Eli5: what is the difference between a generic drug to the original drug, and why do some doctors will swear by the original drug?
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commissions 😁 doctors promote whatever “Big Pharma” tell them to, hence the huge opioid epidemic in the US right now, they were told to promote tramadol and coedine for everything they could and props to them cos they did and now the US is suffering haha, great for non legal drug dealers tho cos i bet they’re raking it in in places like Philli and LA now 🙃
I’ve always been happy to use generic versions of medications. But a few years ago, when I was taking Sertraline, I had been using generics, but one time had to get brand name (Zoloft), as there was a shortage of generics. I found it instantly made me feel queasy, wasn’t good on my stomach at all. So I went back to generic when I could, and the issue went away.
I had the generic form of low estrogen birth control and it killed my sex drive and left me…um….drier. Also had another side effect I don’t remember (something minor like a headache or more cramps). Called my OBGYN after a few months and he write me an RX for only the brand name. Worked perfectly for years.
Many times Doctors don’t care about the difference. The issue is more that the name brand is what’s at the top of their mind and that’s what they write on the prescription pad.
If the pad says “Tylenol” Pharmacists are required to dispense “Tylenol” not “Acetometophan”.
Where I live (Nova Scotia Canada), there is a rule that unless the prescriber says that the name brand is absolutely required, than they can dispense any generic. That is “Bio equivalent”
There has been a massive scandal here in NZ because of a change to generic anti-epilepsy medication.
My wife is epileptic and on lamotrigine, she used to take Lamictal, but there was a national change to only fund the generic Logem. Since then, numerous people who had controlled their seizure activity had breakthrough seizures. My wife has been lucky in that she has only had aura activity, not full seizures, but she hadn’t had any for years prior to the change.
There have been six deaths from seizures of people who were forced to change medications. The chief coroner found that it couldn’t be proven that the change was the cause but there is strong circumstantial evidence. Groups like Epilepsy NZ and Medsafe have been strongly opposed to the change because of the evidence that even a slight change in dose or absorption rate can cause sudden death in people with epilepsy.
A major missing point in the discussion is something called crystal polytypes. When making a solid, the drug molecules can sometimes pack together in different patterns. These differing stacking patterns may dissolve slower or faster in the body changing how you body absorbs the drug molecule. So not only does the molecule have to be identical (that is fda regulated) but the crystal structure and crystal size should be the same which can be very difficult to control and replicate by generics in some cases.
My wife takes a medicine that she can’t take the generic. I accidentally got the generic once and it looked just like her regular pill. I put the medicines in the pill caddy every week so she had no idea. It didn’t work. Generic is $4, name brand is almost $1000 for three months.
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