Generic Drugs compared to Brand Name Drugs.

jayne109, RN · Jun 21, 2005

I don't know if this story will help you but I will tell you anyway.

I had a pt in the ER that had no thyroid and was on thyroid replacement medicine. The doctor prrescribed generic Levothyroxine and sent her home. She wound up with SVT and they couldn't figure it out. Her thyroid level was through the roof! The doctor did some adjusting but was never able to get her thyroid level down. The doctor decided to switch her to Synthroid, the brand name and the patient never had the problem again for several years. The doctor and pt agreed that she would always get the brand name so that her thyroid level would stay okay. Weird, huh?

Hope it helps!!!

Melissa

SusanJean · Jun 21, 2005

I have been out of the pharm business for a few yrs, but will try to give you the gist on generics. Some of my percents might be off, sorry.

Generics are "bio-equivalent" to branded products. With that in mind, they are similar, not the same. They are allowed to be + or - 30% of the branded product. "equivalent."

This may be ok for some drugs, but not others: cardiac, asthma - drugs where life may be at risk.

The real kicker comes in when a pharmacy uses multiple generics and the "equivalancy" may vary by a greater % than 30 - hi vs low.

So if a pt c/o a drug not working - consider the possibility that it is a generic. They are not = to brand drugs and are not = to each other.

Hope this info helps.

(Also, was just discussing this subject w/ my md today - they now break generics into different catagories and allow for even greater differences... new since I left the biz. Unfortunately he was busy and had other things to do - like see sick people - so we couldn't discuss it further. FYI)

live4today, RN · Jun 21, 2005

Some generic drugs are okay, and some are not. My personal experience with using generic drugs is lousy. Some I can take, some I can't. I always ask my doctor to NOT prescribe generic drugs if at all possible....even if I have to pay a little more for them. I have a lot of allergies, some of which are drug allergies, so it is essential that I not be given any old drug brand. I can tell when I take generic drugs that they do not work as effectively as when I'm taking the brand named drug. My system is just that sensitive to medication. :rolleyes:

Rep · Jun 22, 2005

As a medical rep, I say that if a generic drug came from a very refutable company then you don't have to worry. They are bio-equivalent unless a branded drug has a delivery system that is under patent and the generic version does not have then you have to use the branded one.

Take for example, verapamil. There are verapamil preparations in the market right now but if you doctors prescribed Verelan then you can not used a generic version because Verelan comes in once-day formulation while the generic versions do not.

Or diltiazem for example as in Cardizem SR (sustained release).

carolinapooh, BSN, RN · Jun 22, 2005

I don't know if this story will help you but I will tell you anyway.
I had a pt in the ER that had no thyroid and was on thyroid replacement medicine. The doctor prrescribed generic Levothyroxine and sent her home. She wound up with SVT and they couldn't figure it out. Her thyroid level was through the roof! The doctor did some adjusting but was never able to get her thyroid level down. The doctor decided to switch her to Synthroid, the brand name and the patient never had the problem again for several years. The doctor and pt agreed that she would always get the brand name so that her thyroid level would stay okay. Weird, huh?
Hope it helps!!!
Melissa

This is because some drugs - synthetic thyroid replacements and warfarin come to mind - have what is called a narrow therapeutic index. The various fillers in drugs designated as such can cause different pharmacological reactions in different people. So often doctors will specify name brand or generic only for a patient given specific lab results.

BabyRN2Be · Jun 22, 2005

I would also like to add that pain medications aren't all that great when it comes to generics. I'm on a chronic pain regime and I've found that even the difference between the generics themselves can be a problem. One pharm carries one generic (which works OK), another pharm carries another (which doesn't do as great of job). When one pharmacy runs out of the "good" generic, I'm stuck going to the other. I think people realize that and this pharm seems to be more often than not, out of the generic.

I can't even find the brand name.

One of the pain meds which worked wonders isn't covered by my husband's insurance. I couldn't have the other insurance after I got married which did pay for the medication. This med runs about $1500/mo. No way we can begin to afford that. There will not be a generic until 2007. If I want to use this med again, I have to wait until then. It really stinks that I can't get good pain relief.

sjt9721, BSN, RN · Jun 22, 2005

Hello Everybody!
Are Generic Drugs Better than Brand Name Drugs?
My experiment will include conducting a Diffusion Disk Test where, on a Petri plate, I inoculate 'strep' in the spread plate fashion, then drop filter tablets into the strep that have been soaked in water and two different cold medications of liquid or tablet form; one that is a brand name and the other...a generic. Then follow the outcomes and results.
How does this sound to everybody, and what are your stories and experiences. For those who do not mind their input added into my research and final outcome, then do say so because I hope to use some of your stories and experiences in my final paper.
Thank you all so much!
Kindest Regards, Vinnie

My comment is directed toward the lab portion of your experiment. I will state up front that it has been a loonngggg time since I took Micro! :rolleyes:

What are you hoping to see after placing cold-medicine on the strep? OTC (over-the-counter) cold medicine does not contain antibiotic and doesn't seem that it would do anything to the strep innoculations. So whether the cold med is 'brand name' or 'generic' would be a moot point. Wouldn't it? Do I make sense?

These are honest comments and I mean no disrespect. Please enlighten me if I'm way off base!! :)

RN_Jen · Jun 22, 2005

What are you hoping to see after placing cold-medicine on the strep? OTC (over-the-counter) cold medicine does not contain antibiotic and doesn't seem that it would do anything to the strep innoculations. So whether the cold med is 'brand name' or 'generic' would be a moot point. Wouldn't it? Do I make sense?
These are honest comments and I mean no disrespect. Please enlighten me if I'm way off base!! :)

I'm curious about that too. I took micro last semester and we did streak plates with staph and different household cleaners (amonia, bleach, lysol, etc.), but I'd be really interested to hear more about the cold medicines and what the expected outcome is. :)

SusanJean · Jun 22, 2005

As a medical rep, I say that if a generic drug came from a very refutable company then you don't have to worry. They are bio-equivalent unless a branded drug has a delivery system that is under patent and the generic version does not have then you have to use the branded one.
Take for example, verapamil. There are verapamil preparations in the market right now but if you doctors prescribed Verelan then you can not used a generic version because Verelan comes in once-day formulation while the generic versions do not.
Or diltiazem for example as in Cardizem SR (sustained release).

Bio-equivalent is just that - equivalent. Here in the US, the FDA allows for a percentage of "error" (my word) from the original preparation. So, while a generic is safe and equivalent, it may be more or less potent than the branded product.

CHATSDALE · Jun 22, 2005

i have heard a doctor state that he would not use or accept for his family a gerneric drug

but for me the plan i am on is that i pay full price or accept a generic...i am not financially able to pay for this so i hope that ones i have work...i am not on a lot of drugs or on any cardiac drugs but i am taking zocar..was on lipator plan dropped it

grannynurse FNP student · Jun 22, 2005

I take zestoric for my blood pressure. Five years ago, I switched to the generic equivalent. I have experienced no adverse effects from the generic equivalent. Unfortunately, all of my other medications do not have generic equivalents. But I will shortly solve that problem bymoving back to upstate New York. And returning to Canada for my medications.

Grannynurse :balloons: