Tobi/ eFlow/trio?

P

PatrickM

New member
My son has recently started on the inhaled tobi. I have read that there is a nebulizer called the eflow or the trio that dramatically reduces treatment time. I know Foundation Care pharmacy offers this to their customers on Tobi but my insurance won't let me use them. I just asked Curascript the pharmacy I have to go through and they do not offer this neb. Does anyone have any idea how I can get one? Can you just buy one? Also I have an altera neb as my son was tried on cayston but he couldn't tolerate it. I have been told I can not use that neb for the tobi. Does anyone know if that is true? I will double check with the doctor but I am just curious.

Thanks-

Tara
 
P

PatrickM

New member
My son has recently started on the inhaled tobi. I have read that there is a nebulizer called the eflow or the trio that dramatically reduces treatment time. I know Foundation Care pharmacy offers this to their customers on Tobi but my insurance won't let me use them. I just asked Curascript the pharmacy I have to go through and they do not offer this neb. Does anyone have any idea how I can get one? Can you just buy one? Also I have an altera neb as my son was tried on cayston but he couldn't tolerate it. I have been told I can not use that neb for the tobi. Does anyone know if that is true? I will double check with the doctor but I am just curious.

Thanks-

Tara
 
P

PatrickM

New member
My son has recently started on the inhaled tobi. I have read that there is a nebulizer called the eflow or the trio that dramatically reduces treatment time. I know Foundation Care pharmacy offers this to their customers on Tobi but my insurance won't let me use them. I just asked Curascript the pharmacy I have to go through and they do not offer this neb. Does anyone have any idea how I can get one? Can you just buy one? Also I have an altera neb as my son was tried on cayston but he couldn't tolerate it. I have been told I can not use that neb for the tobi. Does anyone know if that is true? I will double check with the doctor but I am just curious.
<br />
<br />Thanks-
<br />
<br />Tara
 
J

just1more

New member
The only way to get the e-flow is through one of the approved pharmacies (there are only 2 I know of). The main reason is 1) you don't pay for the e-flow it is just loaned for free and 2) you can't use "TOBI" in the e-flow; you have to have Tobramyacin compounded specially for the e-flow so it has to be a pharmacy with this ability.

Sorry <img src="i/expressions/face-icon-small-sad.gif" border="0">
 
J

just1more

New member
The only way to get the e-flow is through one of the approved pharmacies (there are only 2 I know of). The main reason is 1) you don't pay for the e-flow it is just loaned for free and 2) you can't use "TOBI" in the e-flow; you have to have Tobramyacin compounded specially for the e-flow so it has to be a pharmacy with this ability.

Sorry <img src="i/expressions/face-icon-small-sad.gif" border="0">
 
J

just1more

New member
The only way to get the e-flow is through one of the approved pharmacies (there are only 2 I know of). The main reason is 1) you don't pay for the e-flow it is just loaned for free and 2) you can't use "TOBI" in the e-flow; you have to have Tobramyacin compounded specially for the e-flow so it has to be a pharmacy with this ability.
<br />
<br />Sorry <img src="i/expressions/face-icon-small-sad.gif" border="0">
 
P

PatrickM

New member
Oh how disappointing. I thought I had found a faster way to do this neb. Well thank you for letting me know.

Tara
 
P

PatrickM

New member
Oh how disappointing. I thought I had found a faster way to do this neb. Well thank you for letting me know.

Tara
 
P

PatrickM

New member
Oh how disappointing. I thought I had found a faster way to do this neb. Well thank you for letting me know.
<br />
<br />Tara
 
C

cf4life

New member
You could probably buy one with a script from one of the pharmacies, but they are something like $1700 to buy, plus neb kits replacements every 6 months at several hundred dollars.

I could be wrong, but I believe all that foundation care does is take a Tobi ampule and squirt a smaller amount into a custom ampule. That is my impression from talking to someone at foundation care. If this is true, someone with an ampule from foundation care could tell you how much Tobi to use in a trio. Can anyone verify this?
 
C

cf4life

New member
You could probably buy one with a script from one of the pharmacies, but they are something like $1700 to buy, plus neb kits replacements every 6 months at several hundred dollars.

I could be wrong, but I believe all that foundation care does is take a Tobi ampule and squirt a smaller amount into a custom ampule. That is my impression from talking to someone at foundation care. If this is true, someone with an ampule from foundation care could tell you how much Tobi to use in a trio. Can anyone verify this?
 
C

cf4life

New member
You could probably buy one with a script from one of the pharmacies, but they are something like $1700 to buy, plus neb kits replacements every 6 months at several hundred dollars.
<br />
<br />I could be wrong, but I believe all that foundation care does is take a Tobi ampule and squirt a smaller amount into a custom ampule. That is my impression from talking to someone at foundation care. If this is true, someone with an ampule from foundation care could tell you how much Tobi to use in a trio. Can anyone verify this?
 
K

Keepercjr

Guest
Patrick

It is possible your insurance may approve the med if the CF doctor writes a script for the compounded tobra and sends it to foundation care. You can't just get that anywhere - you HAVE to get it at one of the 2 pharmacies.
 
K

Keepercjr

Guest
Patrick

It is possible your insurance may approve the med if the CF doctor writes a script for the compounded tobra and sends it to foundation care. You can't just get that anywhere - you HAVE to get it at one of the 2 pharmacies.
 
K

Keepercjr

Guest
Patrick
<br />
<br />It is possible your insurance may approve the med if the CF doctor writes a script for the compounded tobra and sends it to foundation care. You can't just get that anywhere - you HAVE to get it at one of the 2 pharmacies.
 
J

just1more

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>cf4life</b></i>
I could be wrong, but I believe all that foundation care does is take a Tobi ampule and squirt a smaller amount into a custom ampule. </end quote></div>

Be very careful. Yes, the difference between TOBI (brand name in an ampule) and the tobramycin for e-flow is the concentration. Thought from a cost-standpoint I seriously doubt they are buying Tobi & watering it down. They are buying IV tobramycin in bulk and compounding it most likely.

However, tobramycin is VERY toxic and dosing is extremely important. I personally wouldn't risk mixing it myself as there is no way you could 1) control the concentration tightly and 2) maintain aseptic (sterile) conditions while mixing.

Sorry <img src="i/expressions/face-icon-small-sad.gif" border="0">
 
J

just1more

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>cf4life</b></i>
I could be wrong, but I believe all that foundation care does is take a Tobi ampule and squirt a smaller amount into a custom ampule. </end quote>

Be very careful. Yes, the difference between TOBI (brand name in an ampule) and the tobramycin for e-flow is the concentration. Thought from a cost-standpoint I seriously doubt they are buying Tobi & watering it down. They are buying IV tobramycin in bulk and compounding it most likely.

However, tobramycin is VERY toxic and dosing is extremely important. I personally wouldn't risk mixing it myself as there is no way you could 1) control the concentration tightly and 2) maintain aseptic (sterile) conditions while mixing.

Sorry <img src="i/expressions/face-icon-small-sad.gif" border="0">
 
J

just1more

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>cf4life</b></i>
<br />I could be wrong, but I believe all that foundation care does is take a Tobi ampule and squirt a smaller amount into a custom ampule. </end quote>
<br />
<br />Be very careful. Yes, the difference between TOBI (brand name in an ampule) and the tobramycin for e-flow is the concentration. Thought from a cost-standpoint I seriously doubt they are buying Tobi & watering it down. They are buying IV tobramycin in bulk and compounding it most likely.
<br />
<br />However, tobramycin is VERY toxic and dosing is extremely important. I personally wouldn't risk mixing it myself as there is no way you could 1) control the concentration tightly and 2) maintain aseptic (sterile) conditions while mixing.
<br />
<br />Sorry <img src="i/expressions/face-icon-small-sad.gif" border="0">
 
C

cf4life

New member
Not watering down, but using a smaller amount of Tobi. It is not so much the concentration as it is the amount of drug per dose. You need a smaller amount of drug with the eflow because it is much more efficient at delivering the drug.

I mixed my own tobramycin for years before Tobi was around. It is not really a big deal. I started nebbing tobramycin in the 80s. It is important to mix the right amount of antibiotic into normal saline or similar. I used to mix it right in my neb cup each time.
 
C

cf4life

New member
Not watering down, but using a smaller amount of Tobi. It is not so much the concentration as it is the amount of drug per dose. You need a smaller amount of drug with the eflow because it is much more efficient at delivering the drug.

I mixed my own tobramycin for years before Tobi was around. It is not really a big deal. I started nebbing tobramycin in the 80s. It is important to mix the right amount of antibiotic into normal saline or similar. I used to mix it right in my neb cup each time.
 
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