Are Generic and Brand-name Pills Created Equal?

The (our) FDA i# corrupt as the rest of them. You do what feels right for you!!!

I was on Ampyra for years. Then my prescription coverage made me switch to generic.
Two things happened—
1. Lost the Ampyra co-pay assistance so had to pay $60/month when I was paying $25/month before.
2. Generic brand caused diarrhea.

So I had to get a note from my doctor stating I was unable to tolerate the generic brand so I could get prescription coverage to cover the Ampyra.
All of this caused a 2 month disruption of taking my Ampyra daily.

Interesting. I've been on Synthroid for decades. The one time a Dr had me try a generic levothyroxin, my body reacted as though I stopped the medication completely...classic symptoms. Major Hair loss, weight gain, etc. Went back to Synthroid and have never had an issue since. (Thank God my oxybutynin still works fine!)

I too "had to" switch to generic Ampyra. It works a little but I'm back to using a walker. And my insurance won't cover any of the cost of the name brand. They told me it would be $7000 a month. Who can afford that?

Careful Ed, you could be opening Pandora's Box! Generics are, have been, and will continue to be preferred by all Insurance companies; financially they could not remain in business otherwise. We all know the FDA is responsible for the quality of all medications. They must be equivalent in effectiveness and no company will risk loosing their certification to sell in the US if their drugs were found otherwise. Just a whisper of malfeasance can devalue a company overnight! One of the largest - Israel's Teva Pharmaceuticals - manufactures drugs for the world. They guard their reputation emphatically and would take great issue with your suggestions.

Do keep in mind that because a company is based in the US sells the drugs, generic or not, they can and are manufactured elsewhere. Certainly there can be shipping issues in any country, the pandemic has messed up the world. But even suggesting, without any evidence, that drugs 'may' be left on the runway for 'days' is reckless, companies do know how to ship everything. I've received Avonex shipment in August in Alabama with Ice Packs frozen solid. It is done all the time. Why would you even question that?

People do build up a tolerance to drugs, conditions change and can interfere with other drugs. That's why we have so many. To claim that a drug lost its effectiveness when switching to a generic is ignoring the many other issues that could be causing that. I don't know and neither do you. Repeating rumors accomplishes nothing. Also, even with all the safeguards in place drugs can be defective, it's manufacturing. Mistakes do happen.

I know you are voicing a concern, I too have had that thought from time to time. But unless you have evidence that a drug company or the FDA is not properly performing due diligence please do not start careless rumors.

Regarding Modafinil, I took it until it cause elevated blood pressure. My neurologist suggested a sleep study to address fatigue symptoms. I am now using a CPAP and it has helped the fatigue issues immensely. You should ask your doctor for a sleep study. It's simple and can be completed in your home and may be the start to a less fatiguing day.

I’ve had problems with many generics since I first started having to take medications for pretty much anything.
There are a few generics that I’ve tolerated ok, but I’m a firm believer that there is a significant difference between brand name and generic.

Thank you for this. I had researched this issue before and only found websites saying that they are chemically equivalent and therefore there should be no difference. I was trying to switch from amantadine to modafinil because the amantadine was making my skin splotchy (it was a temporary thing that would come and go, but it looked disturbing when it happened). I tried the generic modafinil and it didn't work for me. The brand name was $500 a month which seemed like a lot to pay just to not have splotchy skin, so I'm taking amantadine again. Truth is, I don't mind sticking with the amantadine. It has worked well for me for 20 years and with covid nobody sees my skin anymore anyway. Most of the time I get generics, but I do still wonder about the effectiveness of generics vs brand name for some medicines.

We found out 6 years ago brands and generics are not the same. My husband went to generic Wellbutrin and I went to generic Cymbalta. We were both sicker than dogs during the process…my husband for months. The release rate on the brands work well, while the generics might dump all at once but not steadily like the brand…but the ingredients are the same.

My Mom has taken generic Lipitor for years. However, last year she received a script from a different manufacturer and it made her sick. After narrowing down what might have caused the problem, we received a new script from the old manufacturer and she was fine. Even the manufacturers are not the same.

And Modafinal will never be better than Provigil. It’s just not as effective. But it’s supposed to be the same. Go figure.

I'm unfortunately on 600mg of Lyrica daily (don't get me started on all the problems associated with that) and when I received generic 200mg as my Part D didn't want to to pay for it, it was as if I wasn't taking anything. I was in ALOT of pain. Dr. had to send a challenge detailing the situation and I'm back on brand name. When I tried liquid Lyrica as I've been desperately trying to wean down for 2 years it was even worse.

I've even noticed different brands of generics working better or worse than others. Baclofen, methadone Diclofenac, etc.

I

years ago, i was on a blood pressure medication and the levothyroxine that i was filling at Walmart. they were using those pullout sleeved all in one things that cost $4 a month to fill, and they were made in China. When my Doc saw no improvement in my BP after 6 weeks, she bumped the dose and another 6 weeks saw little change. she asked where i was filling my meds. When i told her she GASPED out loud. She asked me to bring the meds in a few days later and took a few samples to send to the lab.. You guessed right.. they very little of what they were SUPPOSED to have in them. I obtained a script for the original dosage of lisinopril and went to Walgreen's with it and within 10 days my BP was coming down again.. they were also using a generic but it was from a reputable manufacturer here in the US

I am shocked the Doc didn't do that to start with, especially if you were totally stable on the name brand to begin with. There is always a way to get an over-ride for stuff like that. Prior Authoizations are gotten all the time for MS drugs because none of them on any of the Plan D's formulary's. They MUST be authorized. I hate these companies.. I am going to switch mine this year because of all the ridiculous crap they put me thru the beginning of this year. they are still trying to get me to switch pharmacies now. every month they send me a letter saying "this would a less expensive choice" not for me tho because i am in phase 4 so i have no costs..

My daughter says she could not tolerate the generic thyroid medicine. So she pays for the "real McCOY!!. When I was on Copaxone, the pharmacy automatically switched me to the generic version when if first came out. I was upset they did not tell me. They said it was policy. Once I contacted my doctor to make sure I got the brand name, the pharmacy let me return the generic ones. I took Copaxone for 12 years and now I am not on any MS medication... savings thousands of dollars! My policy is if it works don't change it. I do take one generic drug and I guess it works- not issues with it anyway.

I was told, by a reputable source, that the binders used in generic drugs are different in brand named drugs. The binders introduce the drugs into the body. So generics are NOT identical to brand named drugs.

There is a difference for me with Ampyra versus the generic. I used Ampyra for years and it significantly improved my walking. When I turned 65 and went on Medicare the insurance would not cover Ampyra. My walking became worse and fortunately the physical therapist could document my decline and I was able to get it again. I sure am glad I could begin Ampyra again! Many of my other medications are generic and all of them have the main ingredient with different fillers making them cheaper.

Since learning that the majority of the drugs in the USA are made in China, and often questioning the efficacy of generic drugs; I am left to wonder what to do. Everything is so political nowadays, and drug prices are so ridiculously high (especially brand names), how are we supposed to survive? When other cultures respect and revere its older population for their wisdom and knowledge - it seems that our younger people don't listen to us & actually want us to go away & die. I just don't understand.............

Yes generic is different. It's not as good as name brand. I am on copaxone. They tried to put me on generic. Broke out in a rash. Life is challenging enough. I fought the insurance. My NP fought for me. Now I am still on name brand. You have to fight for what is important for oneself. Carla

Hi Ed: regarding release rates of brand vs generic drugs and documentation…I’ll need to do some backtracking on my research from when my husband and I had problems. We did find a site if I recall confirming it was an issue that FDA should look into. I’ll post when I find it.

I've taken brand names and generics of different medications over the years and never noticed any difference between them in either efficacy or side effects. The largest generic medication manufacturers are multi-billion dollar companies in their own right, some having tens of thousands of employees. In some cases the generic manufacturer is part of a group that also markets well-known name brands. For example, the Upjohn name, most recently used to market off-patent medications, was owned by the well-known brand-name manufacturer, Pfizer. More recently, Upjohn has merged with the generic manufacturer Mylan. My feeling is that these companies, whether generic or brand-name, will manufacture to the same standards.

Hi Ed: I found several articles on the subject that may be of interest. Although I’m not a regular reader of VICE, the writer’s personal experience and research is informative. Her article also mentions the disaster with generic Wellbutrin such as my husband experienced. The second article is from Merck Manuals. Evidently there is a short list of brand drugs that should not be substituted for generics. My guess is that list should be substantially longer.

https://www.vice.com/en/article/v7mnm3/my-generic-medication-gave-me-constant-nosebleeds-im-not-alone

https://www.merckmanuals.com/home/drugs/brand-name-and-generic-drugs/bioequivalence-and-interchangeability-of-generic-drugs

Terry

I have 4 drugs right now that don't seem to be doing anything so maybe I should check them out as I usually get generic. Years ago I had 1 that had to be name brand but with my doctor's letter had no problem getting it. I've only been on 1 MS drug, Rebif, when first diagnosed 20 years ago but had to quit it because it started affecting my liver. Now my neurologist says there isn't another that would help me even with so many out there now.

Mmmm interesting article. I have recently been able to cut my citalopram dose by half ( from 20 to 10mg) and was doing very well ( 4 months ) until I was supplied with a generic. The blues came flooding back! As usual one thinks must go back up to the old dose. No, I'm going to insist on the previous brand and see how I go ;)

I have found differences even between generics! I take modafinil, and I've found the only generic that works for me is manufactured by Apotex. I think I had Marcan a couple times and it just wasn't the same. My MRIs have been clean since I started on Tecfidera and frankly I'm nervous about the generic. It looks like Apotex is making a generic Tecfidera so here's hoping that will work for me.