Posted by laima on February 26, 2007, at 9:27:03
In reply to Re: Drug manufacturing and quality control, posted by Squiggles on February 26, 2007, at 6:15:04
Hi Squiggles,I think it varies med to med, and from manufacturer to manufacturer. What cost cutting measures are they employing, who are their suppliers, are they using different "inactive ingredients", are the "inactive ingredients" REALLY inactive, and do they affect absorption? Maybe even it matters how complicated or simple the medication is. I've been perfectly happy with every single generic I've ever had, with that glaring exception of Barr adderall. However, the original's a very designed drug- so maybe it gives more opportunities for something to go "off", if production ingredients and methods are not followed EXACTLY? (Just my theory.)
And truely- yes, my psychiatrist does consult with some drug trials for brand name drugs, but he regularly checks "may substitute" on scripts and has nothing at all against generics. Just acknowledges readily, when asked, that they CAN be different in some cases, for some patients. And can offer concrete reasons as to why they can be different, while also noting that while the differences may be a big deal to some, others can't detect. I think that's a pretty balanced and reasonable position.
I guess my pet peeve is pharmacists and insurance companies who insist that there are NO differences between brand and generics, EVER- when clearly that hasn't been my experience with this med. I appreciate getting this validation about experiencing a difference, and gaining some insight as to "why"-and it's not "all in my head". I'll be amazed and impressed if your friend's pharmacist acknowledges that the switch to generic could be a reason for your friend's worsened depression. Well, when I asked if generics and brand are pretty much the same, an assistant at my pharmacy rolled her eyes and sarcastically said, "Supposedly! Funny how so many patients want brand when it comes to adderall, and so we are always out." She was on her 10th call to other pharmacies in search of brand adderall-and then the pharmacist walked in, boomed, "THEY'RE EXACTLY THE SAME YOU WANT IT OR NOT?" I regretted giving in, and she got in trouble, I guess for not going along with the Walgreens company mantra.
Another idea for your friend- if her med is no longer available anywhere in the version she's done well on- and the generic she tried didn't work out- maybe it's still worth trying some different brands of generic? There could be a difference- certainly they are not all manufacturing in the same way. I saw an interesting chart on an ADD/ADHD site, where the posters voted for their favorite version of adderall IR. There was the Shire brand, and something like 8 generics, and there was a very wide difference of popularity between the various generics. (Shire got 26% of the vote, and the least popular generics looked to be Barr and Ranboxy. One of the generics listed was almost as popular as Shire. Gosh, hope I bookmarked that page...) Very interesting.
Good luck to you guys!
> Thank you laima and notfred. I am suggesting
> to my friend that she switch to Tofranol, and
> not the generics; the problem may be that it
> is not made *anymore*, and all that there is, is
> generics-- these old drugs like lithium and imipramine may also not get the white glove treatment. But, I think that given the switch to a generic at around the same time that depression arose and other unexplained symptoms, it's worth checking with the pharamacist.
>
> I don't mind generics in electronics and shoes (or knock-offs as they are called in the new market), but when it comes to health products, we are in trouble.
>
> Thanks again for your input.
>
> Squiggles
poster:laima
thread:735309
URL: http://www.dr-bob.org/babble/20070224/msgs/736388.html