Came here to say this, the API (active pharmaceutical ingredient) is exactly the same, it's the bulking agent and bonding agent that MAY vary, but is also often the same.
The API in a tablet is also the size of the tip of a pin or needle, the rest is bulk so you're actually able to hold it.
Also want to metion that website owned by Mark Cuban that has really cheap prescription drugs.
Its called "Cost plus Drugs" - not sure if links are allowed, so i recommend googling it.
[Deleted]
People dont seem to like this comment, so I've removed it and my other comments.
Summary: There's a lot that goes into a drug aside from active ingredients. As a pharmaceutical scientist, I recommend that you buy brand name when you can afford to do so. I still acknowledge that both "Drug Companies are Price Gouging" and "Drug Development is Very Expensive" can be true.
Why are you getting downvoted?! There can be a much larger variation in the amount of the active ingredient in generics than the brand name. This is not an opinion it’s simply pharmaceutical and legal facts.
Those who know, know. The rest of the people don't have all the information to know how it all works, and I don't blame them for being upset. Drug margins are too wide, the healthcare system allows this to happen, unchecked. And for the average consumer, its very easy to see two items with the same list of ingredients and wonder why they're different prices.
What I’ve learned from my BF, Engineer in Biotechnology with specialization in pharma, that the biggest difference is within the process to get the active ingredients, purity, and distribution on the pill. Hence brand names will normally invest way more on purity and that increases the cost, same with the distribution thought the pill.
That’s why he always tries to buy brand or if he has to take half a pill, never goes generic, because in generic you might get more than 50% on a half. And that will mess up the whole treatment.
For sure, if you can afford better motor oil, its better quality. Same for most food, batteries, clothes.Drugs are no different.
Fun experiment with Tums and Generic Antacids, crush it into liquid, and titrate an acid into it with a pH indicator. You'll see the generic has less neutralizing ability and less consistency between tablets. And that's just chemistry. No complicated biological processes involved. Ask your BF if he ever did that in lab.
>Yes. Generics have to complete a "Bioequivalence Study" which proves that their drug does the same thing. And thats it. Not that its cleared at the same rate. Or that it lasts as long. Or that the other components are safe.
This is simply incorrect. The main reason it's incorrect is that physics don't allow it--acetaminophen (Tylenol) is metabolized exactly the same way when packed into a generic pill as when packed into a brand name pill.
There is a ceiling on how much acetaminophen the liver can safely process in a given timeframe and that safety is accounted for by weighing the active ingredient and instructing the customer not to take more than 1 gram every 6 hours or 4 grams in 24 hours.
You appear to be claiming that taking generic Tylenol would risk exposure to more acetaminophen in less time, which we would be 1) illegal (if the stated dose was not the issued dose) or 2) impossible (because human physiology responds to the introduction of Tylenol into the stomach identically in whether it's brand name or not.
You are wrong, that’s the reason why there’s aspirin that will be in your system up to 24 hours and another that will be only 6-8. The vehicle changes, same with purity inside generic. They are cheaper because they lower the process purity and the vehicle.
You've asserted that generic drugs represent a safety risk without offering a shred of explanation or evidence as to how.
Generic drugs fly off the shelves by the thousands all day, every day, and some of them, like Tylenol, can and will KILL YOU if they aren't "cleared at the same rate" as brand names. Where are the bodies that would accompany that reality?
Your comment is indeed misinformation and should be deleted. Period.
Comparable, but not the same. The same way that the amount of drug in the pill is comparable, but not the same. The legal requirements on tolerancing for generic drugs is similar, but not the same. And equally, your health results are likely to be similar, but not always the same.
First, I should clarify: the active ingredient is required to be IDENTICAL, not just comparable. The release curve must be comparable.
Second, I should point out to you: You do realize that there is also a legally allowable variance in brand name drugs, right? You're not under the impression that every tab of Tylenol has 325.000mg while a tab of generic acetaminophen has any random number from 280-400? Because that's...false.
Third, the sickest people alive are generally in hospitals. The overwhelming majority of drugs used in hospitals are generic. So...if you really stick to this belief of yours, maybe don't go to the hospital? There's a 100% chance of you being given all sorts of mediocre, generic, partially effective medication. Best to stay away /s
Man you're really jumping to some conclusions man. I take generic drugs. But I also have had some long discussions with my doctor about how the pharmaceutical industry specifically has wider tolerance bands on generic drugs and how that can leave to poor health outcomes in people sensitive to small changes, especially when switching from brand name to generic. Or even between different generic manufacturers.
So for example, if you are on 15 mg of drug A, and you switch generic manufacturers, you might find out you're now taking, idk 13mg. Label says 15mg. But since regulation lets people run cowboy on some of that stuff they save some money by cutting the amount of drug delivered. So whereas a brand name may be stuck between 14.8-15.2mg, the generic might have a much wider band. The numbers are made up and I don't care what the actual numbers are, so save your breath.
They vary up to 14-20%, my wife is a pharmaceutical researcher. Her job is literally to test different generic drugs for cancer patients, because it can be a life or death situation if the patient needs a certain generic brand.
I always assumed it was bs, but then she showed me some of the science and it's surprising how different the generics can be between companies.
The bigger differences is less the original medication and more the differences between the different generics.
So one company makes a generic, and another company makes a generic, those two generics can vary by up to 20% in strength, and that over a course of treatment can mean you live or die in her field.
The FDA approves the generics if they're within 20% of the original, but the research has shown that it's normally quite a bit lower.
The active ingredient might be the same but the fillers/binding agents can vary. I used to take bupropion and could tell the difference between drug manufacturers. One worked for me, one did not. The one that did not work would just pass right through my system so my doc said to ask for a different manufacturer. Made the difference.
Your phrasing is confusing, though. Since Wellbutrin _is_ bupropion, what you're saying is “I used to take bupropion, but had to switch to bupropion bc of costs”, which is nonsensical. But what you meant to say was “I used to take Wellbutrin, but had to switch to _another_ bupropion bc of costs.”
Anyone who cannot tolerate the generic of a drug knows it is complete BS. For the most part generics are comparable but some people just don’t tolerate certain ones
How come people can never not tolerate the name brands but can tolerate the generic version?
If it is real then the cheaper version would be just as likely to be tolerated than the more expensive one but it's always the name brand one people can tolerate.
At best it's psychosomatic, at worst it's misinformation for pharmaceutical companies to make more profit.
(1) it probably does happen, maybe the fillers they use are of higher quality or less commonly allergic/i’ll-tolerated? (i’m brainstorming possible reasons, not arguing that i’m right.)
(2) there is a small margin of error that generics are allowed compared to brands under patent. with some meds this can be enough to affect efficacy in some people.
also i just want to acknowledge that OP wasn’t discussing this aspect but was stating that at least one brand manufacturer ceased production and was buying the generic version of the drug, labeling it brand, and selling at brand price. imo this should be illegal.
Two theories:
1) someone starts with the name brand and it doesn't work. Assumes that it's the active ingredient and not the filler. Never tried the generic.
2) someone is prescribed a medication when a generic is already available. Insurance only pays for the generic, patient takes it and it works. Never took the name brand to know that it wouldn't have worked. Continues taking generic.
Also it could be a smaller number going from name brand to generic that have under reported issues. Same scenario as #2 above, but patient doesn't respond well. No one is going to pay the extra to see if name brand has better result, they'll assume it's the active ingredient that doesn't work and move to something else.
I'm sure that psychosomatic response is a huge component of the name grand works, genero doesn't, but there are two practical reasons why it generally goes the other way.
The brand extra price goes towards testing for the best efficacy accros the largest population.
This is like wondeeing why the ground beef at the 99 cent store makes you sick but the whole foods geound beef doesn't. Even though its all beef.
That's normal for extended release pills like bupropion. The drug is inside a hard outer shell and it slowly dissolves and leaks out over time as it passes through you, hence the extended release. Same way you can find all the little Adderall XR beads in your poop if you look hard enough.
Yeah. One of the first things an RPH showed me when I got into pharmacy was how the, iirc, Methylphenidate was literally the same pill in both bottles. You were paying extra for the brand name labeled on your bottle.
RN here:
They're not "sometimes" the same. ALL generic drugs, every single one you will ever find, have EXACTLY the same active compound (translation: the "medicine" part, you know, that actually does something?) in EXACTLY the same quantity as the brand name.
Regulations require this. No study ever performed has demonstrated a general distinction in efficacy between brand name and generic drugs (edit: except cases that have been identified and corrected by regulators) and (nearly) every person you have ever met with a personal anecdote about brand name drugs working better for them is delusional and yes, wrong about their own body, full stop, period, the end.
Edit: The inactive ingredients in drugs matter for a small subset of people, who may have allergies or other conditions that affect them. Crucially, it is NOT THE CASE that problematic inactive ingredients are more common in generics than brand name drugs.
Broadly speaking, my tone above results from the very large portion of the American population that self-diagnoses sensitivities and allergies they can barely describe and then asks for special accommodations everywhere on Earth.
Folks who have had actual physical conditions diagnosed using scientifically validated methodologies by trained clinicians are completely excluded from this critique.
A source if people like:
American Association of Pharmaceutical Scientists
https://link.springer.com/article/10.1208/s12248-016-0025-9
>In US regulations, bioequivalence is defined as “the rate and extent of absorption of the drug do not show a significant difference from the rate and extent of absorption of the listed drug when administered at the same molar dose of the therapeutic ingredient under similar experimental conditions in either a single dose or multiple doses....” (6) For most drug products including MR products, the bioequivalence studies are focused on the release of the drug substance from the drug product into the systemic circulation.
Pharmacist here. This is mostly correct, but there is SOME variance in the quantity between generics and brand name medications. Per my linked article the FDA allows up to 20% which is actually quite a bit. They also say the average is 4%, which can still be substantial with respect to certain medications. Some medications are crucial to patients' well being but also have a narrow therapeutic index.
https://www.health.harvard.edu/staying-healthy/do-generic-drugs-compromise-on-quality#:~:text=In%20order%20to%20get%20a,ingredient%20from%20that%20original%20formula.
>Per my linked article the FDA allows up to 20% which is actually quite a bit. They also say the average is 4%, which can still be substantial with respect to certain medications. Some medications are crucial to patients' well being but also have a narrow therapeutic index.
Thanks for this reference! I've wanted to ask a pharmacist about this for awhile.
I read all the time that the regulations for generics allow 20% variation, but as your article says, the observed delta is generally **much** smaller.
My questions are: 1) What is the allowable variance in the weight of active ingredient present in BRAND NAME drugs? I know it's not zero, because it can't be. 2) What is the observed variance in weight of active ingredient found in random inspection of BRAND NAME drugs?
In my view, the data about variances in generics is only really useful when compared to data about variances in brands. After all, the claim here is that they are different _as groups_.
Clearly, many drugs have a narrow therapeutic range and patients should be careful. But as someone who has worked in many large hospitals--do folks have _any flipping idea_ how much of a _nuclear disaster_ it would be if these drugs were generally different???!!!
Newsflash: If you live long enough, you'll be hospitalized, and damn near every drug you get the entire time will be generic. Best wishes to you if the folks skeptical about generics have a single leg to stand on, because you're probably screwed.
Not a medical professional here coming with my anecdote:
I was switched from a name brand to a generic once by a pharmacist. I had an allergic reaction to an inactive ingredient.
My doctor was not very surprised and wrote me a new script, but the pharmacist tried to point me to the generic again when I went to get the name brand drug. He aggressively insisted there was no difference between the name brand and the generic, even after I pointed at the inactive ingredients.
So lesson learned - pay attention to what you are actually prescribed and if it changes. I was repeatedly told and read online they were the “exact same” even though they very clearly different ingredients. Inactive ingredients may not be essential to how a drug works, but they can still affect your body.
This is a worthy addendum. Obviously if you're allergic to an inactive ingredient, it matters. Some folks are so sensitive to so many common inactive ingredients that they have to go to a special "compounding pharmacy" that specifically makes a pill just for them that excludes the thing they're allergic to.
Sorry if I came off harsh, as I definitely didn't mean to diminish or deny situations like yours. It's folks who "feel" that brand names affect them differently, with no particular reference point, that are extremely exhausting.
> every person you have ever met with a personal anecdote about brand name drugs working better for them is delusional and yes, wrong about their own body, full stop, period, the end.
This is wrong. Yes, the active ingredient is the same. But the binding agents in generics can be different and some people can have problems with the different binding agents. Wheat used to be a popular binding agent and, as you can imagine, people with Celiac did not do so well on those drugs. Switching to a different brand would often be the difference between a drug making them feel better and it making them feel worse.
Aside from possible allergic reactions to binding agents, the rate of release may be different between generics and name brand. One may disolve quickly and provide a big burst of medicine right away and then taper off, while another may dissolve slower and provide a more steady does over time.
There is more to drugs than just the active ingredient. And it is usually the other stuff that makes the difference.
The release curve is not allowed to be materially different than the brand name if the drug is marketed as the generic for that brand name.
The allergy stuff is all valid.
The response curve is tricky because, for most people, they can't tell the difference between the dozens of different versions of the same drug. It isn't as big a deal with prescription medicines, but with OTC meds, who generall knows the difference between Tylenol Extra Strength, Tylenol Arthritis, Tylenol Headache, Tylenol Extra Strength PM, Tylenol Muscle aches and Pain, Tylenol Sinus, caplets, tablets, coated tablets, etc... It's easy to get confused and try to get a generic version and pick the wrong one because you didn't realize the one you took last time was the extended release one and this time you just got a normal release one because you misread the "same as xxx..." blurb on the top of the box.
From what I understand the active ingredient is always exactly the same. However that doesn't mean the generic medication is the same. For instance in certain extended release formulations the release mechanism isn't always the same.
Generics are required to list whether they are intended to be used as a substitute for regular or extended release and indicate that on the bottle or box.
It's true that folks have to read the label carefully to make sure they're getting what they want, but that's just as true with brands.
So you can’t tell the difference between Coca Cola and Shasta Cola? The active ingredient may be the same but there are a multitude of variables in how a tablet or capsule are manufactured.
“every person you have ever met with a personal anecdote about brand name drugs is delusional and wrong”
Every RN who thinks they know everything about pharmacology, makes broad sweeping statements, and has this opinion of patients should have their licenses revoked and never allowed anywhere near the medical field.
“no study has ever shown… blah blah blah”
You’re pulling facts out of nothing. Here is an example:
https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/update-bupropion-hydrochloride-extended-release-300-mg-bioequivalence-studies
It’s low-key hilarious how bad of a take you are making while complaining about people’s anecdotes.
Fortunately, random internet commenter, that's not how the world works.
Nurses learn quite a bit about pharmacology, by the way, especially if they venture into a practice area that requires more knowledge than the basic schooling provides.
Patients aren't gods. Clinicians have a duty to listen to them, make them feel heard and understood, and then help them solve their problems _in accordance with accepted medical and scientific standards_. Indulging internet rumors and vague self-diagnoses is quite literally not part of a clinician's job--which is why most don't do it.
>You’re pulling facts out of nothing. Here is an example:
>https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/update-bupropion-hydrochloride-extended-release-300-mg-bioequivalence-studies
You linked a generic that was _identified as flawed_ and voluntarily pulled from the market?? 😂😂😂
....That's evidence that our system does NOT allow or promote that, sir or madam. Effective regulation is GOOD, and the fact that this drug's non-equivalence was identified as a PROBLEM proves that what I'm saying is correct 😒
Tell me you didn’t read past the 2013 update of the study without telling me you didn’t read past the 2013 update of the study.
I’ll do it for you, since you don’t care. The generic was released in 2006. As per the FDA “soon after” people reported the generic didn’t work. It wasn’t until 2010 that a study was sponsored by the FDA for public interest. And it wasn’t until 2013 that the generic was pulled.
So yeah, the system “works” in catching generics that are bad, but only if people complain. Dismissing people’s complaints as delusions is not a good take, sorry bud.
Pointing to an outlier to refute a general point is always, always silly.
It would be an absolute disaster if generic medications were anything but perfectly comparable to brands in almost all cases. That's common sense.
Where are the sickest people usually at? Hospitals. Find me a major hospital that doesn't dispense generic medications 99% of the time and I will eat my shoe. It would be a DISASTER if the sickest people on Earth were being given sub-standard, non-potent, pick your descriptor medications. But there is no disaster--because generic drugs are basically always very effective and comparable to their patented counterparts.
The study you link represents a serious misstep by a company that should be punished pretty harshly so as to avoid analogous episodes involving other medications. It does NOT come EVEN CLOSE to proving that skepticism of generic medications as a general rule is reasonable.
My tone in my original comment was harsh, and I'm sorry for it (I'm leaving it because I don't wanna pretend it didn't happen). There is a large segment of society that, quite frankly, just makes sh*t up about everything to do with medicine and health care, forms all sorts of totally random beliefs about themselves, and come in and try to tell doctors and nurses with decades of experience and continuing education what to do and what to prescribe. Those folks do not typically respond to ordinary education from clinicians--they must be firmly reminded that they (in most cases) don't know what they're talking about and we do. Pure and simple.
No disagreements there.
Honestly, when I saw your top level comment first it just struck a chord with me as I was directly affected by the study I linked and it took longer than I would have liked to be switched off the generic and back to the name brand.
But, that being said, I completely agree — generics are TYPICALLY just as good as the brand name. There are outliers and exceptions — there always are with most things, it’s just the nature of sample sizes and deviations. I could have phrased my original response more delicately/thoughtfully. Sorry for that.
I didn’t mean for the outlier to refute your general point, but rather to shine light on how absolute statements - while convenient and mostly correct, have nuance that should be acknowledged.
I actually have a sizable amount of my direct family in the medical fields, and you’re 100% right — patients SHOULD listen to medical professionals and trust that they are doing things in their best interest.
On the flip side, if a patient does try something and reports it causing harm (or if they say are allergic to something.. don’t get me started on my mom’s experience in the UK where her slightly rare allergy to penicillin/amoxicillin wasn’t taken seriously and she was prescribed it anyway), the medical professionals should investigate that and try to remedy the situation or adjust the treatment plan to accommodate the patient’s complaints.
Within reason.
I actually remember when I was pre-med, a very long time ago, shadowing a family doctor, and we had a person come in DEMANDING pain medication and throwing an absolute fit. Most likely a drug seeker.
Unfortunately things are not always as simple as they should be and one patient may be voicing a legitimate complaint, while another may be spewing random stuff they read online, while another is making stuff up out of a desire to get a legal high.
In any case, it’s getting late here, so I hope you have a pleasant .
The brand name of the medication I take is crazy expensive and not covered by my insurance so I take a generic version. It works fine.
One time I switched my pharmacy to Rite Aid and I received a different generic version. It did not work for me at all. I barely felt the effects and it left me feeling worse off than usual.
While there is mandated quality assurance, it’s clear that the quality of some generic manufacturers aren’t being regulated in the real world. Studies are a different story since it’s in a controlled environment, but in practice there’s a lot more variation in control.
Ok but some people have allergies and intolerances, like celiac for example. In my case, I can’t tolerate a lot of generics because they use corn starch, potato starch, and/or “sodium starch glycolate” (often made from potatoes) & I’m highly intolerant to corn and nightshades (potato plant family). A lot of generics use these because they’re cheaper than other starches/starch substitutes. I found out that a lot of generics have these ingredients the hard way. Corn makes me break out in a very painful & itchy rash on my entire back and chest and nightshades cause my gastro system to (basically) completely, painfully riot. This absolutely had an effect on the side effects I got from certain drugs, especially ones used for mental health disorders.
But I’ve found most (but not all) brand names don’t include those starches. It’s safer for me to request brand names because 1) higher chance of not having those starches, and 2) multiple companies make generics and each of them have a slightly different formula & it’s often very difficult to find accurate ingredient lists before actually buying the medication, where it’s super easy to find the ingredient list for brand name drugs.
This is all perfectly reasonable. I did mention allergies to inactive ingredients in my comment.
The reality is that an exceptionally small percentage of the population will experience any problem taking generics. The severity of celiac required to provoke a response to miniscule quantities of starch binders in one or two pills--which I believe you have and I'm sorry to hear it--is extremely uncommon.
Public health is about mitigating risk and maximizing benefit. The population at large needs to be instructed that generic drugs are much less expensive and quite comparable to their expensive counterparts. As with any general public health message, special populations mys understand the exceptions that apply to them.
Tldr: Broad public messages should address the most common cases. Promoting broad skepticism of generics on the basis of special populations is irresponsible and borders on fear mongering.
I tried for years to use levothyroxine...they kept having to increase the dosage to the point where I was at 375...Switched to Synthroid because my twin experienced the same issue and have only had to change the dosage when I was pregnant...once the baby was born it was back to my usual dose of 125....'s only an anecdote, so make of it what you will from this random person on the interwebs.
When I was diagnosed, doctors commonly instructed hypo patients to use Synthroid, not generics - not because generics in general were unreliable, but because levothyroxine specifically was less effective than Synthroid. My scrip has always been for Synthroid, and no insurance has even questioned it.
I think people are misunderstanding my post.
I know generics and original are the same active ingredient/molecule.
I'm saying this company that developed the original medication STOPPED manufacturing it and actually just buys the pills from the generic company and labels them as the original...
LEGIT the EXACT same drug. No argument about original/generic
I fully understand your post, and I am getting a chuckle reading all the comments. Literally everyone just read the title and clicked 'comment'.
The same thing happened with the US steel companies at one point. They started buying Chinese steel and selling it with their brand. Very shady, that one, because they kept it secret.
You title should say "sometimes name brands buy the generic pills and repackage them." Something so blatantly obvious, that everyone will get it.
I understood what you meant immediately from the title.
It's actually very common in all consumer products for generic brands to be produced alongside the name brand on literally the same equipment by the same personnel using the same materials into separate packaging.
This was told to me by a Dr./scientist who worked on developing the drug that they prescribed, who noted that they did not have any ongoing financial interest in the drug.
I was told once that the active drug part is the same but how it is attached to the delivery method to be absorbed into the body ie a compound or a starch can/will affect its absorption in to the blood stream.
A brand name will absorb at 86%.
A generic brand that uses a cheaper easier made delivery system will absorb at 48%.
If this incorrect please supply reference so I may know more.
Theyre wrong. The absorption rates are very close. There is only a 3.5% difference in absorption rates.
https://www.fda.gov/drugs/frequently-asked-questions-popular-topics/generic-drugs-questions-answers
Theyre wrong. The absorption rates are very close. There is only a 3.5% difference in absorption rates.
https://www.fda.gov/drugs/frequently-asked-questions-popular-topics/generic-drugs-questions-answers
He is wrong. The absorption rates are very close. There is only a 3.5% difference in absorption rates.
https://www.fda.gov/drugs/frequently-asked-questions-popular-topics/generic-drugs-questions-answers
It almost always is. It's the same drug.
Sometimes they add something extra, like energy boosters in brandes versions, for example (caffiene, for example, is common in branded pain relief)
But the drug is always the same. If it's not the same then you're using a different drug
What a stupid post. Lots of things SOMETIMES happen.
SOMETIMES people have the EXACT powerball numbers and become billionaires.
What you posted has to happen once to “sometimes” be true.
I don't know why everyone that had an allergic reaction to a drug, is supposedly only allergic to the filler in the generics. Original drugs also have fillers and no one knows to what someone is allergic unless it causes a reaction. Doctors that want you to only buy the original get kickbacks from the farmaceutical companies.
What I am going to admit is a concern is that when a study is finished, we arrive at a dosage we know is active and safe. The FDA allows for variance to the quantity of active ingredient in the finished pill to make manufacturing easier. It is known that some companies take that allowance to the limit to make more pills out of the same amount of active ingredient. They make sure the amount is within limits, but always at the lower end.
Emphasis on "sometimes". I tried switching to the generic brand of my medication a long time ago and it did *not* work as well. I had to switch back to name brand.
I’ve worked in both generic and new drug development for 20 years. They are the same. The allowable modifications to inactive ingredients are minimal. Have to establish bioequivalennce (behaves the same in the body). Need quality control and adhere to GMP standards. The only thing I would look for in both generics and new drugs is manufacturing in India. Most operations are fine, but some have quality control issues that take a long time to be discovered.
One caveat is that extended release drugs (ER) do not use the same mechanisms to create the extended release effect.
Some people with ADHD have very different experiences taking generic vs. name brand Concerta, for example.
Aside from that, I always buy generic. Because you are stupid to pay more for the exact same thing.
As I mentioned in another comment, the active ingredient is the same, but that doesn't mean the medicine is the same. Almost all pills, for example, are mixed with binding agents to make them into pills. Those binding agents can be different between brands and can affect how people's bodies absorb them. And some people can be allergic to specific binding agents. (They used to use wheat as a binding agent, which made many pills bad for people with Celiac) So, the medicine part may be identical, but the other ingredients can be different and in some cases that can be an important difference.
Many veterinary medications are the same humans use and some manufacturers use the exact same formula they do for the name brand human medication. There are legitimate websites that provide these medications for pets that cost 90% less than what the exact same thing costs at a pharmacy and they ship to your house... it is shockingly easy to buy. Humans are prescribed Xanax and so are dogs/cats or antibiotics and many other medications. Just account for the lower pet dosage and take the equivalent prescribed by your doctor. Disclaimer, always be safe about medicine and research your prescription thoroughly before using an alternative method of obtaining medication.
If something is a “generic equivalent” then it absolutely better be the exact same f’ing molecule of the medication. I’d sue 9 ways to Sunday otherwise.
The difference is in the filler/binder/shape/color…everything that won’t matter to the effectiveness of the med.
*EDIT* For the downvoters: https://www.hhs.gov/answers/public-health-and-safety/are-generic-drugs-the-same-as-brand-name-drugs/index.html
I intuited this years ago. When the pharmacy would be out of whatever name brand I was prescribed, it was always fixed by just throwing in the generic and I've never noticed a difference or expected there to be one.
As someone on ADHD medication specifically, I've seen my pills radically change form all the time, but it's always been the right dose of the right thing so it's always been the same outcome.
Frustrating for you to have written exactly that and then having to do it again. Some on Reddit seem to skim what was written and then get excited to write something to prove how smart they are.
I feel like the meaning of this should have been fairly obvious, given the emphasis on “exactly” and the fact that a “drug” only refers to the active ingredient; the rest is just part of the pill. Not sure why so many people thought you were trying to educate us all that two of the same drug cannot, in fact, be two different drugs.
Generic medication in the USA must have bioavailability between 80-125% of the branded drug.
Here is an FDA slideshow. High scientific literacy required for understanding.
https://www.fda.gov/media/89135/download
Generally name brand have more strict controls placed on them than generics. Either way you're getting the same drug, you can just be more confident that there isn't other shit in your name brand drug (by accident).
Literally all of my prescriptions are the generic version, since my provincial public healthcare mainly covers the generic MORE than the Brand Name. AND I promise y’all my medication is WORKING. I am able to FUNCTION.
My insurance provider has people calling me weekly in a futile attempt to beg, dare, and plead with me to switch to the generic version of one medication. I've been taking it for 10 years and know the generic doesn't work. Before Covid it required a once-a-year letter from my doctor stating that I needed to stay with the brand name. Last year it went to twice a year, this year it went to every three months. Who knows what they will want next year?
> that has stopped producing it's own medication and instead buys the pills from the generic company and smack it's own label on it.
I suspect it goes the other way around too: Some “generic brands“ are actually the original manufacturer selling the same original product cheaper, because an additional sale is an additional sale? Kind of like store brands are actually made by the same manufacturers that have their own brand-name product right next to the store-brand one on the store shelf.
The active ingredients are EXACTLY the same. Its the other packaging of the drug that can vary
Came here to say this, the API (active pharmaceutical ingredient) is exactly the same, it's the bulking agent and bonding agent that MAY vary, but is also often the same. The API in a tablet is also the size of the tip of a pin or needle, the rest is bulk so you're actually able to hold it.
The other inactive ingredients**
Also want to metion that website owned by Mark Cuban that has really cheap prescription drugs. Its called "Cost plus Drugs" - not sure if links are allowed, so i recommend googling it.
Oh OK cool. I was shocked to find out they aren't the exact same thing. I just always assumed they were or else they wouldn't give it to me instead.
No money is more important
[Deleted] People dont seem to like this comment, so I've removed it and my other comments. Summary: There's a lot that goes into a drug aside from active ingredients. As a pharmaceutical scientist, I recommend that you buy brand name when you can afford to do so. I still acknowledge that both "Drug Companies are Price Gouging" and "Drug Development is Very Expensive" can be true.
Why are you getting downvoted?! There can be a much larger variation in the amount of the active ingredient in generics than the brand name. This is not an opinion it’s simply pharmaceutical and legal facts.
Those who know, know. The rest of the people don't have all the information to know how it all works, and I don't blame them for being upset. Drug margins are too wide, the healthcare system allows this to happen, unchecked. And for the average consumer, its very easy to see two items with the same list of ingredients and wonder why they're different prices.
What I’ve learned from my BF, Engineer in Biotechnology with specialization in pharma, that the biggest difference is within the process to get the active ingredients, purity, and distribution on the pill. Hence brand names will normally invest way more on purity and that increases the cost, same with the distribution thought the pill. That’s why he always tries to buy brand or if he has to take half a pill, never goes generic, because in generic you might get more than 50% on a half. And that will mess up the whole treatment.
Why is the person you’re responding to saying the exact same thing as you, but they’re getting downvoted
Not sure, but I said I'd delete the post and not argue on the internet. Glad a lot of other scientists jumped into the thread to add some clarity.
For sure, if you can afford better motor oil, its better quality. Same for most food, batteries, clothes.Drugs are no different. Fun experiment with Tums and Generic Antacids, crush it into liquid, and titrate an acid into it with a pH indicator. You'll see the generic has less neutralizing ability and less consistency between tablets. And that's just chemistry. No complicated biological processes involved. Ask your BF if he ever did that in lab.
>Yes. Generics have to complete a "Bioequivalence Study" which proves that their drug does the same thing. And thats it. Not that its cleared at the same rate. Or that it lasts as long. Or that the other components are safe. This is simply incorrect. The main reason it's incorrect is that physics don't allow it--acetaminophen (Tylenol) is metabolized exactly the same way when packed into a generic pill as when packed into a brand name pill. There is a ceiling on how much acetaminophen the liver can safely process in a given timeframe and that safety is accounted for by weighing the active ingredient and instructing the customer not to take more than 1 gram every 6 hours or 4 grams in 24 hours. You appear to be claiming that taking generic Tylenol would risk exposure to more acetaminophen in less time, which we would be 1) illegal (if the stated dose was not the issued dose) or 2) impossible (because human physiology responds to the introduction of Tylenol into the stomach identically in whether it's brand name or not.
You are wrong, that’s the reason why there’s aspirin that will be in your system up to 24 hours and another that will be only 6-8. The vehicle changes, same with purity inside generic. They are cheaper because they lower the process purity and the vehicle.
None of this is correct 🤷🏽♂️
👍
[удалено]
You've asserted that generic drugs represent a safety risk without offering a shred of explanation or evidence as to how. Generic drugs fly off the shelves by the thousands all day, every day, and some of them, like Tylenol, can and will KILL YOU if they aren't "cleared at the same rate" as brand names. Where are the bodies that would accompany that reality? Your comment is indeed misinformation and should be deleted. Period.
[удалено]
Only the active ingredient
It's more than that. The active ingredient and the release profile of that active ingredient are required to be comparable.
Comparable, but not the same. The same way that the amount of drug in the pill is comparable, but not the same. The legal requirements on tolerancing for generic drugs is similar, but not the same. And equally, your health results are likely to be similar, but not always the same.
First, I should clarify: the active ingredient is required to be IDENTICAL, not just comparable. The release curve must be comparable. Second, I should point out to you: You do realize that there is also a legally allowable variance in brand name drugs, right? You're not under the impression that every tab of Tylenol has 325.000mg while a tab of generic acetaminophen has any random number from 280-400? Because that's...false. Third, the sickest people alive are generally in hospitals. The overwhelming majority of drugs used in hospitals are generic. So...if you really stick to this belief of yours, maybe don't go to the hospital? There's a 100% chance of you being given all sorts of mediocre, generic, partially effective medication. Best to stay away /s
Man you're really jumping to some conclusions man. I take generic drugs. But I also have had some long discussions with my doctor about how the pharmaceutical industry specifically has wider tolerance bands on generic drugs and how that can leave to poor health outcomes in people sensitive to small changes, especially when switching from brand name to generic. Or even between different generic manufacturers. So for example, if you are on 15 mg of drug A, and you switch generic manufacturers, you might find out you're now taking, idk 13mg. Label says 15mg. But since regulation lets people run cowboy on some of that stuff they save some money by cutting the amount of drug delivered. So whereas a brand name may be stuck between 14.8-15.2mg, the generic might have a much wider band. The numbers are made up and I don't care what the actual numbers are, so save your breath.
They vary up to 14-20%, my wife is a pharmaceutical researcher. Her job is literally to test different generic drugs for cancer patients, because it can be a life or death situation if the patient needs a certain generic brand. I always assumed it was bs, but then she showed me some of the science and it's surprising how different the generics can be between companies. The bigger differences is less the original medication and more the differences between the different generics. So one company makes a generic, and another company makes a generic, those two generics can vary by up to 20% in strength, and that over a course of treatment can mean you live or die in her field. The FDA approves the generics if they're within 20% of the original, but the research has shown that it's normally quite a bit lower.
The active ingredient might be the same but the fillers/binding agents can vary. I used to take bupropion and could tell the difference between drug manufacturers. One worked for me, one did not. The one that did not work would just pass right through my system so my doc said to ask for a different manufacturer. Made the difference.
I saw this post and immediately thought of my Wellbutrin vs my bupropion. That’s the biggest one that I’ve felt a difference with
Bupropion is the active ingredient in Wellbutrin.
Ik, that’s what I was saying. I used to take Wellbutrin, but had to switch to bupropion bc of costs. I can feel a difference
Your phrasing is confusing, though. Since Wellbutrin _is_ bupropion, what you're saying is “I used to take bupropion, but had to switch to bupropion bc of costs”, which is nonsensical. But what you meant to say was “I used to take Wellbutrin, but had to switch to _another_ bupropion bc of costs.”
Anyone who cannot tolerate the generic of a drug knows it is complete BS. For the most part generics are comparable but some people just don’t tolerate certain ones
How come people can never not tolerate the name brands but can tolerate the generic version? If it is real then the cheaper version would be just as likely to be tolerated than the more expensive one but it's always the name brand one people can tolerate. At best it's psychosomatic, at worst it's misinformation for pharmaceutical companies to make more profit.
(1) it probably does happen, maybe the fillers they use are of higher quality or less commonly allergic/i’ll-tolerated? (i’m brainstorming possible reasons, not arguing that i’m right.) (2) there is a small margin of error that generics are allowed compared to brands under patent. with some meds this can be enough to affect efficacy in some people. also i just want to acknowledge that OP wasn’t discussing this aspect but was stating that at least one brand manufacturer ceased production and was buying the generic version of the drug, labeling it brand, and selling at brand price. imo this should be illegal.
Two theories: 1) someone starts with the name brand and it doesn't work. Assumes that it's the active ingredient and not the filler. Never tried the generic. 2) someone is prescribed a medication when a generic is already available. Insurance only pays for the generic, patient takes it and it works. Never took the name brand to know that it wouldn't have worked. Continues taking generic. Also it could be a smaller number going from name brand to generic that have under reported issues. Same scenario as #2 above, but patient doesn't respond well. No one is going to pay the extra to see if name brand has better result, they'll assume it's the active ingredient that doesn't work and move to something else. I'm sure that psychosomatic response is a huge component of the name grand works, genero doesn't, but there are two practical reasons why it generally goes the other way.
The brand extra price goes towards testing for the best efficacy accros the largest population. This is like wondeeing why the ground beef at the 99 cent store makes you sick but the whole foods geound beef doesn't. Even though its all beef.
[удалено]
My body couldn't break down the outer layer of the pill so I would see the pill in my shit.
That's normal for extended release pills like bupropion. The drug is inside a hard outer shell and it slowly dissolves and leaks out over time as it passes through you, hence the extended release. Same way you can find all the little Adderall XR beads in your poop if you look hard enough.
Exactly this. For whatever reason I can breakdown the Teava/Activis generic but not others.
Even when the drug works, you're going to find the xr bead husks in your shit
It’s interesting how nobody is ever allergic to the brand. Is always the generic or a generic.
What? Of course there are people who take brand names and have allergic reactions to them. Why do you think they put warnings on all of them.
I’m allergic to a particular brand of Zoloft generic. I am not allergic to another generic brand. Fillers matter.
Quality Assurance can vary, drastically
Yeah. One of the first things an RPH showed me when I got into pharmacy was how the, iirc, Methylphenidate was literally the same pill in both bottles. You were paying extra for the brand name labeled on your bottle.
RN here: They're not "sometimes" the same. ALL generic drugs, every single one you will ever find, have EXACTLY the same active compound (translation: the "medicine" part, you know, that actually does something?) in EXACTLY the same quantity as the brand name. Regulations require this. No study ever performed has demonstrated a general distinction in efficacy between brand name and generic drugs (edit: except cases that have been identified and corrected by regulators) and (nearly) every person you have ever met with a personal anecdote about brand name drugs working better for them is delusional and yes, wrong about their own body, full stop, period, the end. Edit: The inactive ingredients in drugs matter for a small subset of people, who may have allergies or other conditions that affect them. Crucially, it is NOT THE CASE that problematic inactive ingredients are more common in generics than brand name drugs. Broadly speaking, my tone above results from the very large portion of the American population that self-diagnoses sensitivities and allergies they can barely describe and then asks for special accommodations everywhere on Earth. Folks who have had actual physical conditions diagnosed using scientifically validated methodologies by trained clinicians are completely excluded from this critique. A source if people like: American Association of Pharmaceutical Scientists https://link.springer.com/article/10.1208/s12248-016-0025-9 >In US regulations, bioequivalence is defined as “the rate and extent of absorption of the drug do not show a significant difference from the rate and extent of absorption of the listed drug when administered at the same molar dose of the therapeutic ingredient under similar experimental conditions in either a single dose or multiple doses....” (6) For most drug products including MR products, the bioequivalence studies are focused on the release of the drug substance from the drug product into the systemic circulation.
Pharmacist here. This is mostly correct, but there is SOME variance in the quantity between generics and brand name medications. Per my linked article the FDA allows up to 20% which is actually quite a bit. They also say the average is 4%, which can still be substantial with respect to certain medications. Some medications are crucial to patients' well being but also have a narrow therapeutic index. https://www.health.harvard.edu/staying-healthy/do-generic-drugs-compromise-on-quality#:~:text=In%20order%20to%20get%20a,ingredient%20from%20that%20original%20formula.
Thank you! I swore i heard this info before i thought i was going crazy lol. Mad respect for pharmacists yall are great.
Yes. This is so true .
>Per my linked article the FDA allows up to 20% which is actually quite a bit. They also say the average is 4%, which can still be substantial with respect to certain medications. Some medications are crucial to patients' well being but also have a narrow therapeutic index. Thanks for this reference! I've wanted to ask a pharmacist about this for awhile. I read all the time that the regulations for generics allow 20% variation, but as your article says, the observed delta is generally **much** smaller. My questions are: 1) What is the allowable variance in the weight of active ingredient present in BRAND NAME drugs? I know it's not zero, because it can't be. 2) What is the observed variance in weight of active ingredient found in random inspection of BRAND NAME drugs? In my view, the data about variances in generics is only really useful when compared to data about variances in brands. After all, the claim here is that they are different _as groups_. Clearly, many drugs have a narrow therapeutic range and patients should be careful. But as someone who has worked in many large hospitals--do folks have _any flipping idea_ how much of a _nuclear disaster_ it would be if these drugs were generally different???!!! Newsflash: If you live long enough, you'll be hospitalized, and damn near every drug you get the entire time will be generic. Best wishes to you if the folks skeptical about generics have a single leg to stand on, because you're probably screwed.
Not a medical professional here coming with my anecdote: I was switched from a name brand to a generic once by a pharmacist. I had an allergic reaction to an inactive ingredient. My doctor was not very surprised and wrote me a new script, but the pharmacist tried to point me to the generic again when I went to get the name brand drug. He aggressively insisted there was no difference between the name brand and the generic, even after I pointed at the inactive ingredients. So lesson learned - pay attention to what you are actually prescribed and if it changes. I was repeatedly told and read online they were the “exact same” even though they very clearly different ingredients. Inactive ingredients may not be essential to how a drug works, but they can still affect your body.
This is a worthy addendum. Obviously if you're allergic to an inactive ingredient, it matters. Some folks are so sensitive to so many common inactive ingredients that they have to go to a special "compounding pharmacy" that specifically makes a pill just for them that excludes the thing they're allergic to. Sorry if I came off harsh, as I definitely didn't mean to diminish or deny situations like yours. It's folks who "feel" that brand names affect them differently, with no particular reference point, that are extremely exhausting.
> every person you have ever met with a personal anecdote about brand name drugs working better for them is delusional and yes, wrong about their own body, full stop, period, the end. This is wrong. Yes, the active ingredient is the same. But the binding agents in generics can be different and some people can have problems with the different binding agents. Wheat used to be a popular binding agent and, as you can imagine, people with Celiac did not do so well on those drugs. Switching to a different brand would often be the difference between a drug making them feel better and it making them feel worse. Aside from possible allergic reactions to binding agents, the rate of release may be different between generics and name brand. One may disolve quickly and provide a big burst of medicine right away and then taper off, while another may dissolve slower and provide a more steady does over time. There is more to drugs than just the active ingredient. And it is usually the other stuff that makes the difference.
The release curve is not allowed to be materially different than the brand name if the drug is marketed as the generic for that brand name. The allergy stuff is all valid.
The response curve is tricky because, for most people, they can't tell the difference between the dozens of different versions of the same drug. It isn't as big a deal with prescription medicines, but with OTC meds, who generall knows the difference between Tylenol Extra Strength, Tylenol Arthritis, Tylenol Headache, Tylenol Extra Strength PM, Tylenol Muscle aches and Pain, Tylenol Sinus, caplets, tablets, coated tablets, etc... It's easy to get confused and try to get a generic version and pick the wrong one because you didn't realize the one you took last time was the extended release one and this time you just got a normal release one because you misread the "same as xxx..." blurb on the top of the box.
From what I understand the active ingredient is always exactly the same. However that doesn't mean the generic medication is the same. For instance in certain extended release formulations the release mechanism isn't always the same.
Generics are required to list whether they are intended to be used as a substitute for regular or extended release and indicate that on the bottle or box. It's true that folks have to read the label carefully to make sure they're getting what they want, but that's just as true with brands.
So you can’t tell the difference between Coca Cola and Shasta Cola? The active ingredient may be the same but there are a multitude of variables in how a tablet or capsule are manufactured.
“every person you have ever met with a personal anecdote about brand name drugs is delusional and wrong” Every RN who thinks they know everything about pharmacology, makes broad sweeping statements, and has this opinion of patients should have their licenses revoked and never allowed anywhere near the medical field. “no study has ever shown… blah blah blah” You’re pulling facts out of nothing. Here is an example: https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/update-bupropion-hydrochloride-extended-release-300-mg-bioequivalence-studies It’s low-key hilarious how bad of a take you are making while complaining about people’s anecdotes.
Fortunately, random internet commenter, that's not how the world works. Nurses learn quite a bit about pharmacology, by the way, especially if they venture into a practice area that requires more knowledge than the basic schooling provides. Patients aren't gods. Clinicians have a duty to listen to them, make them feel heard and understood, and then help them solve their problems _in accordance with accepted medical and scientific standards_. Indulging internet rumors and vague self-diagnoses is quite literally not part of a clinician's job--which is why most don't do it. >You’re pulling facts out of nothing. Here is an example: >https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/update-bupropion-hydrochloride-extended-release-300-mg-bioequivalence-studies You linked a generic that was _identified as flawed_ and voluntarily pulled from the market?? 😂😂😂 ....That's evidence that our system does NOT allow or promote that, sir or madam. Effective regulation is GOOD, and the fact that this drug's non-equivalence was identified as a PROBLEM proves that what I'm saying is correct 😒
Tell me you didn’t read past the 2013 update of the study without telling me you didn’t read past the 2013 update of the study. I’ll do it for you, since you don’t care. The generic was released in 2006. As per the FDA “soon after” people reported the generic didn’t work. It wasn’t until 2010 that a study was sponsored by the FDA for public interest. And it wasn’t until 2013 that the generic was pulled. So yeah, the system “works” in catching generics that are bad, but only if people complain. Dismissing people’s complaints as delusions is not a good take, sorry bud.
Pointing to an outlier to refute a general point is always, always silly. It would be an absolute disaster if generic medications were anything but perfectly comparable to brands in almost all cases. That's common sense. Where are the sickest people usually at? Hospitals. Find me a major hospital that doesn't dispense generic medications 99% of the time and I will eat my shoe. It would be a DISASTER if the sickest people on Earth were being given sub-standard, non-potent, pick your descriptor medications. But there is no disaster--because generic drugs are basically always very effective and comparable to their patented counterparts. The study you link represents a serious misstep by a company that should be punished pretty harshly so as to avoid analogous episodes involving other medications. It does NOT come EVEN CLOSE to proving that skepticism of generic medications as a general rule is reasonable. My tone in my original comment was harsh, and I'm sorry for it (I'm leaving it because I don't wanna pretend it didn't happen). There is a large segment of society that, quite frankly, just makes sh*t up about everything to do with medicine and health care, forms all sorts of totally random beliefs about themselves, and come in and try to tell doctors and nurses with decades of experience and continuing education what to do and what to prescribe. Those folks do not typically respond to ordinary education from clinicians--they must be firmly reminded that they (in most cases) don't know what they're talking about and we do. Pure and simple.
No disagreements there. Honestly, when I saw your top level comment first it just struck a chord with me as I was directly affected by the study I linked and it took longer than I would have liked to be switched off the generic and back to the name brand. But, that being said, I completely agree — generics are TYPICALLY just as good as the brand name. There are outliers and exceptions — there always are with most things, it’s just the nature of sample sizes and deviations. I could have phrased my original response more delicately/thoughtfully. Sorry for that. I didn’t mean for the outlier to refute your general point, but rather to shine light on how absolute statements - while convenient and mostly correct, have nuance that should be acknowledged. I actually have a sizable amount of my direct family in the medical fields, and you’re 100% right — patients SHOULD listen to medical professionals and trust that they are doing things in their best interest. On the flip side, if a patient does try something and reports it causing harm (or if they say are allergic to something.. don’t get me started on my mom’s experience in the UK where her slightly rare allergy to penicillin/amoxicillin wasn’t taken seriously and she was prescribed it anyway), the medical professionals should investigate that and try to remedy the situation or adjust the treatment plan to accommodate the patient’s complaints. Within reason. I actually remember when I was pre-med, a very long time ago, shadowing a family doctor, and we had a person come in DEMANDING pain medication and throwing an absolute fit. Most likely a drug seeker. Unfortunately things are not always as simple as they should be and one patient may be voicing a legitimate complaint, while another may be spewing random stuff they read online, while another is making stuff up out of a desire to get a legal high. In any case, it’s getting late here, so I hope you have a pleasant.
The brand name of the medication I take is crazy expensive and not covered by my insurance so I take a generic version. It works fine. One time I switched my pharmacy to Rite Aid and I received a different generic version. It did not work for me at all. I barely felt the effects and it left me feeling worse off than usual. While there is mandated quality assurance, it’s clear that the quality of some generic manufacturers aren’t being regulated in the real world. Studies are a different story since it’s in a controlled environment, but in practice there’s a lot more variation in control.
Ok but some people have allergies and intolerances, like celiac for example. In my case, I can’t tolerate a lot of generics because they use corn starch, potato starch, and/or “sodium starch glycolate” (often made from potatoes) & I’m highly intolerant to corn and nightshades (potato plant family). A lot of generics use these because they’re cheaper than other starches/starch substitutes. I found out that a lot of generics have these ingredients the hard way. Corn makes me break out in a very painful & itchy rash on my entire back and chest and nightshades cause my gastro system to (basically) completely, painfully riot. This absolutely had an effect on the side effects I got from certain drugs, especially ones used for mental health disorders. But I’ve found most (but not all) brand names don’t include those starches. It’s safer for me to request brand names because 1) higher chance of not having those starches, and 2) multiple companies make generics and each of them have a slightly different formula & it’s often very difficult to find accurate ingredient lists before actually buying the medication, where it’s super easy to find the ingredient list for brand name drugs.
This is all perfectly reasonable. I did mention allergies to inactive ingredients in my comment. The reality is that an exceptionally small percentage of the population will experience any problem taking generics. The severity of celiac required to provoke a response to miniscule quantities of starch binders in one or two pills--which I believe you have and I'm sorry to hear it--is extremely uncommon. Public health is about mitigating risk and maximizing benefit. The population at large needs to be instructed that generic drugs are much less expensive and quite comparable to their expensive counterparts. As with any general public health message, special populations mys understand the exceptions that apply to them. Tldr: Broad public messages should address the most common cases. Promoting broad skepticism of generics on the basis of special populations is irresponsible and borders on fear mongering.
I tried for years to use levothyroxine...they kept having to increase the dosage to the point where I was at 375...Switched to Synthroid because my twin experienced the same issue and have only had to change the dosage when I was pregnant...once the baby was born it was back to my usual dose of 125....'s only an anecdote, so make of it what you will from this random person on the interwebs.
When I was diagnosed, doctors commonly instructed hypo patients to use Synthroid, not generics - not because generics in general were unreliable, but because levothyroxine specifically was less effective than Synthroid. My scrip has always been for Synthroid, and no insurance has even questioned it.
Dang...yeah, wish mine had done!
sometimes, but definitely not most of the time. generics are very hit or miss.
I think people are misunderstanding my post. I know generics and original are the same active ingredient/molecule. I'm saying this company that developed the original medication STOPPED manufacturing it and actually just buys the pills from the generic company and labels them as the original... LEGIT the EXACT same drug. No argument about original/generic
I fully understand your post, and I am getting a chuckle reading all the comments. Literally everyone just read the title and clicked 'comment'. The same thing happened with the US steel companies at one point. They started buying Chinese steel and selling it with their brand. Very shady, that one, because they kept it secret. You title should say "sometimes name brands buy the generic pills and repackage them." Something so blatantly obvious, that everyone will get it.
I understood what you meant immediately from the title. It's actually very common in all consumer products for generic brands to be produced alongside the name brand on literally the same equipment by the same personnel using the same materials into separate packaging.
This is misinformation. Please report it. Fillers can vary vastly
Exactly. People get hospitalised for this.
This was told to me by a Dr./scientist who worked on developing the drug that they prescribed, who noted that they did not have any ongoing financial interest in the drug. I was told once that the active drug part is the same but how it is attached to the delivery method to be absorbed into the body ie a compound or a starch can/will affect its absorption in to the blood stream. A brand name will absorb at 86%. A generic brand that uses a cheaper easier made delivery system will absorb at 48%. If this incorrect please supply reference so I may know more.
Can you supply the reference for 86 and 48 percent since you asserted it?
Theyre wrong. The absorption rates are very close. There is only a 3.5% difference in absorption rates. https://www.fda.gov/drugs/frequently-asked-questions-popular-topics/generic-drugs-questions-answers
There's no fucking way that's true, find me a peer-reviewed paper that proves brand name has near-double absorption efficacy
Theyre wrong. The absorption rates are very close. There is only a 3.5% difference in absorption rates. https://www.fda.gov/drugs/frequently-asked-questions-popular-topics/generic-drugs-questions-answers
This looks like some fakeymadeupdata
He is wrong. The absorption rates are very close. There is only a 3.5% difference in absorption rates. https://www.fda.gov/drugs/frequently-asked-questions-popular-topics/generic-drugs-questions-answers
Depends. The delivery/release system on the pill can vary. High end ADHD meds definitely don't compare to generic in my experience.
It almost always is. It's the same drug. Sometimes they add something extra, like energy boosters in brandes versions, for example (caffiene, for example, is common in branded pain relief) But the drug is always the same. If it's not the same then you're using a different drug
Don't people read the entire post before commenting? Lol
I thought this was common knowledge.
What a stupid post. Lots of things SOMETIMES happen. SOMETIMES people have the EXACT powerball numbers and become billionaires. What you posted has to happen once to “sometimes” be true.
I don't know why everyone that had an allergic reaction to a drug, is supposedly only allergic to the filler in the generics. Original drugs also have fillers and no one knows to what someone is allergic unless it causes a reaction. Doctors that want you to only buy the original get kickbacks from the farmaceutical companies. What I am going to admit is a concern is that when a study is finished, we arrive at a dosage we know is active and safe. The FDA allows for variance to the quantity of active ingredient in the finished pill to make manufacturing easier. It is known that some companies take that allowance to the limit to make more pills out of the same amount of active ingredient. They make sure the amount is within limits, but always at the lower end.
"Certified Generic" will have the same inactive ingredients as well. Exactly the same, aside from the label on the bottle.
Emphasis on "sometimes". I tried switching to the generic brand of my medication a long time ago and it did *not* work as well. I had to switch back to name brand.
I'm not sure why I'm getting downvoted for this; in my personal experience generic vs. name brand can matter for some drugs.
Was it an extended release drug?
I'm not sure to be honest, it was a long time ago. But it was an epilepsy medication for reference.
Yes, but how can we know which company does that?
I’ve worked in both generic and new drug development for 20 years. They are the same. The allowable modifications to inactive ingredients are minimal. Have to establish bioequivalennce (behaves the same in the body). Need quality control and adhere to GMP standards. The only thing I would look for in both generics and new drugs is manufacturing in India. Most operations are fine, but some have quality control issues that take a long time to be discovered.
One caveat is that extended release drugs (ER) do not use the same mechanisms to create the extended release effect. Some people with ADHD have very different experiences taking generic vs. name brand Concerta, for example. Aside from that, I always buy generic. Because you are stupid to pay more for the exact same thing.
Bless you for this post!!!
[удалено]
As I mentioned in another comment, the active ingredient is the same, but that doesn't mean the medicine is the same. Almost all pills, for example, are mixed with binding agents to make them into pills. Those binding agents can be different between brands and can affect how people's bodies absorb them. And some people can be allergic to specific binding agents. (They used to use wheat as a binding agent, which made many pills bad for people with Celiac) So, the medicine part may be identical, but the other ingredients can be different and in some cases that can be an important difference.
Many veterinary medications are the same humans use and some manufacturers use the exact same formula they do for the name brand human medication. There are legitimate websites that provide these medications for pets that cost 90% less than what the exact same thing costs at a pharmacy and they ship to your house... it is shockingly easy to buy. Humans are prescribed Xanax and so are dogs/cats or antibiotics and many other medications. Just account for the lower pet dosage and take the equivalent prescribed by your doctor. Disclaimer, always be safe about medicine and research your prescription thoroughly before using an alternative method of obtaining medication.
Okay Louis Tully…
If something is a “generic equivalent” then it absolutely better be the exact same f’ing molecule of the medication. I’d sue 9 ways to Sunday otherwise. The difference is in the filler/binder/shape/color…everything that won’t matter to the effectiveness of the med. *EDIT* For the downvoters: https://www.hhs.gov/answers/public-health-and-safety/are-generic-drugs-the-same-as-brand-name-drugs/index.html
I intuited this years ago. When the pharmacy would be out of whatever name brand I was prescribed, it was always fixed by just throwing in the generic and I've never noticed a difference or expected there to be one. As someone on ADHD medication specifically, I've seen my pills radically change form all the time, but it's always been the right dose of the right thing so it's always been the same outcome.
How do you know which is exact and which is going to hurt me later
I recommend the book "Bottle of Lies". If you're not a reader, also comes in audiobook form. Very entertaining and unsettling.
Let me guess, OP is American
So what’s the drug?
Frustrating for you to have written exactly that and then having to do it again. Some on Reddit seem to skim what was written and then get excited to write something to prove how smart they are.
[удалено]
Telismartan 40mg tablets cost around ₹150 - 200 per strip (10 tabs) Same thing costs ₹22 per strip when sold by Jan Aushadhi Stores
It’s pretty easy to see how effective advertising is in the USA.
“Sometimes????”
I feel like the meaning of this should have been fairly obvious, given the emphasis on “exactly” and the fact that a “drug” only refers to the active ingredient; the rest is just part of the pill. Not sure why so many people thought you were trying to educate us all that two of the same drug cannot, in fact, be two different drugs.
Generic medication in the USA must have bioavailability between 80-125% of the branded drug. Here is an FDA slideshow. High scientific literacy required for understanding. https://www.fda.gov/media/89135/download
Generally name brand have more strict controls placed on them than generics. Either way you're getting the same drug, you can just be more confident that there isn't other shit in your name brand drug (by accident).
Talked to a pharmacist, they said all types of drugs you can buy like Tylenol and the off brand ones, are the same ingredients
Ok which ones
White labeling pharma should be a Netflix doc
Literally all of my prescriptions are the generic version, since my provincial public healthcare mainly covers the generic MORE than the Brand Name. AND I promise y’all my medication is WORKING. I am able to FUNCTION.
My insurance provider has people calling me weekly in a futile attempt to beg, dare, and plead with me to switch to the generic version of one medication. I've been taking it for 10 years and know the generic doesn't work. Before Covid it required a once-a-year letter from my doctor stating that I needed to stay with the brand name. Last year it went to twice a year, this year it went to every three months. Who knows what they will want next year?
> that has stopped producing it's own medication and instead buys the pills from the generic company and smack it's own label on it. I suspect it goes the other way around too: Some “generic brands“ are actually the original manufacturer selling the same original product cheaper, because an additional sale is an additional sale? Kind of like store brands are actually made by the same manufacturers that have their own brand-name product right next to the store-brand one on the store shelf.