Is there an effective alternative medication for Ampyra? My copay is a hefty $580 a month which is a budget buster for us. The ampyra seems to help with my mobility so really hate giving it up.
Ampyra is branded 4 aminopyridine. We used to get compounding pharmacies to provide 4 aminopyridine to our patients before Ampyra was approved by the FDA. Insurance will not cover the compounded drug but the price used to be reasonable. Many neurologists will no longer prescribe compounded 4 aminopyridine for patients but you could ask your doctor. Their reasons are multiple:
1. There is no strict oversight of the compounded product for purity, shelf life etc. This is why I always used the same compounding pharmacy years ago when I used the compounded product.
2. 4 aminopyridine is somewhat unstable because of its chemical properties.
3. There is a history of batch to batch differences with the compounded product; # 3 and 4 can lead to increased side effects like seizures because of people adjusting doses upwards to gain benefits
4. There are potential medical legal issues of prescribing compounded 4 aminopyridine now that Ampyra is available.
If you do use the compounded product, do not take more than 10 mg twice a day regardless of whether you achieve the same benefit as you did with Ampyra.
Perhaps your best move is to call Acorda, the company that makes Ampyra and find out if they have a drug assistance program to help you with the cost.
Revere (Rip) Kinkel MD
Director of the Multiple Sclerosis Program
Director of Hillcrest Neurology
Professor of Clinical Neurosciences
University of California San Diego