Reaction to Generics?

[Eeyores Butterfly]

A medicine I was using recently went generic and I have started using the generic. Within the last week, I have been feeling very sick to my stomach, throwing up, etc. I went to the doc and she thinks it might be food poisoning, but we can't think of anything I might have eaten that would cause food poisoning. These are all side effects of the medication I'm on and I'm wondering if switching to a generic could be the culprit? Don't they use different fillers many times in generics? Has anybody ever experienced this, a different reaction to a generic medication than to a brand name?

 

[Christine]

A medicine I was using recently went generic and I have started using the generic. Within the last week, I have been feeling very sick to my stomach, throwing up, etc. I went to the doc and she thinks it might be food poisoning, but we can't think of anything I might have eaten that would cause food poisoning. These are all side effects of the medication I'm on and I'm wondering if switching to a generic could be the culprit? Don't they use different fillers many times in generics? Has anybody ever experienced this, a different reaction to a generic medication than to a brand name?

Yes, it is possible.

I have taken brand name Prilosec for YEARS. A few years ago it went OTC and generic. The first thing I did was take the brand name OTC product. It was no longer a capsule and was now a tablet. No big deal, right? Within 5 days I was EXTREMELY nauseous all the time. I went back to prescription but in order to get it I had to have the doc write me a higher dose. I just empty out the capsules. I still have to get brand name Prilosec because if I take the generic omeperazole, I get a dry mouth. It's obviously from the different fillers. It sucks because I have a really hard time getting the brand name without some justification from my doctor.

For many years I took Synthroid. All of a sudden, I started getting a weird hive anytime I took certain medications (most notably, ibuprofen and Feosol). I tracked it down to a filler called povidone. I stopped taking everything with povidone in it. I still had this odd rash on my chest. Realized my Synthroid has povidone in it. I switched to Levoxyl (which is another brand name of thyroid medication) and I have no problems.

Fillers can cause problems. Or sometimes it is not actually the fillers themselves but the way the medicine is released into your system based on the fillers that are used. It could be with the generic you are actually digesting/getting more medication because of the way the pill disintegrates, thereby giving you more side effects.

 

[KPeveler]

Yep - I had a reaction to a generic, but just one brand. In the future I learned not to take that brand and just got another generic.

 

[nmmom95]

I had the same reaction to a generic. I was throwing up and both my hemoglobin and WBC counts became very low. My doctor now has to specify "brand medically necessary." for this particular medication. I don't know what you are taking, but mine was Imuran, the generic is azothioprine.

 

[daughter_of_amid_chaos]

I have had 2 generic medications stop working after a few months on them so I am very weary of generic medications now and have my doctor write no substitutions.

 

[krcit]

I just saw this subject on Dr. Oz I think it was. They said some times generics have different side effects. Hope you get it straightened out.

 

[dejr_8]

http://www.medicinenet.com/script/main/art.asp?articlekey=46204

Generic Drugs, Are They as Good as Brand Names?

Medical Author: Melissa Stoppler, M.D.
Medical Editor: Barbara K. Hecht, Ph.D.

Generic drugs are copies of brand-name drugs that have exactly the same dosage, intended use, effects, side effects, route of administration, risks, safety, and strength as the original drug. In other words, their pharmacological effects are exactly the same as those of their brand-name counterparts.

An example of a generic drug, one used for diabetes, is metformin. A brand name for metformin is Glucophage. (Brand names are usually capitalized while generic names are not.) A generic drug, one used for hypertension, is metoprolol, whereas a brand name for the same drug is Lopressor.

Many people become concerned because generic drugs are often substantially cheaper than the brand-name versions. They wonder if the quality and effectiveness have been compromised to make the less expensive products. The FDA (U.S. Food and Drug Administration) requires that generic drugs be as safe and effective as brand-name drugs.

Actually, generic drugs are only cheaper because the manufacturers have not had the expenses of developing and marketing a new drug. When a company brings a new drug onto the market, the firm has already spent substantial money on research, development, marketing and promotion of the drug. A patent is granted that gives the company that developed the drug an exclusive right to sell the drug as long as the patent is in effect.

As the patent nears expiration, manufacturers can apply to the FDA for permission to make and sell generic versions of the drug; and without the startup costs for development of the drug, other companies can afford to make and sell it more cheaply. When multiple companies begin producing and selling a drug, the competition among them can also drive the price down even further.

So there's no truth in the myths that generic drugs are manufactured in poorer-quality facilities or are inferior in quality to brand-name drugs. The FDA applies the same standards for all drug manufacturing facilities, and many companies manufacture both brand-name and generic drugs. In fact, the FDA estimates that 50% of generic drug production is by brand-name companies.

Another common misbelief is that generic drugs take longer to work. The FDA requires that generic drugs work as fast and as effectively as the original brand-name products.

Sometimes, generic versions of a drug have different colors, flavors, or combinations of inactive ingredients than the original medications. Trademark laws in the United States do not allow the generic drugs to look exactly like the brand-name preparation, but the active ingredients must be the same in both preparations, ensuring that both have the same medicinal effects.

 

[SueM in MN]

My daughter was switched to generic medication for seizures a few years ago. We fully expected it to work just fine, but she was hardly eating anything after being on the generic for a month PLUS it did not control her seizures as well.
Her doctor said he had run into that with several other patients, switched her back to the non-generic and her appetite came back back, but the seizures have not gotten back into as good of control as they were before. The biggest difference was that the brand name medication was a chewable dispersible (which means it melts). The non-generic was chewable, but did not disperse and was very hard to chew. We think that the pills staying in DD’s mouth for a long time left a very bad taste which made her nauseated and unable to eat. That may have also made a difference for her in the absorption. So, same active ingredients, but the other ingredients (fillers, etc) were very different.

They say the generics are equivalent and are tested to make sure they work the same. Some are even made by the same company that makes the brand name version, but when talking to patients who think they are having a problem, I say to talk to the doctor or pharmacist. I also tell the “Chocolate Cake” story.

If you go to the grocery store, you can find many cake mixes for chocolate cake. They are all equivalent - if you look at the ingredient lists and the calories per serving, some will even be almost exactly the same. The ‘active ingredients’ in chocolate cake are chocolate, sugar, eggs, flour, plus a leavening agent (to make it rise). Since they all have the same “active ingredients", they should all turn out the same.
But, if you pick out a few mixes and bake the cakes, you may find they can be quite different. To some people, chocolate cake is chocolate cake and they may not notice any differences between the different cake mixes. Some of the cake mixes may be virtually identical; it would not be possible for most people to notice a difference. Other people may find that one really doesn’t taste that good to them and will have a preference for another brand.
Even if 2 people bake the exact same cake mix or follow the exact same recipe, there may be some differences because of the size of eggs they use, how accurately they measured or differences in how their oven bakes.

For most people, there will not be that much difference generic to non-generic and they will do just fine.
But, if there can be that much difference in something as simple as chocolate cake, it’s easy to see that the differences in generic and non-generic medications may make a big difference for some very sensitive people.

 

[tvguy]

Talk to your doctor, that's the best advice.

ALL generics have to be chemically identical by law to the brand name drug and thus should perform identically.

This is a very controversial topic because a lot of people report problems with generics.

I have never seen a study that ever found a scientifc reason for a generic drug not performing identically to the name brand.

 

[Mimi1965]

Interesting
My husband just got two letters from our Insurance -recommending that he switch to Generics-and its quite a lot cheaper-but is it worth it?

 

[MariDisney]

I have always used generics successfully. Then, when I had my thyroid out earlier this year my endocrinologist was absolutely insistent that I use the brand name drug for thyroid replacement. Every time I see him he reiterates that I am not to switch this one to a generic under any circumstances. He said this particular med is so "delicate" (or whatever, I forget the word he used) that the generics are often not as consistent from pill to pill. Who knows, but I trust him enough to follow his instructions on it.

 

[PatsMom]

I've always switched to generics whenever they were available and I haven't had any problems, although I've heard many do. I swapped from Glucophage to metformin, Zestril to lisinopril, Tricor to fenofibrate, Zocor to simvastatin all with no problems. With my drug plan if a generic is available, I will pay through the nose for a name brand so I always try the generic.

If I felt the generic wasn't working or was causing side effects, I would speak to my doctor about possible reasons why. Or ask to switch back - if a drug wasn't working, it would be worth it to me to pay the higher price.

 

[tvguy]

I've always switched to generics whenever they were available and I haven't had any problems, although I've heard many do. I swapped from Glucophage to metformin, Zestril to lisinopril, Tricor to fenofibrate, Zocor to simvastatin all with no problems. With my drug plan if a generic is available, I will pay through the nose for a name brand so I always try the generic.

If I felt the generic wasn't working or was causing side effects, I would speak to my doctor about possible reasons why. Or ask to switch back - if a drug wasn't working, it would be worth it to me to pay the higher price.

I haven't had any issues with generics. Insurance is another issue. DD had insurance issues with a medicine she takes that there is no generic for yet and no there is no other drug that treats her ailment. Insurance did a lot of singing and dancing until they determine there was no alternative. Also, my co-pay is $20 for a 90 day mail order supply, but one very old blood pressure medicine (been on the market 50 yers ) I take, the full retail price for a 90 supply is $8. They wanted to charge me the $20!!!

 

[C.Ann]

My problem was with switching from one generic to a different generic.. There's no question that it was the switch and the pharmacy now has it on file that my prescription must be filled with the med from "xyz"..

When my late DH was still alive, the VA switched his heart medication to a generic and he ended up in the hospital.. I insisted they switch him back to the name brand (actually had to throw somewhat of a hissy fit because the VA is all about generics), but they eventually gave in and the name brand went back to doing what it was supposed to do..

Each persons system is different - and what may work for one, doesn't necessarily mean it will work the same way for another..

Good luck!

 

[beachlover9395]

Many people had a problem in switching from Wellbutrin XL to the generic. Here's some info:

"The Teva product released nearly half of its ingredients in the first four hours," says Cooperman. "The original Wellbutrin released 25 percent."

Within the first two hours, 8 percent of the original Wellbutrin had dissolved, compared with 34 percent of the Teva product, according to Cooperman. By 16 hours, both drugs had released all the medicine.

If the active ingredient is released more quickly into a patient's bloodstream, that could mean there is less medication available to the patient later, which may explain why people like Douglas experienced a return of their depression, Cooperman says. It also may explain why some readers who wrote in complained of more side effects, such as headache, irritability and nausea, given they may have received a higher dosage of the medicine upfront, he says. "Too much Wellbutrin can cause side effects, even the potential for seizure," he says.

http://www.msnbc.msn.com/id/21142869/

That's just one example I could think of off the top of my head. So for some, the generic medication is released differently than the name brand. And fillers can be different and can cause problems. Personally, I can't take at least one company's version of Biaxin - the generic (don't know who made it) made my stomach feel like it was absolutely on fire.

 

[denisem]

SueM in MN: Love your chocolate cake analogy!

Many people can take generic drugs with no side effects or ineffectiveness. That's great & I have nothing against generic drugs. However, they are not always equal to name brand. I've twice switched to generic on a med I've taken for many years, and have had 2 doctors in 2 different states assure me I'm not mistaken in the generic being ineffective. Here's a link to a 2009 Today Show story http://today.msnbc.msn.com/id/30940044 and I've cut & paste some of the issues that echo my doctors' explanations:

""""If the drugs were truly bioequivalent, what could account for such divergent reactions? Last fall, the Graedons collaborated with ConsumerLab.com, an independent testing laboratory in White Plains, New York, to find out. Testing revealed that the 300 mg Budeprion XL dose Hubbard had taken dumped four times as much active ingredient during the first two hours as the brand name did. Graedon compares the effect to guzzling alcohol. "If you sip a glass of wine over the course of two or three hours, you're not going to feel drunk," he explains. "But if you drink the whole thing in 15 minutes, you're getting too much too fast."

Release formulas, which control how quickly a drug dissolves in your bloodstream, are something drug companies carefully develop and patent. And these release-formula patents often remain in place after the patent on a drug's active ingredient has expired. That means generic companies must sometimes engineer their own release mechanism, as happened in the case of Budeprion XL. After complaints started rolling in, the FDA concluded in a 2008 report that patients' problems were more likely caused by normal relapses of depression than by differences in the drugs, and Teva stressed that it followed all the FDA's rules. But that report — and the original approval of the 300 mg pill — was based solely on data Teva had submitted for the 150 mg pill; the agency's judgment was that the doses were proportional and would behave similarly in the body. "Neither the FDA nor Teva did the required bioequivalence studies for this pill," counters Tod Cooperman, M.D., president of ConsumerLab.com.

Buehler notes that the FDA won't approve generics that its scientists deem to have "clinically significant" differences in release rates compared to the original. But the bioequivalence studies they base this judgment on aren't public, so doctors and patients have no way of knowing when the FDA has found a difference and how dramatic it is. Nor can they easily find out about differences in fillers and additives, which might change the release rate or in rare cases trigger allergic reactions. "It's scary to think the FDA would approve something it knows is different and still call it equivalent," Dr. Cooperman says. """

DH just wandered by, wondering what I was doing. When I told him, he mentioned a story on CNN this week about American drug mfrs having "issues" with some meds imported from China. Here's the link to that story: http://www.cnn.com/video/?/video/health/2010/07/14/sylvester.drugs.from.china.cnn

I don't mean to alarm people - but trust your gut (literally) when it comes to your health.

 

[SandrA9810]

My grandmother is on Kepra for seizures. She's tried the generic before, and it doesn't work well for her. Since she's on medicare, but with the HMO through BC&BS. Medicare requires that all prescriptions be filled with a generic if one is available, but the HMO plans allow her to have the name brand. So whenever there's a change in pharmacist or pharmacy, my aunt has to go over the whole ordeal that she can not take the generic of Kepra. Although there's a few other meds she does just fine with generics.
I say, if your insurance allows it, go for the name brand. Since that's what probably works best. Even with OTC meds, any generics of Midol just don't work for me. So I spend the few extra bucks for the name and a medicine that works.

 

[JessicaR]

Twice I have had issues with switching from a brand to a generic. Major issues, from the drug not working as well to having horrible physical side effects. Both times I went online and found 1000's of others that had the same issue. No sorry, I don't believe that is a coincidence.

One of the brands I was taking became a generic last year. I have been taking this drug for 5 years. Why is the generic more than 3 times larger than the brand? Made me so ill I would not have taken it at all unless I took the brand.

Fight with your insurance company.

 

[Eeyores Butterfly]

It is a Teva marketed drug like the Wellbutrin mentioned earlier (the TEVA on the packaging caught my eye becaus it reminded me of the sandals.) I'm not for sure that's it, but it did make me wonder if that could be why I'm feeling sick all of a sudden.

I remember reading somewhere that generics only have to be something like 60% as effective as the name brands, but I can't remember where I read that or if it is a reliable source.

 

[Christine]

Release formulas, which control how quickly a drug dissolves in your bloodstream, are something drug companies carefully develop and patent. And these release-formula patents often remain in place after the patent on a drug's active ingredient has expired. That means generic companies must sometimes engineer their own release mechanism, as happened in the case of Budeprion XL.

This is the reason the Prilosec OTC does not work for me. If I remember correctly, Astra-Zeneca, the maker of Prilosec holds X number of patents on the Prilosec forumulation. Of that X number, only 3 were released so it could be made generic; hence, the manufacturers cannot make the omeperazole identical to Prilosec. As time goes on and the patents release, they probably can. It makes a big difference in the performance of the drug *for me.*

I do believe that drug companies spend a lot of time and money getting their brand name drugs "just right" prior to releasing them. For another company to come in and throw the active ingredient together with some cheaper fillers is probably not good enough from some of the more sophisticated drugs.

I think it's fine for some simpler things like ibuprofen, amoxicillan, etc. that have simple fillers to begin with in their brand name form. But not all.