Most generic drugs absolutely do work just like the branded product, no worries. HOWEVER, in order for a generic product to meet FDA standards, they must conduct studies to show they are bioequivalent.
Bioequivalent does not mean they are just as effective and are just as safe as the branded product and meet the exact same standards as the branded product. It means the generic version releases its active drug into the bloodstream at the same speed and in the same amounts as the branded drug.
That is all they need to study to meet FDA requirements. The joke in industry is that R&D companies for generic companies is really lawyers and my ex-husband is the one who told me that joke, while he was working at a generic company.
So why is this important? Most of the time, it is completely safe and works. I work on branded products. I’ve also launched biosimilars - which are the biologic theory of generic products. Most of my medications that I take are now generic. I tell you this because I have no issue taking generics and I believe in them because people need money saving options and they should take their healthcare into their own hands.
But this is the important part - sometimes the generics do not perform as intended. Due to the fact that they only release the drug at the same speed and amount, they have no idea about anything else that happened. Sometimes that is an issue. And in some issues, that are documented, it’s critical.
Warfarin generics: You can take the generic of Coumadin, the anti-coagulant. This drug is notoriously hard to manage already. You have to have it monitored, eating spinach can throw you off, etc. However, something as simple as getting generic manufacturer X’s warfarin one month, and then getting generic manufacturer Y’s the next can cause you to bleed or clot.
So you have to pay attention and if you notice that the pills look different, flag it to your pharmacist immediately, or your doctor. My pharmacist actually tells me when I have a different manufacturer’s pills for less consequential meds. With Pradaxa and Eliquis out there, I don’t know if a lot of people still take warfarin, but they’re expensive and warfarin is cheaper (hell, it’s rat poison).
Generics for patients with disorders related to the central nervous system, eg, ADHD, serious mental illnesses, etc.: Some researcher got together to look into whether there were any issues with all of the generic medications being used. They acknowledged that there were cost savings. But there were also patient concerns as well - it’s not always all about being less expensive. So they did an analysis.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5417581/
What is a bit alarming, once you get through attitudes and acceptance in the results section, is that there are some increases of reported side effects by patients with schizophrenia. They would only take generics if their doctor prescribed it (on brand, and I would be suspicious otherwise!).
Then, people with epilepsy had a significant increase of breakthrough seizures taking antiepileptic medications, as well as other symptoms such as headaches, blurred vision, depression, mood swings, aggression, and memory loss after switching. This was pretty horrible and shocking.
Another call out was citalopram (Celexa) a popular SSRI, was associated with significant breakthrough adverse events. These were suicidal ideation, anxiety, intrusive thoughts, impulsivity, obsessive thoughts, and depressive thoughts. It took longer to get those symptoms under control going back to the branded version than they did to emerge using the generic.
So this isn’t me bashing generics as a Marketing Director at a biotech. This is me giving some watch outs. It’s only a few in the wide, wide world of branded drugs, so that’s pretty good.
Some money saving tips as well:
-If you want to take a few vitamins, get your doctor ti write a prescription if you don’t have a high deductible plan. You’ll pay the generic drug copay or less!
-Samesies with things like a PPI (omeprazole, Omeprazole, NSAIDs
-If you’re taking a PPI - Nexium works way faster than Prilosec. Nexium did their studies against Prilosec. It was a cannibalization strategy by AstraZeneca. Nexium is the s-isomer of Prilosec. It’s onset is really fast, within one hour. Prilosec (omeprazole) is 24 hours. Aciphex is actually the fastest, but don’t tell anyone I actually said that 😉
Username: brownlab319