Dear Friends,

Solu-Cortef is again the subject of distribution problems. I understand that it is still available, but perhaps you might have some difficulty finding it. You can call the Pharmacia Customer Services Center at (800-821-7000). They keep emergency supplies and can help you to obtain the product.

Before using alternative products, I suggest you try this route. As Carol said, the alternatives, such as Solu-medrol (methylprednisolone) which comes in a
40 mg/ml Acto-vial, do not have the same mineralcorticoid effect as Solu-Cortef. In addition, the dosing will be different due to the strength differences in the products. Please go over the exact instructions for usage carefully with your physician and read over the full information about the differences between these substitute products at http://www.ashp.org/shortage/methylprednisolone.cfm?cfid=13318177&CFToken=45161663 before using.

You can also ask your physician about the possibility of using hydrocortisone suppositories. One of the CARES Foundation medical advisors just told me about this alternative. Monarch makes Anusol-HC which come as 25 mg suppositories (12 in pkg). In addition, some pharmacies will compound suppositories in the appropriate dosage. They are used in Europe often in lieu of the injection. However, they cannot be used when the child has diarrhea.

With the virus season upon us, please make sure you have some alternative for stress dosing on hand. I just learned of the death of a 10 year old CAH child in Colorado who went into adrenal crisis when he came down with that horrible Norwalk virus that is going around. Be vigilant in watching for signs of adrenal crisis in your children, loss of appetite, vomiting, diarrhea, nausea, stomach ache, unusual tiredness and weakness, lethargy, dizzyness when standing up. These can come on quickly when your child is ill, especially with high fevers and/or stomach and intestinal viruses. The Johns Hopkins Adrenal insufficiency booklet can be downloaded at http://www.caresfoundation.org/adrenal_insufficiency.pdf which goes over adrenal crisis in depth and has instructions on giving injections.

Stay Healthy!

Kelly

Kelly R. Leight, Executive Director
CARES Foundation, Inc.
(Congenital Adrenal hyperplasia Research, Education and Support)
973-912-3895
866-227-3737 (toll free)
email: kelly@caresfoundation.org
URL: www.caresfoundation.org
Disclaimer:
Any communication from CARES Foundation, Inc. is intended for informational and educational purposes only and in no way should be taken to be the provision or practice of medical, nursing or professional health-care advice or services.  The information should not be considered complete or exhaustive and should not be used in place of the visit, call, consultation or advice of your physician or other health-care provider.  You should not use the information in this or any CARES Foundation, Inc. communication to diagnose or treat CAH or any other disorder without first consulting with your physician or healthcare provider. Any referral to physicians is provided as a courtesy only.  CARES Foundation, Inc. does not specifically endorse or recommend these physicians.