Brand name medications vs. generics

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CRPSpatient
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   Posted 8/11/2011 3:14 AM (GMT -6)   
Just wondering what peoples' experiences are, as I'm in the midst of an argument with another friend with CRPS. Having experienced it, I say YES, she says no. I tried generic topiramate a little while back and it did nothing at all - might as well not have been taking it- yet 'Topamax' works well for me.

Anyone else experienced similar, or know why it is? Interaction of supposedly inactive ingredients? Different formulation, different coatings on the tablets?

Laura
CRPS since 1999, diagnosed in 2005 and since spread to full body, spasms, dystonia & contractures, gastroparesis, orthostatic hypotension,bradycardia/tachycardia, bone spurs, bursitis, carpal tunnel syndrome.

On Oxycontin/Endone, Topamax, Mobic, Magnesium, Florinef, Midodrine, Somac, Cipramil. Have a spinal cord stimulator, intrathecal pump with baclofen & bupivacaine and doing physio.

Screaming Eagle
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Date Joined Sep 2009
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   Posted 8/11/2011 8:51 AM (GMT -6)   
 
        Morning Laura! Great topic! wink  
 
             I can see where one could get into an arguement over this issue! However according to the FDA....

The U.S. Food and Drug Administration (FDA) requires that all generic drugs be identical to their brand-name equivalents in terms of ingredients and dosages. This means that if you purchase a brand-name drug or its generic equivalent, you are getting the same pill with a different label. There is a common misconception that the FDA allows generic drugs to differ from their brand-name counterparts, but according to the FDA's website, this claim is absolutely false.

        I myself have thought that even with different manufactures with the generics...there was a difference...but again according to this information...there is not. I'm sure you will find someone that will argue this all day long.

     SE wink


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Post Edited (Screaming Eagle) : 8/11/2011 9:14:20 AM (GMT-6)


Snowbunny21
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Date Joined Jan 2010
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   Posted 8/11/2011 9:17 AM (GMT -6)   
SE...If I may add in a bit to your information above:)

Generics are considered (by the FDA) identical in dose, strength, route of administration, safety, efficacy, and intended use. They have to pass those type of quality tests before they can get FDA approved.

The average difference in absorption into the body between the generic and the brand name was 3.5 percent and is comparable to differences between two different batches of a brand drug.

Also...as the inactive ingredients (fillers) can be different...that is where some people can have a specific reaction or side effect that they didn't get when they took the brand name.

As well as everyone processes medication a bit differently based on their own health issues such as issues with their immune system, kindney function, liver function and metabolism.

And I say this gently...but the biggest issue is the pyschological effect when someone knows that they are going on a generic. The brain is extremely powerful in helping provide a positive outlook on a situation or a negative one depending on what people focused on.

New studies about placebos just came out where people were actually given a placebo pill but told by the Dr. that this particular one has worked very well to help with 'x' The patients knew they were getting a placebo and it was written on the bottle....The results were identical to the patients who took the actual medicine in helping them.

I'm not saying that people don't have reactions to medication or that some medicines work better than others for each person.

But that is where the internet, at times, can do harm in that those who are doing extremely well with their treatments that include medicine or surgeries...don't come online and talk about it. So people can get a skewed view of certain things in a negative slant. If someone reads that a certain surgery they are about to have hasn't worked for some people..they tend to worry that it won't work for them. Same with medicine.

That is why when I am taking a new medicine...I just talk to my Pharmacist about the life threatening side effects...and then go from there. I give it a good month to work out the nuisance side effects that may occur...but I want to give it an honest try to see if it works for me without any outside influence.

Because of not having health insurance...I am on all generics and they do a good job at helping me manage my pain. The key is that I don't rely just on the medication...I do many other modalities that help me each day as a medicine isn't meant to do it all.

It's a great topic to have on the boards though as I know there are many misconceptions out there. But it truly boils down to what works for you (collective you) and finding the best treatments that you and you Dr. decide upon.

Post Edited (Snowbunny21) : 8/11/2011 8:20:27 AM (GMT-6)


Jim1969
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Date Joined Jul 2009
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   Posted 8/11/2011 9:38 AM (GMT -6)   
The FDA only requires that the active ingredients be the same in the generic versions. Inactive ingredients (fillers) may be different so long as they are approved as safe by the FDA and that they are not shown to radically alter how the medication gets into the system which means that if it takes Topomax 20 mintues on average to enter the blood stream then its generic will have to enter the blood stream in approximately the same time frame.

Unless someone is highly sensitive to these fillers, by all rights they should never even be aware of going from a brand name to a generic or from one generic to another, but it would appear to be one of those "looks good on paper" things.

I suspect that the problem is in the "fillers". My theory is that while they may not effect how the active med enters the blood stream they may effect how the active ingredients actually work once there. Most likely this is only a problem for a small portion of the population.

On the flip side of the "generics don't work as well as name brand argument" I have talked to people who have had better results with a generic version than they did with the name brand.

As much as we do know about biological processes there is still much more that we don't know. In another 100 years the way we practice medicine may seem to our decendents as barbaric as blood letting and leaches seem to us today.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

Alcie
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Date Joined Oct 2009
Total Posts : 5028
   Posted 8/11/2011 10:12 AM (GMT -6)   
Moostly I agree with all the above. However, from experience, I have had different reactions with a few generics vs brand name, and also between different brands of generics. Generic metoprolol gave me nightmares, dizziness and a pounding headache, while Toprol XL gave only the usual fluid retention.

As far as Topamax, I haven't taken the brand name, but had problems with the generic. It worked for my pain but gave me side effects I couldn't tolerate. I am not willing to keep taking something that keeps me from sweating for an entire month in this heat. I had problems with confusion with it also. I may try it again when the weather cools, though, because my pain doc wants me off tramadol.

Fillers and "non-active" ingredients have been my biggest problems. I am searching for a place that still uses unflavored and artificially sweetened barium for my next swallow test. Even the nurses, technicians and doctors don't seem to understand that stuff is in the product they are using, or that it can give some people, like me, a reaction. There is an alternative, but it doesn't have the same thickness and won't give the same test results. There are many products that I can take in tablet form but cannot tolerate the additives in the liquids and injectibles. Mostly, it's because of the preservatives in the liquids.
Alcie
 
 

Snowbunny21
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Date Joined Jan 2010
Total Posts : 3557
   Posted 8/11/2011 10:40 AM (GMT -6)   
Alcie...In a case like yours...a lot of people choose to go to a Pharmacy that does compounding. This way...they can control the type of fillers that go into a medication.
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

CRPSpatient
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Date Joined Mar 2011
Total Posts : 1276
   Posted 8/11/2011 12:16 PM (GMT -6)   
I didn't expect such great responses so soon... Thanks guys!

SB... I don't know if the 'gentle comment' was aimed at me, or a general comment. I know exactly what you're saying, because it's the same with our TGA here. But I discovered the Topamax/topiramate problem in hospital without initially realising that I was on a generic med. Save the markings on the brand name Topamax pill, the two are almost identical and without glasses, to me they ARE identical. Nobody could figure out why my burning pain and hypersensitivity had returned so dramatically. about day four or a five day stay I finally realised that the pills DID look different and was told they were generics. After a week or so back at home on my 'real' topamax' and back to normal again.

Laura
CRPS since 1999, diagnosed in 2005 and since spread to full body, spasms, dystonia & contractures, gastroparesis, orthostatic hypotension,bradycardia/tachycardia, bone spurs, bursitis, carpal tunnel syndrome.

On Oxycontin/Endone, Topamax, Mobic, Magnesium, Florinef, Midodrine, Somac, Cipramil. Have a spinal cord stimulator, intrathecal pump with baclofen & bupivacaine and doing physio.

Snowbunny21
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Date Joined Jan 2010
Total Posts : 3557
   Posted 8/11/2011 12:26 PM (GMT -6)   
Oh..Laura..that was not meant towards you at all..Definitely a 'collective' you...thanks for asking as I wouldn't want it taken the wrong way.

I think all of us were just saying that the actual physical reactions that you or others have are absolutely real and it's due to the inactive ingredients (fillers) that are put in medicines...That could be either generic or brand that cause this is some people.

I'm glad that you figured out what was going on and back on the medicine that helps you as well as has less side effects for you:)
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

Alcie
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Date Joined Oct 2009
Total Posts : 5028
   Posted 8/11/2011 12:45 PM (GMT -6)   
SB - Good hint. Unfortunately the only compounding pharmacy is in another town 20 miles away. For something like the barium though, I might just call them and ask about getting my own to take with me.

My best solution is just to read what's in prescriptions before I fill them. I once made the mistake of taking Darvocet - N, now off the market, shortly after my fundoplication and it made me vomit blood. tearing some of the internal stitches. My stomach re-herniated partly back above my diaphragm where it now causes chest pain every time I eat or drink anything. I suspected it might cause a problem because the napsylate has a sulfite group attached, didn't take my own advice and refuse to take it.

My worst problem is being given meds I don't tolerate without my knowledge, even after I've refused them. All doctors assume they know more than I do because I have white hair - IV solutions with dextrose (OK less than 1 L), meds I've refused in writing, during surgery, which caused myalgia.
Alcie
 
 

NiNi53
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Date Joined Mar 2011
Total Posts : 816
   Posted 8/11/2011 2:49 PM (GMT -6)   
I have personally not had a bad reaction, nor noticed any difference between generic and brand, of course except the price.  Which begs the question Why?  If the fda in its infinite wisdom requires the same amounts of whatever, why the difference in the price.  How is it done, how are the manufacturers of generic meds able to keep costs down but not brand name?
 
I never have understood the entire process, but I have also not suffered due to generic meds.  My mom on the other hand would only get brand name medicines, she swore that she could tell the difference.  Just one more reason for my mom and I to disagree I think.  While she was alive, she could never be wrong.  So if I said, "generics are less expensive mom", she replied "thats because they dont work as well".  Of course if I said the sky was blue, she said green, thats just how she was.
 
Anyway, I really feel fortunate that the meds I have had to take, did not have an adverse affect on me because they are generic.  I think thats one of those things that is completely random in the effects of the meds.
 
Take care all, hope all are feeling well today.
 
Kathy
degenerative disc disease, fibromyalgia, osteoarthritis, neuropathy, lumbar laminectomy july 1998 no help, rechargeable neurostimulator unit low right back w/lead wires to left side and right leg unit not working just sitting there.i am 57 years young in may will turn 58. i have 2 grown daughters, 25 and 29. i have 2 grandchildren, 9 year old grandaughter and 5 yr. old grandson

Snowbunny21
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Date Joined Jan 2010
Total Posts : 3557
   Posted 8/11/2011 3:33 PM (GMT -6)   
Kathy...if you do a quick google search on FDA and generics vs. brands...You will find some more detailed information..

It's basicially about a labaratory that discovers and then produces a new medication. They own the patent on it. Then, once they decide to either sell part or all of the patent, or the patent time runs out...then other labaratories....are able to mass produce this medication for cheaper prices..

*Info about Oxycontin if curious to read....

Purdue was the first laboratory to come up with 'Contin' meds...(long acting)...both MSContin and Oxycontin...

It has given so many pain patients a better way to control their chronic pain.

They were touting that because of the LA method...these were less susceptible to addiction. So it also made lots of money on the brands of both medications being the first.

After some years...Purdue then sold part of it's patent to a few different laboratories to make/sell the generic.

Unfortunately...those that abuse medicine...found that by crushing this...it released the medication faster...this was causing overdoses and death both deliberate and accidental.

In the mid 2000's...Oxycontin soon became the number 1 abused drug and along with getting a lot of bad press...there were hundreds of wrongful death lawsuits piling up.

Because one of their main offices was in Connecticut..In 2001 Attorney General Richard Blumenthal urged Purdue to take steps to figure out a way for less abuse potential for this medicine.

So they started developing the new version of Oxycontin that would be useless if crushed. But Blumenthal was not letting up and publicly stated:

"Purdue Pharma has a moral, if not legal, obligation to take effective steps now that address addiction and abuse even as it works to reformulate the drug"...

So they put hundreds of millions of dollars to help the DEA and states develop a comprehensive program designed to assist in detecting the illegal trafficking and abuse of prescription drugs. As well as Purdue lost one of the larger lawsuits for 600 million dollars...and it's President, top lawyer, and chief medical officer plead guilty in 'misbranding' the medication.

So when Purdue finished developing and started making the new Oxycontin in 2007..they let the patent run out on the old version...so over the next year or two the leftover stock of the old Oxycontin was running out state by state until all gone..

Now that the new version is out there with a new patent...there won't be a generic for a few more years. There are many patients who don't get the same relief with this version as they did before as it does have some different active ingredients.

So...it was for the most part, the unfortunate nature of abuse that caused all of these issues with the change of Oxycontin and loss of generic.

NiNi53
Veteran Member


Date Joined Mar 2011
Total Posts : 816
   Posted 8/11/2011 5:58 PM (GMT -6)   
I dont google, I have you, you give me more information that first I can understand then all the technical words that would take a medical dictionary to understand lol.  I say laugh but I am very serious about the way you make it so it can be understood by a layperson.  I do think I will start googling more before I ask questions, but if I cant understand something, I dont want to search and search until I do.  I will lose track of what I wanted to ask in the first place.
 
I have alot of time on my, or I will once school starts and the grandchildren go back to school (Yeaaaaaaah) which in this area is Aug.22, cant get here soon enough.  So at that time I will have much time on my hands to research more.  I used to say I was going to the library, but since I am becoming more computer savvy, I will not need the library so much.  I actually  like the library, it is good to get out amoung people and not just a computer.  I need human contact.
 
Again, thank you and keep up the great work.
 
Take care and hope you are feeling well today.
degenerative disc disease, fibromyalgia, osteoarthritis, neuropathy, lumbar laminectomy july 1998 no help, rechargeable neurostimulator unit low right back w/lead wires to left side and right leg unit not working just sitting there.i am 57 years young in may will turn 58. i have 2 grown daughters, 25 and 29. i have 2 grandchildren, 9 year old grandaughter and 5 yr. old grandson

CRPSpatient
Veteran Member


Date Joined Mar 2011
Total Posts : 1276
   Posted 8/12/2011 2:07 AM (GMT -6)   
Cheers SB...and although I'm going OT, I have to ask - what sort of pup do you have? 'Cos I bet s/he couldn't out-snore my pair tongue smilewinkgrin
CRPS since 1999, diagnosed in 2005 and since spread to full body, spasms, dystonia & contractures, gastroparesis, orthostatic hypotension,bradycardia/tachycardia, bone spurs, bursitis, carpal tunnel syndrome.

On Oxycontin/Endone, Topamax, Mobic, Magnesium, Florinef, Midodrine, Somac, Cipramil. Have a spinal cord stimulator, intrathecal pump with baclofen & bupivacaine and doing physio.

rjbeck
Regular Member


Date Joined Feb 2008
Total Posts : 255
   Posted 8/12/2011 4:41 AM (GMT -6)   
I have found no difference in brand or generic medication that I take I was taking Brand Oxycontin 80mg ER and Generic Oxycodone 30IR and was fine even when Purdue changed the formula on the 80mg so the addicts could not crush the pill to snort. It became easier for me since my pharmacy had it in stock. But I did use brand oxycodone and generic with no difference. same with my pulmonary meds no difference for ME. But it's comical to see the drug addicts freaking out at the pharmacy because they didn't have a certian generic brand they wanted. You would think that they just lost a member of there family when the pharmacist comes to tell them we only have X brand and not Y brand for them.
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