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Monday, May 26, 2014

Are Generic Medications Equivalent?


There's your short answer. The longer answer:
After  intense personal experiences with generics and some online research, I've come to the conclusion that:

  • Drug companies, including those that produce generics, are mostly concerned with making money. 
  • The major pharmaceutical companies that produce the original (name-brand) medications have a lot to lose if generic drugs are successful and therefor don't have a lot of incentive to cooperate with the generic companies. 
  • The FDA is not able to handle the number of new drugs and generics coming into the market every year.
  • Many generics come from countries with different standards of production from the original brand names, and bio-hazards (chemical and bacterial) have been found in some generic drugs.
  • Some medications have more than a dozen ingredients in them but only one of these (the "active" ingredient) has to be "equivalent" in a generic medication. 
  • The way a product is released can be just as important as the drug itself, especially with medications that are meant to release over time (often these have the letters "XR" or "XL" after the name). Because the "filler" used in generics is not the same, it may not release at the same rate as the brand name. 
  • Some fillers used in generics have their own side-effects. 
  • Even concerning the "active" ingredient, drugs sold as "equivalent" only have to demonstrate a 90% similarity to the original drug, and there is an additional 10% possible fluctuation in production which means a generic might be 20% stronger or weaker than the brand name.
In my online generic search, I've come across actual recalls for generic blood thinners, antibiotics, birth control pills, anti-seizure medications, infant and adult pain relievers, acne creams and antacids. If you do your own search you will find a lot of information about a recall of a generic for Lipitor. I guess a drug that lowers cholesterol has a lot of popular impact but my particular issue has been with psych meds. If you want to read a few horror stories, try these links:

My particular visits to generic hell have been on the wings of two generic medications:

  • Wellbutrin XL (Buproprion) the name brand saved my life (not an exageration) but the generic brought on a whole series of side-effects leading up to a suicidal cliff within a few days. 
  • Seroquel (quetiapine) I don't take the extended release version - I only take 25 mg.s, which has been helping me sleep for  about five years now. With the generic, I not only did not sleep, but felt increasingly anxious and had a strong metallic taste in my mouth which lasted all day. I never had either of those issues with the Seroquel, but I might have overlooked them if the generic at least helped me sleep!
I believe those of us taking psych meds may be particularly vulnerable to generic incongruities because there's no big money in looking out for our well being and because most people have a tendency to turn away from mental illness. We've come a long way from the times when anyone with a different view of reality was locked behind actual, physical walls, but many people still hold tight to emotional walls erected to separate themselves from anyone different.

I'm not saying all the name brands are perfect, but they are more researched and better controlled. Whatever your generic medication, here's a VERY important and highly un-publicized point - you may be able to get the name brand as cheaply as the generic! If you call the company that makes your name brand medication you may find you can buy the name brand drug directly from them at about the same cost as the generic. This is not true of all drugs, of course, but I'm currently getting name brand Wellbutrin directly from Valeant for $50 a month instead of $550 a month at the pharmacy. Ipaid full price for years, ever since my pharmacy switched to a generic that made me absolutely crazy!

I'd be interested in hearing others' experiences with medications, especially generic UNequivalents and I'd really like to encourage you to do your own research. If you are taking a generic and the results are not as expected, don't assume it's you. Put the words, "generic" and the name of the drug in a search and see what you come up with. If you find (as I did) that hundreds of others are asking the same questions you are, it may be that the drug is to blame. And, if you are having an issue with a medication, make your complaint public. Others need to know they are not alone! Some of these generics stay on the market for years before the FDA realizes the dangerous truth, but with social media we can all become our own advocates.


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