Actavis has initiated a class 1 recall for all strengths of oral use Digitek (digoxin).

On April 25, 2008, Actavis initiated a class 1 recall of Digitek (digoxin) all strengths for oral use. The products are also distributed under the Bertek label by Mylan Pharmaceuticals and UDL. This voluntary recall is due to the possibility that tablets with double the appropriate thickness may have been commercially released. Those tablets may contain twice the approved level of active ingredient than is appropriate. Double strength tablets may pose a risk of toxicity in patients with renal failure. Digitalis toxicity can cause nausea, vomiting, dizziness, low blood pressure, cardiac instability and bradycardia. Death can also result from excessive digitalis intake. Several reports of illness and injuries have been received. Digitek is used to treat heart failure and abnormal heart rhythms.

Sudden discontinuation of Digitek without your doctor's knowledge can also cause serious health problems. Please speak with your doctor immediately about this Digitek recall.

What you should do:

you are currently using Digitek, please contact your prescriber immediately. and your prescriber should discuss the best therapy options for you, and then obtain a 10-14 days supply prescription to be filled locally. Medco will be sending notification to all patients who are currently taking the medication.

• • If you have refills for Digitek you can safely refill by calling the toll free number located on your prescription medication bottle to receive medication which is not impacted by the product recall.
• • If you do not have refills remaining, please obtain a new mail order prescription and mail it to Medco to receive medication which is not impacted by the product recall.

Important Note: Medco is working to secure an alternative generic manufacturer for future Digitek or digoxin new and refill prescription requests. If we are unsuccessful, all prescriptions previously filled for Digitek will be filled as the brand name product, Lanoxin, and you would be charged your plan's brand copay or co-insurance.

For more information:

For Product Return Information and Reimbursement and any other inquiries, Actavis has provided a toll free number for patients to obtain a product return kit by calling, 1.888.276.6166 Monday through Friday, 8 a.m. to 5 p.m. eastern time or visit www.actavis.us.

If you have any additional questions or concerns relative to this medication recall or about your prescription drug benefit, please call the phone number on your prescription bottle label or ID card.

If you have medical questions please contact your health care provider.

The information on this site is not intended to take the place of your doctor or other healthcare professionals. It is a resource to help you make the best decisions and get the most from the medical services available to you. A licensed physician should be consulted for diagnosis and treatment of all medical conditions.

On or about May 21, Medco By Mail will exhaust its supply of clopidrogel bisulfate, the generic version of the blood thinner Plavix. Per an August 31, 2006 court order, the generic manufacturer has been barred from sending clopidrogel to pharmacies because of patient litigation. Once supplies are depleted, Medco will dispense Plavix and charge plan members the brand co-payment. Beginning the week of May 14, Medco will insert the attached letter into the literature pack accompanying all prescriptions for Plavix.

The letter informs members that their prescription has been filled with the brand-name drug Plavix instead of the generic equivalent because Medco's mail-order pharmacies no longer have the generic in stock; they will be charged their plan's brand co-payment; the generic's removal from the marketplace was due to a patent issue and not because of any safety issue; and if they have questions, they should call the number on the back of their prescription card.

The Health Plan Pharmacy Health Services division is available to answer any additional questions the members may have. Please call 740.695.7914 or 1.800.624.6961, ext 7914.