Elite Pharmaceuticals Inc (ELTP)

[WeeZuhl]

The idea that there is risk in manufacturing opioids is not ludicrous nor incomprehensible. What other explanation can you come up with for Elite not being able to 'give' away their approved acetaminophen and Codine?

Nobody wants Tylenol #3 because nobody wants codeine. It is a weak analgesic with a limited therapeutic window. It requires higher doses for effective analgesia, but it has the typical opioid side effects (i.e. nausea, lethargy) at those doses. In 2017, FDA restricted codeine use in kids (which was a full 18 months before Elite filed the ANDA). Oxycodone, hydrocodone, and hydromorphone are much stronger, and therefore they are much more effective at lower doses, which means the side effects are much less. Methadone tends to have more side effects, but it has the benefit of a longer half-life and is longer lasting.

It was a waste of money to develop, and that is why nobody wants to waste their money to buy it. Please don't confuse Nasrat's stupid decision to develop codeine with some rational explanation for the Great Opioid Massacre of 2019. And also, don't mistake Nasrat's smart-alecky disdain for Elite shareholders as one of his positive attributes.

As for whether or not opioids are over-prescribed, yes, for sure, but not as much lately as in the past. For chronic pain, I tend to have better luck over the long term with some old non-narcotic favorites, like escitalopram and bupropion, and new friends, like pregabalin. But there is a role for opioids for acute and breakthrough pain, and I refuse to leave my patients to suffer when there is something I can do about it. I've said it before on this board, in regards to lumbar spinal stenosis, I've made people walk again with a fentanyl patch. Very low side effective profile, very effective drug. Should I leave those people in pain in their wheelchairs because I have a moral objection to fentanyl? Not me.