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  • #1

    Question about instill drug names/percentages

    PLEASE

    Hi,

    Hopefully one of the nurses are on here or someone that has a bottle at home and can type in the compound mixture drugs and percentages for a lidocaine and heparin bladder instillation. I am waiting for my doctor to call this in to a compound pharmacy and I am almost positive that Tricare won't pay for it...so here are my questions:

    1) Does anyone know the exact prescription with percentages and drug names that I can look up on the Tricare formulary? Stuff like whether it's injection Lidocaine or Heparin?

    The web site is asking form the route of administration and they list things like: intravenous and injection. Actually, if someone has time, the web site is http://www.tricareformularysearch.org OR copied from my browser, it is: http://www.tricareformularysearch.or...r/default.aspx

    2) If your insurance does not pay for this compound, does anyone know about how much it costs in cash?

    I just must say this: Tricare is retarded, no offense to anyone who loves it...but the recognize IBS on their dx list but don't recognize PFD or IC. I am definitely going to write an appeal if this doesn't get covered. The customer service rep. was really nice and gave me an appeals address.

    Who in the world can even work if they need instills twice a week and have to sit in the doctor two days a week to get them? Then, the other issue is that Tricare has only allowed me seven visits to the Urologist and they won't do them anywhere else. Also, Tricare won't allow more visits. I checked. Try multiplying twice per week and seven visits won't even cover a month's worth.

    What in the world do Tricare patients do? Do you guys pay cash for this concoction or what?

    PLEASE HELP!
    Diagnosed in 2007, but had IC symptoms since 2002. My current regimen includes: home instillations of Marcaine, Heparin and Solu-Medrol plus vaginal valium suppositories nightly. I also use Tramadol for pain as needed.
    Tags: None
  • #2
    For my instills, I mix the components myself at home. I use one 10 mL ampule of 2% lidocaine (for injection - epidural or caudal block), 2 1mL bottles of heparin (20,000 units each for a total of 40,000 units), and one 5 mL bottle of 4.2% sodium bicarbonate. I mix in a sterile container and instill with a 12 French catheter attached to a 60cc syringe.
    ****
    Jen

    *Diagnosed with severe IC in 2004
    *Also diagnosed with PFD, fibromyalgia, chronic myofascial pain, IBS, migraines, allergies/asthma, dermatographism
    *Kept trying a million different treatments for all these things until I found what works, and I am doing okay these days with the help of a cocktail of medications and the InterStim, which was first placed in 2007. [I have had 2 revisions - one in 2010 when my battery died and had to be replaced, and one complete replacement (lead and generator) in 2012 after a fall on my stairs caused my lead to move.]
    *Current meds include Atarax (50mg at night), Lyrica (150mg twice a day), Xanax (0.5mg at night and as needed), Zanaflex (4mg at night), hydrocodone (10/325, every 6 hours as needed), Advair, Nasonex, Singulair (10mg at night), oral contraceptives, home instills containing Elmiron and Marcaine (as often as I need to do them).

    **I am not a medical authority nor do I offer definitive medical advice. I strongly encourage you to discuss your medical treatment with your personal medical care provider. Only they can, and should, give medical recommendations to you.

    Comment

    • #3
      April,
      I am just going to type what is written on each of the bottles. I used to get them pre-mixed, then the pharmacy quit doing that so we have to buy all the components and mix at home. This actually works out better because when you get them pre-mixed, you have to keep them refrigerated and must use them within a short period of time. The drawback is that my insurance covered them as a generic when they were premixed, and now they don't, so we have to pay for each component as well as syringes.

      Heparin Sodium injection, USP 20,000 USP units/ mL
      8.4% Sodium Bicarbonate Injection
      Lidocaine HCl injection 2% 20mg/mL

      I hope this helps you out!
      Claudia

      ~Claudia

      "A heart is not judged by how much you love; but by how much you are loved by others."
      ~ The Wizard of Oz

      "If I ever go looking for my heart's desire again, I won't look any further than my own
      back yard. Because if it isn't there, I never really lost it to begin with!" ~ Dorothy

      Comment

      • #4
        Thank you guys so much. This will help so much.
        Diagnosed in 2007, but had IC symptoms since 2002. My current regimen includes: home instillations of Marcaine, Heparin and Solu-Medrol plus vaginal valium suppositories nightly. I also use Tramadol for pain as needed.

        Comment

        • #5
          Hey, do either of you guys pay without insurance for this? Do you know about how much it costs?
          Diagnosed in 2007, but had IC symptoms since 2002. My current regimen includes: home instillations of Marcaine, Heparin and Solu-Medrol plus vaginal valium suppositories nightly. I also use Tramadol for pain as needed.

          Comment

          • #6
            I don't know the cost retail but sodium bicarbonate,lidocaine,and heparin are all generic. I don't know if they are on the WalMart $4 list or nor. I think some of the gals here get there meds for instillation over internet sites from the manufacture.

            I do home instillations and they are really convenient. Now I only need instills about 2 times a week but there was a time when I needed one almost every day...it just comes and goes.
            TREATMENT: PRN lidocaine/heparin Home Instillations since 2004
            My Helpful Hints for Home Instillation: http://www.ic-network.com/forum/show...985#post309985
            Institute of Female Pelvic Medicine (J. Dell, My MD) http://www.mypelvicmedicine.com/index.asp
            Thank you for allowing me to share my experiences and offer support. Your physician is the only one to give you medical advice. I hope sharing the information from this site will help you and your physician develop successful management of your IC.
            I post to encourage and offer total support for rescue instillations.
            Find me on facebook: L. Clark Thomas
            Louann

            Comment

            • #7
              Thanks. It was really great, but our insurance covered everything except for about $52...that was getting some catheters and syringes w/ needles. The heparin was $244 at cost and only cost $3 with insurance...so that was nice. So, our military insurance was decent.

              Thanks.
              Diagnosed in 2007, but had IC symptoms since 2002. My current regimen includes: home instillations of Marcaine, Heparin and Solu-Medrol plus vaginal valium suppositories nightly. I also use Tramadol for pain as needed.

              Comment

              • #8
                My insurance will cover catheters and syringes but I have to use a durable supplies provider ( you know the business that supply O2 etc). My insurance covers 90%. But it covers nothing if I take the Rx to the pharmacy. You do have to have a Rx for insurance to cover the durable supplies. My insurance will not cover needles but my durable supplier sells them to me at cost.
                TREATMENT: PRN lidocaine/heparin Home Instillations since 2004
                My Helpful Hints for Home Instillation: http://www.ic-network.com/forum/show...985#post309985
                Institute of Female Pelvic Medicine (J. Dell, My MD) http://www.mypelvicmedicine.com/index.asp
                Thank you for allowing me to share my experiences and offer support. Your physician is the only one to give you medical advice. I hope sharing the information from this site will help you and your physician develop successful management of your IC.
                I post to encourage and offer total support for rescue instillations.
                Find me on facebook: L. Clark Thomas
                Louann

                Comment

                • #9
                  My covers almost all of it; I end up paying about $94 for about one-two months supply, depending on how often I do the instills...
                  ****
                  Jen

                  *Diagnosed with severe IC in 2004
                  *Also diagnosed with PFD, fibromyalgia, chronic myofascial pain, IBS, migraines, allergies/asthma, dermatographism
                  *Kept trying a million different treatments for all these things until I found what works, and I am doing okay these days with the help of a cocktail of medications and the InterStim, which was first placed in 2007. [I have had 2 revisions - one in 2010 when my battery died and had to be replaced, and one complete replacement (lead and generator) in 2012 after a fall on my stairs caused my lead to move.]
                  *Current meds include Atarax (50mg at night), Lyrica (150mg twice a day), Xanax (0.5mg at night and as needed), Zanaflex (4mg at night), hydrocodone (10/325, every 6 hours as needed), Advair, Nasonex, Singulair (10mg at night), oral contraceptives, home instills containing Elmiron and Marcaine (as often as I need to do them).

                  **I am not a medical authority nor do I offer definitive medical advice. I strongly encourage you to discuss your medical treatment with your personal medical care provider. Only they can, and should, give medical recommendations to you.

                  Comment

                  • #10
                    Hey Jen,

                    That's about how much ours was and so far this week, we have done them three times. I know people who do them everyday and that's really all that helps the pain.

                    It seems like I am starting out as an every other day girl.

                    April
                    Diagnosed in 2007, but had IC symptoms since 2002. My current regimen includes: home instillations of Marcaine, Heparin and Solu-Medrol plus vaginal valium suppositories nightly. I also use Tramadol for pain as needed.

                    Comment

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