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Frequently Asked Questions:
Guaifenesin Product Troubleshooter
Written by Terry K.
In collaboration with Tesa Marcon
Revised January 31, 2007
October 17, 2003:
FDA Proposes Steps to Assure the Safety and Efficacy of Certain Currently
Unapproved Medicines
Disclaimer: This information was gathered
in conjunction with pharmacists and manufacturers and does not represent the
research of Dr. St. Amand or his office (also see
An Evolving
Protocol). Any information contained or
referenced in this FAQ is not meant to be medical advice. Instead, it
reflects general information gathered from a limited number of companies and
professionals. For specific advice, please contact your own health care provider.
All users of this FAQ agree
that neither Tesa Marcon, her helpers or other contributors will be held liable
in any way for any information contained in or referenced from this page; nor
shall there be any liability for any information construed as missing from this
page.
Note: This information
is preliminary, anecdotal and provided only as a source of general
information. Please check back with this FAQ periodically. It will be
updated as we learn more about product troubleshooting issues. We encourage GG
list members to share their experience so that it can be added to the Guaifenesin
knowledge base.
Statement of Interest:
In order to maintain appropriate ethical standards, Tesa wishes to inform all
members that she receives a small affiliation fee from several guaifenesin
product sources. No guai product is endorsed, nor is any product promoted
over another, as has been demonstrated over the years (and can be verified by a
check of the archives). Even if ethics were not the prevailing guide, there
would be little point in such promotion given the range of products advertised.
A senior
executive at Europe's largest drug maker has admitted most prescription
medicines don't work for most people,
it is reported. Click on
Drugs 'don't work on many people' to see full article.
Allen Roses, of GlaxoSmithKline, is quoted in a national newspaper as
saying "more than 90% of drugs only work in 30-50% of people. "
Contents
What is the best brand or type of
guai?
What are the differences between
LA (long acting), QA (quick acting [pharma: regular or immediate release) and OTC (over the counter)?
Do all brands of LA
guai work the same?
Is there a difference between the name brand medication and a generic brand?
Are LA and QA (regular
release) equally
effective for everyone?
Will
breaking or crushing my LA tablets make them the same as QA?
Are any particular
inactive ingredients a problem?
What
do I do if guai causes stomach pain
Does the color of my
guai make any difference?
Will
testing my LA guai in water or vinegar tell me if it is dissolving properly?
What does it mean
if a tablet comes out in my stool?
How
will I know if my guai product is causing me a problem?
What
can I do if I think my LA guai brand is a problem for me?
How
will I know if I should take LA or QA?
How
will I know if changing to a different brand, breaking my LA tablets or
switching to a QA product is helping?
Are
there any difference in titration or dosage between LA and QA?
How will I know if my guai is old?
How should I store guai?
How much
water do I need to drink when taking my LA guai?
Is it OK to drink juice with my
guai?
Do
manufacturers ever change ingredients or the way they make their brand of guai?
Who should I ask if I have
questions about my brand of guai?
Click here to become a GG member,
signoff or change mail options
What is
the best brand or type of guai?
There
is no "best" brand of guai or "bad" brand. This also
applies to types of guai, i.e. QA (quick acting - regular release) vs LA (long acting
- sustained action). Instead,
some (but not all) people may find that their own body responds differently to different
brands and types.
Back To Top
What are the differences between
LA (long acting),
QA (quick acting) and OTC (over the counter)?
LA stands for 'long acting' (other
abbrev.: SR, ER, XR, or XL)
LA guai is made to dissolve slowly, over a 12 hour period. QA stands for
quick acting (pharmacology: regular release). QA provides for an immediate
release of all the medication. OTC stands for 'over the counter' and means
that it can be purchased without a prescription. Most, but not all QA is
OTC. In some countries LA is OTC and does not require a prescription
to be purchased. Check with a pharmacist/chemist in your country to
determine guai LA or QA availability and see the guai
sources page.
NOTE: Since Mucinex
acquired a patent for their LA Guai the availability of LA guai has been
compromised.
Back
To Top
Do all brands of
LA guai work the same?
Some people (but not all) may
find that various brands of LA guai work better for them than others. Each
manufacturer makes their product slightly different, from how tightly the tablet
is compressed to inactive ingredients. In addition, each person's
digestive system etc. is different. These differences can make a particular
brand of LA guai easier or harder to dissolve and absorb for a given individual.
Back
To Top
Is
there a difference between the name brand medication and a generic brand?
In the US, drug manufacturers
are allowed a 5% variance (either up or down)
in active ingredient between their product and a name brand product.
This difference means that you can have as much as a 10% variance when
switching between generic brands. When switching between the name brand
and
a generic you will only have a 5% variance.
For example, brand A contains 5% less of the active ingredient than the name
brand and brand B contains 5% more. If you switch from brand A to brand B
you will be getting 10% more with brand B than you were getting with brand
A.
Back
To Top
Are LA and
QA equally effective for everyone?
Several pharmacists have said that
some people don't do well
with LA forms of medications. Anecdotal evidence points to
some of the newer QA guai products working well for some people
who were experiencing very little to no recovery on the LA guai.
Back
To Top
Will
breaking or crushing my LA tablets make them the same as QA?
Breaking your tablet along the score line will not destroy the time release
mechanism but breaking your tablet into several pieces or crushing it will. If you are having a problem with your guai because of
the time release mechanism, breaking the tablet into several pieces or crushing
it may solve your problem. However, if you
have some other problem, like an inability to digest a particular inactive
ingredient, breaking or crushing the tablet may not fix the problem. If
you find that crushing your tablet is helping, you may want to switch to QA guai.
Back
To Top
Are
any particular inactive ingredients a problem?
Some pharmacists/chemists have
stated that lactose in prescription medications can be an issue for lactose
intolerant people. If you are lactose intolerant and not progressing as
outlined in the protocol, you might want to try switching to a brand that does
not have lactose.
It is possible that other inactive ingredients could cause a problem for a particular
individual. If you suspect a problem consult with your pharmacist/chemist
and/or health care provider.
Back
To Top
What do I do if guaifenesin causes
stomach pain?
One option is to do a trial with topical guaifenesin (it bypasses the stomach).
Another is to try putting the guai into a capsule. And yet another is to
try various brands with different fillers as it could possibly be a particular
'inactive' filler causing the problem. There is also the possibility that
it could be cycling rather than a specific problem with guai itself but try all
other options before continuing to push through the cycle (herxheimer
response).
You can also discuss the issue with the
membership via the mailing list. Not a member yet?
Click here
to join.
Does
the color of my guai make a difference?
No, the color of your guai doesn't
matter at all. Some people have negative reactions to some dyes that are
used to color pills. The color of the pill is completely unrelated to it's
potency.
Back
To Top
Will testing my
LA guai in
water or vinegar tell me if it is dissolving properly?
Manufacturers have special
equipment to test the dissolution of their products. Their equipment is
designed to emulate the stomach. According to a pharmacist, using water or
vinegar in a glass to test whether your LA guai is working properly will not be of any value because manufacturers use ingredients that will only dissolve in the
gastrointestinal fluids.
Back To Top
What does it mean if a tablet comes out in my stool?
The meaning depends on the
particular medication that you are taking. In some brands, it
means the medication is defective and that you are not getting it's intended benefits. You should contact
the manufacturer to find out if this is a
problem with your particular brand. If it is a problem, return the
remaining guai to them for further testing. They cannot fix a problem if
they don't know that it exists. Back
To Top
How will I know if my
guai product
is causing me a problem?
There is no fool proof way to know
of course, but if you believe you've stalled, have never progressed/improved as
outlined in the protocol,
or have other symptoms you are
concerned about then it is worth considering whether your guai is a factor.
First make sure that you have
followed the protocol correctly for finding your dose, monitoring your progress and checking for salicylates.
Also consider that you might be hypoglycemic
and need the HG
diet. See
Protocol
Troubleshooting
for a
quick list of things to check.
Those who have experienced
success on the protocol for a time and later
encountered product problems often report a dramatic change in their cycling
pattern. This change often brings about severe, constant pain, and/or a
return of symptoms that had previously disappeared or reduced. At least
one member reported that maps indicated she had gone backward, in addition to
her symptoms.
Back
To Top
What
can I do if I think my LA guai brand is a problem for me?
Do
not drink juice when taking your tablet but instead make sure you are drinking a
full 8 oz glass of water. If you are still having problems after that, you
might consider breaking your tablets into several pieces (breaking along the
score line will
not remove the time release mechanism), crushing and putting into a capsule,
switching to a different batch of the same brand or switching to
a different brand. There is anecdotal evidence to suggest some people do
better on a quick acting form of guai instead of long acting and at least one
clinician is working with QA Guaifenesin regularly enough to have seen good
results.
Dr. Greg
Penniston's FAQ. Ask
for help on the list.
Back
To Top
How
will I know if I should take LA or QA?
See "How will I
know if my guai product is causing me a problem?"
Back
To Top
How will I know if
changing to a different brand, breaking my LA tablets or switching to a QA
product is helping?
For those who have never
progressed/improved as expected they should notice that their maps improve
and/or cycling is more in line with what is expected as outlined in the Guai-Treatment
FAQ. You may
also want to look at the Basic
Treatment Instructions.
Those who experienced a brand
problem after previous success with the protocol typically report
that they resumed their previously normal cycling patterns within days of
switching to a different brand, or breaking their tablets. Many symptoms
that were particularly problematic, such as severe, body-wide pain or fatigue
also improved dramatically within days of the switch. Back
To Top
Are
there any differences in titration or dosage between LA and QA?
Dr. St. Amand recommends following the
protocol as written, including dose titration. He also advises that your cycling
dose is the same on QA as it is on LA guai. However, some people have reported
needing a different dose when changing from LA to QA. At this stage, Dr Greg Penniston is the only practitioner, of whom we have knowledge, who has treated a
significant number of patients with lower than 'standard' doses . (Please refer
to Dr. Greg Penniston's site
to learn more about his experience.) We would be interested to hear from any
members who are aware of other practitioners finding success with their own
variations (see:
Variations)
Please be aware that there are many brands
of quick acting Guaifenesin (see "resources list" for some of these)
and that no particular brand is being recommended. It is 'change'
itself that is suggested (an exploration of one's own reactions) as a possible
viable option for those people who appear to be making little or no progress, or
who are not experiencing 'good days' following the basic protocol version.
Back
To Top
How
will I know if my guai is old?
The laws relating to medication expiration dates vary depending on your State (in the US) or Country.
Please ask your pharmacist for information regarding your medication expiration date.
For OTC products, look on the bottle for the expiration date. The product should
be good until the expiration date but exposure to heat or humidity, either in
your custody or on it's way to you can change it's efficacy. Some tips:
Don't stockpile guai. One pharmacist advises to use it within
a year of purchase for best results. Be sure to store your
medications properly. Back
To Top
How should I store
guai?
Heat and/or humidity can affect the efficacy of
medications so store your
guai properly, and buy from sellers you trust to do the same. Store
guai between 59 & 86 degrees F and l5 & 30 degrees
C.
-Do not store in the refrigerator.
-Store away from heat and direct light.
-Do not store in the bathroom, near the kitchen sink, or in other
damp places. Heat or moisture may cause the medicine to break down.
-Do not leave the cotton plug in a medicine container that has been opened; the cotton may draw moisture into the container.
-Do not leave the cap off the bottle
Back To Top
How
much water do I need to drink when taking my LA guai?
A minimum of 8 ounces
for the long acting form of guai. Water is required in order for the tablet to dissolve properly. Back
To Top
Is it OK to drink juice with my
guai?
Do not take guai with
juices, use water instead. Substances in juice may bind with medications,
altering their absorption.
It has been reported that
grapefruit juice alters the absorption of some medications. The effect
depends on the medication. We have no way of knowing how it will affect
guai without specific studies of guai and grapefruit juice. For further
details see: http://powernetdesign.com/grapefruit/index.html
Back
To Top
Do
manufacturers ever change ingredients or the way they make their brand of guai?
Yes, like other products,
the ingredients or manufacturing process is subject to change. If you have
reason to be concerned about particular ingredients or other product issues,
please work with your pharmacist/chemist. Back To Top
Who
should I ask if I have questions about my brand of guai?
Contact
your pharmacist/chemist. If you don't get the information you need,
contact the manufacturer. Back
To Top
Back To Top
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