Jump to content

Menu

Has anyone here experienced problems with the efficacy of generic drugs?


Greta
 Share

Recommended Posts

I will try to make a long story short:  when I reached perimenopause, my migraines became chronic (chronic being defined as at least 15 migraine days per month, mine were more like 25-28 days per month).  Went through a year of hell trying to find something that worked, finally got my life back when my neuro put me on amitriptyline.  It reduced the migraines down to once or twice a week.  Hallelujah!

 

Three weeks ago, very suddenly, my migraine frequency went back up to what it was before:  6 days per week.  I have been racking my brain trying to figure out what changed.  Nothing has changed.  No dietary changes.  No lifestyle changes.  No new stressful situations.  Nothing.

 

Then this morning it finally dawned on me that this started around the same time that I last picked up my usual amitriptyline refill, and that the pills had been blue-green instead of their usual yellow.  I didn't think much of the change at the time, but I checked my records (I keep a journal) and sure enough, the increase in frequency started just a few days after I started taking these new pills.

 

So I went to the pharmacy today to make sure they'd given me the right prescription, and they had, but they have switched providers/manufacturers (which is why the color was different).  They told me the FDA regulates generics and they're all the same blah, blah, blah.  I'm not buying it.  The timing and the profoundness of the difference is way too much to be mere coincidence.  I've seen articles in the media about how the cheap fillers and binders they use in generics can have an impact on the efficacy of the drug.

 

So, mostly I'm just curious if others have experienced problems with generic drugs.

 

Also, if you have any advice for me regarding what to do about it, I'm all ears!  I'm going to try to find out if my doctor prescribes the name-brand version specifically, whether or not my insurance will still cover it.  My guess is not.  Why would they pay for a very expensive version when the cheaper version is "the same"?  I'm also going to try to find out if some other local pharmacies use the "old" manufacturer (I did get the names of both the original manufacturer whose pills worked and the new manufacturer whose pills don't work from my pharmacist).  

 

 

  • Like 1
Link to comment
Share on other sites

Yes! My oldest ds and my dh take medicine that doesn't work as well if they get a different generic. Our pharmacist is wonderful. We asked her about it and she now orders the correct ones for them and has them ready. We use the same pharmacy all the time, so that helps. Some pharmacists aren't as understanding though. I hope yours will be helpful.

  • Like 2
Link to comment
Share on other sites

Yes! My oldest ds and my dh take medicine that doesn't work as well if they get a different generic. Our pharmacist is wonderful. We asked her about it and she now orders the correct ones for them and has them ready. We use the same pharmacy all the time, so that helps. Some pharmacists aren't as understanding though. I hope yours will be helpful.

 

 

I'm so glad you posted this!  The "head" pharmacist at my pharmacy is amazing, and she has helped me out with odd things several times over the years.  I will go back some day when she is there (she doesn't work on Sundays) and maybe she will be more sympathetic to my plight then the person I spoke to today.  Thank you for the great suggestion!

Link to comment
Share on other sites

Yes- I have. And coming from pharma it's insane to say that something produced at one plant is going to be identical to something produced at another. It irritates me that the FDA sticks to this line when it is one of those things that just doesn't work out in reality. Yes, The processes should be the same, and the active ingredient yes, but the quality of the ingredients or the process itself is subject to differ between manufacturers. "Should" and "do" are two different things in the reality of manufacturing! If you can afford it, I would talk to your doctor and ask that a generic

Not be substituted since you're having issues.

Link to comment
Share on other sites

To add- if you have time go on to the FDA website and enter a complaint of the efficacy of the drug (you can find the manufacturer on the Rx bottle). So many of the problems with drug issues after approval are due to lack of reporting adverse events. Patients either don't report to doctors, or the doctors don't report the complaints either. As a consumer you can report it yourself. It won't do much for you, but if more people reported issues would definitely come to attention faster, and you may be helping someone else down the road.

Link to comment
Share on other sites

Yes- I have. And coming from pharma it's insane to say that something produced at one plant is going to be identical to something produced at another. It irritates me that the FDA sticks to this line when it is one of those things that just doesn't work out in reality. Yes, The processes should be the same, and the active ingredient yes, but the quality of the ingredients or the process itself is subject to differ between manufacturers. "Should" and "do" are two different things in the reality of manufacturing! If you can afford it, I would talk to your doctor and ask that a generic

Not be substituted since you're having issues.

 

 

Thank you!

Link to comment
Share on other sites

Dh and my brother had a bad reaction to generic thyroid meds. I don't remember specifics but I remember talking to my mom about it when dh was having problems and she said my brother was having the same issue. Both returned to Synthroid and the problems went away.

 

ETA: I said "bad" but it wasn't bad bad where they had to go to the ER or anything like that, but it was a noticeable negative reaction to whatever was in the generic.

Edited by Cinder
  • Like 1
Link to comment
Share on other sites

Yes! I had this issue with thyroid meds. I can only take name brand Synthroid, no generics. Two doctors have told me that some people just don't tolerate whatever the other inactive ingredients are  in the generic. Definitely talk to your doctor.

 

 

Will do!

 

 

Here's where to file a report:

 

http://www.fda.gov/Safety/MedWatch/default.htm

 

 

 

Done!

  • Like 2
Link to comment
Share on other sites

After a ridiculous argument with the target pharmacy about everything texasmom said, a different pharmacy said, sure! We can totally get you that other generic brand even though we normally carry this third generic brand.

 

The point is that I learned that different pharmacies carry different brands of generic stuff and they can usually order your regular brand. Unless it's target. And as long as your insurance company still considers it generic <insert eye roll>

  • Like 2
Link to comment
Share on other sites

legally - generics can have many more ingredients than brand name drugs.

there are some fillers to which I react badly.

for some things - getting into organic chemistry and HOW the molecules are arranged can make a difference.  it can contain the same atoms - but a different arrangement may or may not bond/receive to the cells the way that is most advantages.

  • Like 2
Link to comment
Share on other sites

Absolutely! The actual pharmacist said that? WOW. Complete ignorance. I personally have had really bad side effects from a generic that I didn't have from the brand name drug. DH can only take the brand and a certain generic from his ADHD meds. My best friend's daughter is allergic to the filler in one generic of her asthma meds. And on and on and on. You're not crazy--the pharmacist is!

 

ETA: Your doctor should be able to note the adverse effects and write a script for the brand name, but if it's not on your insurance schedule, you'll pay out the nose for it. My friend whose child is allergic had to go 12 rounds with her insurer to get them to cover it. Pharmacy shopping would be much easier!

Edited by zoobie
  • Like 1
Link to comment
Share on other sites

I had steroid skin goo that finally went generic and I was glad because it saved a ton of money. But it didn't work. It wasn't the generic steroid that was off; it was the carrier-the cream base-that didn't work.

 

I went to a compounding pharmacy and they were able to get the generic steroid before it was mixed into the carrier and put the steroid in a carrier that did work. So I saved most of the money compared to name brand and got something that worked.

 

So, yeah.

Link to comment
Share on other sites

After a ridiculous argument with the target pharmacy about everything texasmom said, a different pharmacy said, sure! We can totally get you that other generic brand even though we normally carry this third generic brand.

 

The point is that I learned that different pharmacies carry different brands of generic stuff and they can usually order your regular brand. Unless it's target. And as long as your insurance company still considers it generic <insert eye roll>

I'm sorry that happened. In my case, Target is the incredible helpful pharmacy. My guess is that it is the specific pharmacist, not the pharmacy. Also, be sure to ask the person who actually order the medicine.

  • Like 1
Link to comment
Share on other sites

I haven't, but I think it's totally possible.

 

Something I just figured out.  Not saying this is your situation, but who knows.  I have sometimes wondered if the generic Prevacid was not as good or something.  It really didn't seem to be working all that well for me sometimes.  I read the details of when/how to take it and discovered I had been taking it WRONG since FOREVER.  It says it is activated by food.  So it says take 30 minutes before you eat.  I was taking it and not eating for hours.  Day after day like that.  Uhhh...I had no idea.  This might seem stupid on my part except I really didn't know why it mattered that I ate around 30 minutes after taking it.  So now I'm making a point to follow this carefully. 

 

So are you sure you are taking it correctly?  If it matters?  (Just another possibility to consider.) 

 

 

  • Like 1
Link to comment
Share on other sites

Absolutely! The actual pharmacist said that? WOW. Complete ignorance. I personally have had really bad side effects from a generic that I didn't have from the brand name drug. DH can only take the brand and a certain generic from his ADHD meds. My best friend's daughter is allergic to the filler in one generic of her asthma meds. And on and on and on. You're not crazy--the pharmacist is!

 

ETA: Your doctor should be able to note the adverse effects and write a script for the brand name, but if it's not on your insurance schedule, you'll pay out the nose for it. My friend whose child is allergic had to go 12 rounds with her insurer to get them to cover it. Pharmacy shopping would be much easier!

 

 

Yeah, I mean, she said it nicely, but she said it had to be something else, like a change in my diet or a change in the weather.  But I haven't changed my diet and my migraines have never correlated to the weather.  But she was still convinced it was just something else I hadn't thought of.  She was rather dismissive, and walked away at that point, but the other pharmacist (or pharm tech, I think) who was helping me was nicer and he said if I didn't see an improvement I should definitely contact them again.  There is an older pharmacist there who I'm pretty sure is a Pharm.D who has helped me a great deal in the past so I'll try again when she's there!

Link to comment
Share on other sites

I haven't, but I think it's totally possible.

 

Something I just figured out.  Not saying this is your situation, but who knows.  I have sometimes wondered if the generic Prevacid was not as good or something.  It really didn't seem to be working all that well for me sometimes.  I read the details of when/how to take it and discovered I had been taking it WRONG since FOREVER.  It says it is activated by food.  So it says take 30 minutes before you eat.  I was taking it and not eating for hours.  Day after day like that.  Uhhh...I had no idea.  This might seem stupid on my part except I really didn't know why it mattered that I ate around 30 minutes after taking it.  So now I'm making a point to follow this carefully. 

 

So are you sure you are taking it correctly?  If it matters?  (Just another possibility to consider.) 

 

I do appreciate you mentioning it, because that's an important point.  Both the doctor and the pharmacist told me to take it before bed because it makes you drowsy, but they didn't give any other specific instructions, and neither does the bottle, just "take one tablet by mouth every night at bedtime."  That's the way I've always done it.  Thanks, though!

  • Like 1
Link to comment
Share on other sites

Synthroid is actually one of the drugs where the generic is NOT the same as the brand.  Not even to the degree of bioequivalence that current generics supposedly have.  Usually it is not recommended to switch back and forth between Synthroid and generics unless you are experiencing problems.  

 

Dh is a generic pharma analytical chemist.   He's explained a few times about how different brands use different fillers and binders, which can affect how you react to them.  I can't take generic benedryl at night because it makes my RLS worse.  But I can take it in Advil PM or the brand without a problem.  

  • Like 3
Link to comment
Share on other sites

Synthroid is actually one of the drugs where the generic is NOT the same as the brand.  Not even to the degree of bioequivalence that current generics supposedly have.  Usually it is not recommended to switch back and forth between Synthroid and generics unless you are experiencing problems.  

 

Dh is a generic pharma analytical chemist.   He's explained a few times about how different brands use different fillers and binders, which can affect how you react to them.  I can't take generic benedryl at night because it makes my RLS worse.  But I can take it in Advil PM or the brand without a problem.  

 

 

Awesome!  By chance, has he ever mentioned whether the fillers and binders are changing the actual digestibility of the pill?  I am wondering if splitting or crushing it might help.  I am going to try to get switched back to the other manufacturer's pills, but in the meantime I've got a lot of these to use up.  I'm wondering if there's any way to make them work better.

Link to comment
Share on other sites

Awesome!  By chance, has he ever mentioned whether the fillers and binders are changing the actual digestibility of the pill?  I am wondering if splitting or crushing it might help.  I am going to try to get switched back to the other manufacturer's pills, but in the meantime I've got a lot of these to use up.  I'm wondering if there's any way to make them work better.

 

He said that yes, it could make a difference.   It shouldn't have gotten approved if it didn't react the same way within a certain margin, but that range may be as wide as 90-110% of the brand, which depending on the therapeutic range could make quite a difference.  And the difference between generics could be wider because one could be at the top of the allowable range while another is at the bottom, since both are tested versus the brand, not versus each other.

 

I hope that makes sense.  :-)

 

Many generic manufacturers will try to use the same fillers/binders but they don't have to.  Bioequivalence is the only requirement.

  • Like 1
Link to comment
Share on other sites

He said that yes, it could make a difference.   It shouldn't have gotten approved if it didn't react the same way within a certain margin, but that range may be as wide as 90-110% of the brand, which depending on the therapeutic range could make quite a difference.  And the difference between generics could be wider because one could be at the top of the allowable range while another is at the bottom, since both are tested versus the brand, not versus each other.

 

I hope that makes sense.  :-)

 

Many generic manufacturers will try to use the same fillers/binders but they don't have to.  Bioequivalence is the only requirement.

 

 

Thank you so much for helping me out, and please pass my thanks along to him as well.  :001_smile:

  • Like 1
Link to comment
Share on other sites

Synthroid is actually one of the drugs where the generic is NOT the same as the brand.  Not even to the degree of bioequivalence that current generics supposedly have.  Usually it is not recommended to switch back and forth between Synthroid and generics unless you are experiencing problems.  

 

Dh is a generic pharma analytical chemist.   He's explained a few times about how different brands use different fillers and binders, which can affect how you react to them.  I can't take generic benedryl at night because it makes my RLS worse.  But I can take it in Advil PM or the brand without a problem.  

 

That is so interesting! I have a similar issue!  I have always wondered why Advil PM or Nyquil work better for me than just popping two generic Benadryls and a couple of Advil. I figured in this case diphenhydramine was diphenhydramine, and though maybe they actually (secretly) spiked slightly more than the 25 mg in the PM versions. I never thought the binders would affect on a drug such is that. Learn something new every day around here! I guess I now have an excuse not to be cheap and should spring for my Advil PM! :) 

Link to comment
Share on other sites

NZ has a centralised buying system for pharmaceuticals so you get what is funded. I do ask the doctor not to tick the 'generic substitution allowed' box for ventolin even though it means paying more - the generic is horrible to use and tastes dreadful. I am think the main ingredient is usually the same but all the other stuff causes problems

  • Like 1
Link to comment
Share on other sites

I had issues with a generic bc pill back when I was using it to treat my PCOS. I normally took one generic version of Yazmin called Ocella, but one month my pharmacy switched me to something else with no warning. My hormones freaked out, my PCOS symptoms came back, and I was in a rage constantly. I had the pharmacy order my normal generic, went back to that, and was fine. For my other prescriptions I'm okay with whatever generic I happen to get, but that one really messed me up.

  • Like 1
Link to comment
Share on other sites

That is so interesting! I have a similar issue!  I have always wondered why Advil PM or Nyquil work better for me than just popping two generic Benadryls and a couple of Advil. I figured in this case diphenhydramine was diphenhydramine, and though maybe they actually (secretly) spiked slightly more than the 25 mg in the PM versions. I never thought the binders would affect on a drug such is that. Learn something new every day around here! I guess I now have an excuse not to be cheap and should spring for my Advil PM! :)

 

Yeah, it was a surprise to me too.  If it wasn't for the extremely twitchy leg reactions, I would even have noticed.

 

There's actually three "salts" of Benedryl - diphenhydramine citrate, HCL and succinate - which one is used affects absorption and dose.  My branded Benedryl is HCL, one of my generic brands is also HCL and I can't find the other, but the Advil PM is citrate.

  • Like 1
Link to comment
Share on other sites

The manufacturer makes a huge difference. The "inactive" ingredients can make a big difference in how your body absorbs the medication.

 

My 18yo has been on the same dosage of trazodone since 12.5yo for insomnia. Walgreen's switched to a different manufacturer last summer and suddenly we had to double the dosage. We had to hunt around to find a pharmacy that had trazodone from Pliva instead of Apotex. People have had the exact same issue switching the other way, from Apotex to Pliva. The inactive ingredients make a difference.

  • Like 1
Link to comment
Share on other sites

The manufacturer makes a huge difference. The "inactive" ingredients can make a big difference in how your body absorbs the medication.

 

My 18yo has been on the same dosage of trazodone since 12.5yo for insomnia. Walgreen's switched to a different manufacturer last summer and suddenly we had to double the dosage. We had to hunt around to find a pharmacy that had trazodone from Pliva instead of Apotex. People have had the exact same issue switching the other way, from Apotex to Pliva. The inactive ingredients make a difference.

 

Not totally related to the thread but Pliva is where Dh and I worked when we met.   :)

 

I also worked for the company that developed Synthroid, and was involved in the lawsuits regarding generics.

Link to comment
Share on other sites

I will try to make a long story short:  when I reached perimenopause, my migraines became chronic (chronic being defined as at least 15 migraine days per month, mine were more like 25-28 days per month).  Went through a year of hell trying to find something that worked, finally got my life back when my neuro put me on amitriptyline.  It reduced the migraines down to once or twice a week.  Hallelujah!

 

Three weeks ago, very suddenly, my migraine frequency went back up to what it was before:  6 days per week.  I have been racking my brain trying to figure out what changed.  Nothing has changed.  No dietary changes.  No lifestyle changes.  No new stressful situations.  Nothing.

 

Then this morning it finally dawned on me that this started around the same time that I last picked up my usual amitriptyline refill, and that the pills had been blue-green instead of their usual yellow.  I didn't think much of the change at the time, but I checked my records (I keep a journal) and sure enough, the increase in frequency started just a few days after I started taking these new pills.

 

So I went to the pharmacy today to make sure they'd given me the right prescription, and they had, but they have switched providers/manufacturers (which is why the color was different).  They told me the FDA regulates generics and they're all the same blah, blah, blah.  I'm not buying it.  The timing and the profoundness of the difference is way too much to be mere coincidence.  I've seen articles in the media about how the cheap fillers and binders they use in generics can have an impact on the efficacy of the drug.

 

So, mostly I'm just curious if others have experienced problems with generic drugs.

 

Also, if you have any advice for me regarding what to do about it, I'm all ears!  I'm going to try to find out if my doctor prescribes the name-brand version specifically, whether or not my insurance will still cover it.  My guess is not.  Why would they pay for a very expensive version when the cheaper version is "the same"?  I'm also going to try to find out if some other local pharmacies use the "old" manufacturer (I did get the names of both the original manufacturer whose pills worked and the new manufacturer whose pills don't work from my pharmacist).  

I've had the same thing happen with one of my prescriptions.  My local pharmacy now orders a specific generic for me.  That might be a possibility to look into.

 

I have other prescriptions that we just didn't see the same response in the generic.  One they went on years later to pull from the market because of that problem.  I have three meds that I take dispense as written, name-brand only.  I think we are having this problem with one of DH's generics.  We are currently documenting symptoms.

Edited by melmichigan
  • Like 1
Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

×
×
  • Create New...