[indigo girl]

Are Generics Really Just As Good?

http://scienceblogs.com/corpuscallos...just_as_go.php

Passing medications over the years, occasionally I have come across a few
patients that would not take their pills because they "looked different" from
what they took at home or had been taking in the nursing home prior to that
time. Usually, they were talking about a generic being switched for a brand
name. I have to say that I would try to reassure them, and if they refused the
drug, then a call to the physician would occur about this. I was never certain
as to whether or not the patient really needed to have a brand name drug.
This article has helped to make the case for what some patients have been
saying all along. There can be a difference, and not just in how the drug looks
either...

Originally Posted by www.latimes.com

The FDA considers "bioequivalence" a good surrogate for "therapeutic equivalence" -- the equal ability of two drug formulations to ease symptoms or cure disease. Physicians and pharmacologists say that for some copycat drugs, showing bioequivalence to the original is not proof enough that the "same medicine" will yield "the same results."...

[Xbox Live Addict]

Originally Posted by indigo girl

Are Generics Really Just As Good?

http://scienceblogs.com/corpuscallos...just_as_go.php

Passing medications over the years, occasionally I have come across a few
patients that would not take their pills because they "looked different" from
what they took at home or had been taking in the nursing home prior to that
time. Usually, they were talking about a generic being switched for a brand
name. I have to say that I would try to reassure them, and if they refused the
drug, then a call to the physician would occur about this. I was never certain
as to whether or not the patient really needed to have a brand name drug.
This article has helped to make the case for what some patients have been
saying all along. There can be a difference, and not just in how the drug looks
either...

I've been hearing about this too, and have encountered the odd patient here and there who only wanted the brand-name drug because the generic "wasn't the same thing" or didn't work as well as the brand-name.

From my own experience, the only "brand-name" drugs I have given or been prescribed by my own physician were those which were still under patent and for which no generic form was available. In most cases, insurance or Medicaid eventually demanded a switch to either a generic, or a cheaper, older drug for which a generic form was available rather than a patented medication. If a physician was insistent that his patient have a specific drug, s/he had to write a long letter convincing the payor that the drug of choice was more effective than the payor's requested alternatives, and usually had to prove that taking the patient off of the drug of choice would cause negative outcomes for the patient. For myself, I've never noticed any difference between generic acetaminophen and Tylenol, except that McNeill charges a heck of a lot more than Wal-Mart's Equate brand does.

I imagine that the fillers and additives used in drugs vary from manufacturer to manufacturer. Does anyone know how much research has been done on how additives affect pharmacokinetics?

[banditrn]

I would imagine that the supplier of the ingredients for the generics has a great deal to do with the effects of the medications, also. I watched a news show awhile back that reported that a great deal of our generic drugs come from China, and I don't feel that China has any real committment to producing safe products, let alone life saving drugs.

[CHATSDALE]

this can be a sticky wicket
some generic drugs deliver the same amt of med as the brand name some of these disolve quicker or slower than desired
this is not something that the consumer can determine
many throid meds are routinely ordered 'brand name only'

[dria]

Every so often we run across a pt with INRs all over the place, and a switch from warfarin to Coumadin evened things out.
I've seen the same with thyroid meds.
Glad to see that the science may be catching up with experience...

[nyapa]

Surely the FDA would assess whether generic and brand name drugs are both meeting an equivalent standard?

[Diary/Dairy]

I have also heard that about Phenobarbital or some other anti-seizure med - The patients themselves refuse to take the generic form because it messes them up.

[sharlynn]

Originally Posted by diarygirl512

I have also heard that about Phenobarbital or some other anti-seizure med - The patients themselves refuse to take the generic form because it messes them up.

My neurosurgeon insisted on Dilantin for this reason.

[banditrn]

Originally Posted by nyapa

Surely the FDA would assess whether generic and brand name drugs are both meeting an equivalent standard?

Well, you'd think so, but actually we'd probably be scandalized if we knew how bad it REALLY was!
Take this recent heparin thing for instance - seems 'no one' was really checking the chinese factory where it was made. I saw a new piece on it last nite on CNN that they've found that they were using a cheap expander in the heparin. I think people from the FDA on down ought to go to prison for that one.

[CHATSDALE]

after reading this post i was checking o the web about generics and i found many disturbing cases mainly considering products from china

there are limited resources that fda has for checking at the factory where the meds are made to insure that sterile procedures, stability of drugs esp piggy-backs
random testing after drugs arrive in USA should be demanded
if you find out that a toy is lead heavy you can throw it out, you don't have that option with drugs