative. If switched to something similar there is a chance she won't have the same problem with side effects.

      Comment by Matthew Robinson — April 26, 2016 #
      Reply

      1. My consultant has indicated that Nadolol will remain commercially available in Canada. Do you know how I validate this and what methods there are order it from there?
        I have been on 160mg a day (2 x 80mg) for the past 20 years. I too have the Long QT Syndrome so keen to stay with it.
        Many thanks
        Tony

        Comment by Tony Eames — June 13, 2016 #
        Reply

        1. @Tony,

          I believe there are generic versions available in Canada. On checking with a big generic manufacturer in the UK there are no plans to launch. There are specialist companies that import medicines from abroad but this obviously is a service that comes with a significant cost. It's worth discussing with your consultant and GP.

          Comment by Matthew Robinson — June 27, 2016 #
          Reply

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