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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by AMD on January 17, 2005, at 13:54:08
Folks,
I went into the pharmacy yesterday to pick up a refill of Celexa only to find out that Blue Cross has removed it from its formulary now that a generic version is available. The brand version is $180 per refill.
I've heard anecdotal reports that generic versions can be less potent than their brand-name equivalents. Thus I'm a little worried about making the switch. Is this simply another myth, or perhaps some fear-mongering by the pharmaceutical companies? Or are there are the valid studies confirming this? Do I really have any risk of inadvertently lowering my dosage by switching to the generic version?
Thanks,
amd
Posted by SLS on January 17, 2005, at 14:35:08
In reply to Generic citalopram: yes or no?, posted by AMD on January 17, 2005, at 13:54:08
> Folks,
>
> I went into the pharmacy yesterday to pick up a refill of Celexa only to find out that Blue Cross has removed it from its formulary now that a generic version is available. The brand version is $180 per refill.
>
> I've heard anecdotal reports that generic versions can be less potent than their brand-name equivalents. Thus I'm a little worried about making the switch. Is this simply another myth, or perhaps some fear-mongering by the pharmaceutical companies? Or are there are the valid studies confirming this? Do I really have any risk of inadvertently lowering my dosage by switching to the generic version?
I'm sure you will see this question debated over and over. At best, the generic drug contains exactly the same active ingredients at exactly the same amounts. However, there are other things that go into making a drug preparation - excipients. These often vary between different manufacturers. They can become critical when it comes to being a vehicle for delivery of the active ingredients into the system. Thus, the bioavailability of the drug might be different among these preparations. They are not necessarily bioequivalent.I have heard stories told by clinicians describing situations where generics were not as efficacious as the original name brand. My doctor has very recently seen this with paroxetine.
Perhaps all that needs to be done is to adjust the dosage when a relapse occurs subsequent to a change in drug preparations. I don't know. I doubt anyone could give you a guarantee, so I would go ahead and continue with the generic as if nothing untoward were to happen.
- Scott
Posted by zmg on January 17, 2005, at 21:14:38
In reply to Generic citalopram: yes or no?, posted by AMD on January 17, 2005, at 13:54:08
Crazymeds (http://www.crazymeds.org/) has a page (or..rant) about exactly that.
The short version is: "...there can be a plus or minus of 20% of bioavailability of the active ingredient!"
His site pretty colorful. I don't know how accurate or inaccurate his information is, but he makes a good argument:
Posted by Tabitha on January 18, 2005, at 0:15:10
In reply to Generic citalopram: yes or no?, posted by AMD on January 17, 2005, at 13:54:08
Same thing happened to me last month. I think it's less potent. Felt like a bit more than 1/2 a dose to me.
Posted by Sebastian on January 20, 2005, at 18:45:36
In reply to Re: Generic citalopram: yes or no? » AMD, posted by SLS on January 17, 2005, at 14:35:08
I liked that deffinition of a generic. Didn't realize that the fillers did any effect. Had a verbal fight with the pharmacist when she tryed to tell me that there is no difference, at all. I knew from experience that generics sometimes don't work.
This is the end of the thread.
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