August 2007- ProHealth Guaifenesin FA 400 mg. has been reformulated. New ingredients are:guaifenesin,  silica, calcium phosphate, modified cellulose gum (vegetable source), magnesium stearate (vegetable source), and microcrystalline cellulose (vegetable source). www.immunesupport.com

In 2002 the FDA made a ruling that changed the guaifenesin protocol substantially. The many brands of generic prescription long acting guaifenesin were taken off the market.  A substantially more expensive (but over the counter) product, Mucinex (Adams Labs) was approved in their place. Although Mucinex is considered a replacement for what had been on the market for so long it really isn’t the same. Mucinex is a blue and white bi-layered tablet with a short acting component as well as a timed release layer.

     We were suddenly faced with a dual challenge: trying to figure out how this might be different from what we’d been using and what to do for the people for whom this higher price was a real hardship. Many of Dr. St. Amand’s patients were able to stock up on the older prescription brands such as Caracao, Ethex and Amibid. Around the country patients whose doctors were not willing to write prescriptions for huge quantities of guaifenesin were facing the unknown by January or February 2003.  But now those supplies are gone and countless new patients and old patients have helped us learn what follows. 

     We’re finding it’s no longer necessary to use the high doses of guaifenesin we often utilized in the past. To our surprise, short acting guaifenesin has been a very effective delivery system especially in conjunction with long acting. As we’ve speculated previously we believe this is due to the action of the cytochrome system.  Testing of the older brands showed them to have a substantial variability in release time and absorbability. 

We start patients with 300 mg twice daily of guaifenesin. This can be either the Mucinex (or the Pro Health 600 mg. product) or a compounded tablet. (Compounded guaifenesin requires a prescription.) If that doesn't make patients feel worse during the first week we ask them to increase the dose to 600 mg twice a day.

     If the left thigh has not cleared after one month, or a patient notices no change in symptoms, we a 400 mg guaifenesin twice a day. This combination is working very well and seems to be handling between 90-95% of our patients. If money is not an issue, 1800 mg. of Mucinex with its two layers accomplishes the same thing.

 AVAILABLE GUAIFENESIN:

COMBINATION LONG ACTING/SHORT ACTING IN ONE PILL
Mucinex/ Pro Health 600 mg. Extended Release Formula.
Inactive ingredients: carbomer 934P, dyes, hydroxypropyl methylcellulose, USP, magnesium stearate,, microcrystalline cellulose, sodium starch glycolate. (for ProHealth: www.immunesupport.com)

COMBINATION LONG ACTING/SHORT ACTING IN ONE PILL

Humibid 1200 mg Extended Release bi-layered tablet. Inactive ingredients: carbomer 934p, NF, Green lake blend, hypromellose, USP, magnesium stearate USP, microcrystalline cellulose NF,sodium starch glycolate.

 

Marina del Rey Pharmacy Compounded Guaifenesin (600 mg)

GUAIFENESIN—DYE FREE

For patients with chemical sensitivities who cannot tolerate the dyes in Mucinex (Pro Health) or for patients who cannot break the Mucinex as needed.  This requires a prescription and is not FDA approved.  It is a compounded formula made for patients who need it. Your doctor must order it for you.
Inactive ingredients: Microcrystaline Cellulose, Stearic Acid, DiCalcium Phosphate, Magnesium Stearate.  For information contact Marina del Rey Pharmacy (www.fibropharmacy.com)

FAST-ACTING- FIBROPHARMACY GUAI 400 QA- from the same source as the compounded guaifenesin (see above).  Inactive ingredients: Stearic Acid, Dicalcium Phosphate, Croscarmellose, Sodium and Silica. (www.fibropharmacy.com)

FAST ACTING—400 mg: SOLOGUAI - guaifenesin 400 mg. Inactive ingredients: calcium phosphate dibasic, magnesium sterate, microcrystalline cellulose, Poridene K-30, prosolv, stearic acid. Latex exposure free. Does not contain lactose or maltodextrin which may be a problem for some patients with corn allergies and reactive hypoglycemia. (www.cleure.com/ftc)

                                                                                                                           
FAST ACTING: Pro Health Guaifenesin FA 400 mg
Inactive Ingredients: Collodial silicon dioxide, maltodextrin, microcrystalline cellulose, povidone, sodium saccharin, sodium starch glycolate, stearic acid, talc and vanillin.(www.immunesupport.com)

FAST ACTING: Guai-Aid formulas of guaifenesin.  Capsules or caplets are available in 200, 300, 400, 600 mg. strengths.  Includes "Guai Ultra Pure."  Despite the advertising done by the manufacturer this guaifenesin should be considered short acting.  Available from various websites or Marina del Rey Pharmacy (www.fibropharmacy.com).  Ultra Pure is a statement that has not been evaluated by the FDA.

LIQUID GUAIFENESIN: These two formulas do not contain mint or menthol.  If using any other liquid guaifenesin be sure to check ingredients to make sure there is no menthol listed or as an ingredient in the flavor:

Children’s Mucinex Grape Flavor. 1 tsp contains 100 mg of guaifenesin.  Alcohol free.  Inactive ingredients: citric acid anhydrous, dextrose, FD&C Blue #1, FD&C red #40, flavor, glycerin, methylparaben, potassium sorbate, propylene glycol, propyl paraben, saccharin sodium, sodium hydroxide, sucralose, xanthan gum, water. Salicylate free

Marina del Rey Pharmacy also carries a liquid guaifenesin.  For information please contact them directly: (www.fibropharmacy.com )

JUNIOR STRENGTH Mucinex Mini-Melts (for older kids) –fast acting.  Take every four hours

Mucinex Grape Mini Melts: 50 mg of guaifenesin per packet.  Inactive ingredients: aspartame, butylated methacrylate copolymer, carbomer, carboxymethylcellulose sodium, grape flavor, magnesium stearate, microcrystalline cellulose, povidone, raspberry flavor, sodium bicarbonate, sorbitol, stearic acid, talc, triethyl citrate.  Salicylate free.

Mucinex Bubble Gum Flavor Mini Melts: 100 mg. of guaifenesin per packet.  Inactive Ingredients: aspartame, banana flavor, butylated methacrylate copolymer, carbomer, carboxymethylcellulose, sodium, magnesium stearate, microcrystalline cellulose, povidone, sodium bicarbonate, sorbitol, stearic acid, talc, triethyl citrate, tutti frutti flavor. (Salicylate free)

NOTE: Children’s Mucinex Cough (Cherry) is not plain guaifenesin --contains dextromethorthan.

SOURCES:
For Mucinex: Check local discount pharmacies such as Cost-Co for price. Also online outlets such as drugstore.com. The mail order price is best from Marina del Rey Pharmacy www.fibropharmacy.com 1-800- or ProHealth www.immunesupport.com or 1-800-366-6056.

Marina del Rey Pharmacy and ProHealth sell both long and short acting guaifenesin  (Mucinex) If it is 600 mg. guaifenesin long acting it is Mucinex even if it carries the Pro Health label.  Both,therefore, are obviously acceptable.  SoloGuai is from Cleure, formerly Grace Advantage, www.cleure.com/ftc.