Comment

Comment by Linda G on June 1, 2013 at 6:50am

Perhaps Dr Wong can shed some light on the prognosis of Corneal Dystrophy :)

Comment by Randall Wong, M.D. on May 31, 2013 at 1:57pm

Compared to a CVS, Walgreen's, Rite Aid, etc., a compounding pharmacy custom makes (like Steve D says) drugs, ointments, etc not mass produced by manufacturers.

They can also repackage drugs. In the case of Avastin, Avastin is purchased in large quantities fit for systemic chemotherapy...where as we need less than 0.1 cc.

r

Comment by Randall Wong, M.D. on May 31, 2013 at 1:55pm

Comment by Steve D on May 31, 2013 at 1:08pm

A "Compounding' Pharmacy does actual drug mixing and compounding on site. They require phamacists with special licenses to mix drugs.

Comment by shoshana27 on May 31, 2013 at 12:56pm

WHAT IS A COMPOUNDING PHARMACY??? please explain. thank you.

Comment by Randall Wong, M.D. on May 31, 2013 at 12:51pm

Amanda02,

The difference between Lucentis and Avastin has to do with FDA approval and compounding pharmacies.

Avastin is not FDA approved for the eye. Hence, the manufacturer can not package smaller "eye" doses. Instead, a "compounding pharmacy" must purchase a larger of volume of the drug from the manufacturer and divide it into smaller doses for use in eye patients.

The drug manufacturer must comply with FDA guidelines where as compounding pharmacies are not governed by the FDA.

Hence, several "outbreaks" of infections have occurred due to a few irresponsible compounding pharmacies.

r

Comment by Randall Wong, M.D. on May 31, 2013 at 12:46pm

Leata,

Avastin is not FDA approved for diabetic macular edema whereas Lucentis is FDA approved. Both drugs are made by Genentech and are remarkably similar. Lucentis blocks more types of VEGF than Avastin.

Avastin, used in chemotherapy, is approved for treatment of certain cancers but is the standard of care in many areas of the U.S. for treating many eye diseases such as wet macular degeneration and diabetic macular edema.

It is my personal drug of choice for both of these conditions.

Randy

Comment by Leata on May 31, 2013 at 9:32am

Also, (and I apologize if this has been covered), Lucentis is a lot (like, tens of times) more expensive than Avastin.(It's a whole big controversy, my doctor says that Lucentis is keeping Genetech in business! Probably an exaggeration.0 My insurance so far hasn't balked at covering it (a miracle!) but my doctor said that if it did, she would probably use Avastin, instead, and thought it would be a viable other option.

Comment by amanda02 on May 31, 2013 at 6:26am

I apolgize for the broken links. Basically,a number of cases of blindness occurred among people being treated with Avastin by the Veterans Administration in 2011. The problem seemed to be that the Avastin had to be broken into smaller doses than it was sent by the manufacturer and therefore required additonal handling which resulted in occasional contamination. The people treated with the contaminated Avastin were made completely blind in the treated eyes.
Lucendis is a slightly different formulation of the same drug. The manufacturer received FDA approval for its use with Macula Edema in August 2012, and the manufacturer claims to have reformulated it specifically for the new use. The molecules are smaller than those in Avastin. I can say from having had both, that my eyes tolerated the Lucendis better and i saw dramatically more improvement.

Comment by Anu Marjaana on May 31, 2013 at 6:09am

Can't open the links, but sounds scary. In my case Avastin helped, but that was a few years ago and there might be better options today. I can also confirm, that the injections are really not that bad as they sound, could not feel any pain.
Miss Robbie: You asked about working. Unfortunately I lost my job during the vision loss, I was simply not able to work. After my vision recovered, I have luckily found other work. Really wishing you strenght and I hope you will be able to work soon again! Computers' own magnifying screen function helps already a lot.
Brigitte: My laser, Avastin and vitrectomy treatments were in the Netherlands. Strenght to you as well!
And of course to all of you guys, xxx

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