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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Phil on May 26, 2009, at 8:29:23
and here's another example.
Posted by seldomseen on May 26, 2009, at 9:20:54
In reply to Generics suck, posted by Phil on May 26, 2009, at 8:29:23
The problems with generic Wellbutrin 300 have been long documented. The company didn't even test it, and it was allowed to the market.
In any case, there CAN be up to a 20% difference in the drug absorption, clearance and maximal plasma concentration between name brand and generic. I think switching from generic to another brand of generic (which pharmacies will do all the time) can lead to some truly clinically differences, this worries me and I get after my pharmacy when they switch out one generic for another.
What especially worries me though are the drugs, like prozac, that have a slow slow clearance from the body. The changes that may manifest when switching out these drugs occur so gradually that they are unlikely to be attributed to the switch. The patient may just experience a gradual decline. I worry that this may expose the patient unnecessarily to either higher doses of the drug, or, worse yet, start the patient down the long road of drug trials and all the morbidity associated with them.
Seldom
Posted by Phil on May 26, 2009, at 10:01:42
In reply to Re: Generics suck, posted by seldomseen on May 26, 2009, at 9:20:54
Thanks seldom
I work with a lady who has a 14 y.o. daughter with epilepsy--she takes Lamictal. So do I.
The state of Texas several years ago changed our insurance on meds. Even if the pdoc writes dispense as written the pharmacies computer changes it to the generic.
The doctor wrote a letter say the girls seizure activity increased on the generic and she needed brand. Didn't help.
I don't see how some people sleep at night.
Posted by greywolf on May 26, 2009, at 11:15:29
In reply to Generics suck, posted by Phil on May 26, 2009, at 8:29:23
I agree that this article raises some very serious questions about the quality of generics. But the cost of brand names is so high, sometimes you don't have a choice. For instance, my co-pay for 6 pills--that's right, 6 pills--of Lunesta is $70.00.
I just try to make sure that the generic is made by an American company in the United States. Not a perfect solution, but better than ignoring the problem altogether.
Greywolf
Posted by Phillipa on May 26, 2009, at 12:07:34
In reply to Re: Generics suck » seldomseen, posted by Phil on May 26, 2009, at 10:01:42
Phil same here in North Carolina. Not lamictal as not on that but any and all meds except synthroid. Phillipa
Posted by manic666 on May 26, 2009, at 12:56:50
In reply to Re: Generics suck, posted by seldomseen on May 26, 2009, at 9:20:54
thats, true prozac worked well for 2 years for me but when it went to generic fluxidine, or how ever spelt i crashed
Posted by ricker on May 26, 2009, at 14:23:43
In reply to Generics suck, posted by Phil on May 26, 2009, at 8:29:23
I've never had a bad reaction with any of the generic's..... except Seroquel!!!!!!
I was given brand for 2 weeks and then switched to generic. The first night on generic, my head was so plugged up I could hardly breath.. wtf!
Second night was the same so I went to my gp and got a script for brand.... no more congestion, I could breathe clearly again... hmmm.Rick
Posted by Phil on May 26, 2009, at 15:30:08
In reply to Re: Generics suck » Phil, posted by ricker on May 26, 2009, at 14:23:43
That's weird. When I was on Ritalin(before the docs figured out I was bipolar lol) I used to get Barr generics and they were alright. The pharmacy switched mfg. and the generic I got was very thin and flat. You could squeeze it between you fingers and it would crumble. I'm like, WTF?
Posted by linkadge on May 26, 2009, at 18:54:23
In reply to Generics suck, posted by Phil on May 26, 2009, at 8:29:23
>Within a month, she had gained 15 pounds, >couldn't sleep well, developed gastrointestinal >problems and felt such extreme fatigue and lack >of motivation that she thought about quitting >her job.
Thats a bunch of nonsense. Even if a generic had a different bioequivilancy, I highly doubt it is so marked as to warrent such an extreme relaspe.
People just have bad crap happen and the want something to blame it on.
Linkadge
Posted by linkadge on May 26, 2009, at 18:57:44
In reply to Re: Generics suck » ricker, posted by Phil on May 26, 2009, at 15:30:08
The whole brand name generic battle is most extreme with depression meds, where the placebo effect accounts for a good portion of clinical responce.
Linkadge
Posted by Zyprexa on May 26, 2009, at 22:58:33
In reply to Re: Generics suck, posted by linkadge on May 26, 2009, at 18:57:44
What I do is get the doctor to write the manufacturer of the generic I want. I test the different types first and when I find the best one thats what I get the doctor to write for. Unless they are all the same like zoloft and celexa.
Posted by garnet71 on May 26, 2009, at 23:20:08
In reply to Re: Generics suck, posted by Zyprexa on May 26, 2009, at 22:58:33
You don't ask the doctor to indicate a manufacturer--just ask the pharmacist; they can special order from various manufacturers.
FWIW-I've tried switching generic manufacturers in the past and it didn't make a bit of difference. I think there's a lot of hype about the generic vs. brands. I think if the brands were tested, they'd show less than 100% efficiacy as well. Light, heat, age etc.; who knows how the chemicals deteriorate.
Posted by garnet71 on May 26, 2009, at 23:23:09
In reply to Re: Generics suck, posted by garnet71 on May 26, 2009, at 23:20:08
Oh, I saw you take Wellbutrin..there's one generic that has the same purple coating as the brand..the pharmacist should know which manuf. it is and order it for you. It didn't make a diff. for me at all, but it doesn't cost anything or take much effort, so it doesn't hurt to try...
Posted by yxibow on May 27, 2009, at 5:20:20
In reply to Re: Generics suck, posted by linkadge on May 26, 2009, at 18:54:23
> >Within a month, she had gained 15 pounds, >couldn't sleep well, developed gastrointestinal >problems and felt such extreme fatigue and lack >of motivation that she thought about quitting >her job.
>
> Thats a bunch of nonsense. Even if a generic had a different bioequivilancy, I highly doubt it is so marked as to warrent such an extreme relaspe.
>
> People just have bad crap happen and the want something to blame it on.
>
> LinkadgeI completely agree -- the whole "report" just reeked with sensationalism.
And generics ARE tested for bioequivalency. Its not true that they're just dumped on the market without testing, that's nonsense. They have to pass testing as noted in the FDA Orange Book.
There is a fair degree of placebo effect with generics. Yes, I worry about certain medications that I am very sensitive to change in, but basically more than half of my medications are generic. Anafranil, Valium, Lamictal, Neurontin -- all generic. I doubt anyone takes non-generic TCAs, and its pretty rare for off-patent benzodiazepines and beta blockers to be non-generic.The ones that aren't even with insurance are ferociously expensive.
-- Jay
Posted by Zyprexa on May 27, 2009, at 9:22:02
In reply to Re: Generics suck, posted by garnet71 on May 26, 2009, at 23:20:08
I was instructed by the pharmacy to have the doctor write the manufacturer on the script. This was a mail order pharmacy. At the local pharmacy I would just tell them.
I've noticed a big difference in the two different generics of perphenazine. On gives me headacks and is weaker than the other.
Posted by Zyprexa on May 27, 2009, at 9:26:41
In reply to Re: Generics suck, posted by garnet71 on May 26, 2009, at 23:23:09
Didn't you notice a difference between the generic and brand of wellbutrin sr. The origional smells like rotten eggs and the two generics smell sweet. Not to mention they have a different effect. I will admit that the two generics are almost the same. And for a lot of generics are the same but just some times they are not.
Posted by Phillipa on May 27, 2009, at 20:10:55
In reply to Re: Generics suck, posted by garnet71 on May 26, 2009, at 23:20:08
Garnet did you know from what I've heard the military keeps old meds and uses them. Expiration dates if med stored right are much longer. Phillipa
Posted by Phillipa on May 27, 2009, at 20:14:12
In reply to Re: Generics suck » linkadge, posted by yxibow on May 27, 2009, at 5:20:20
Jay see Scott's new thread on generic lamictal. Love Jan
Posted by Phil on May 28, 2009, at 6:06:45
In reply to Re: Generics suck » yxibow, posted by Phillipa on May 27, 2009, at 20:14:12
And see my post in this thread about Lamictal. If the generic increases seizures in an epileptic, there's a problem.
Posted by Zyprexa on May 28, 2009, at 9:55:34
In reply to Re: Generics suck » garnet71, posted by Phillipa on May 27, 2009, at 20:10:55
Whats the right way to store meds? Is it at room temp away from light?
Posted by Phil on May 28, 2009, at 10:39:23
In reply to Re: Generics suck » Phillipa, posted by Zyprexa on May 28, 2009, at 9:55:34
That's the way I've done it for past 25 years. The years roll by.
Posted by Phillipa on May 28, 2009, at 19:33:54
In reply to Re: Generics suck » Phillipa, posted by Phil on May 28, 2009, at 6:06:45
Phil huge problem. Agree Love Phillipa
This is the end of the thread.
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