Posted by Michael Barber, August 23, 2013 (last updated on November 28, 2018)
About 80 percent of the prescription drugs Americans take year are generic versions, yet consumers know very little about what makes generic drugs different from their name brand counterparts. According to the FDA, generic drugs are essentially the same thing as their name brand versions, but this isn't actually true. There are some striking differences between generics and name brand prescription drugs, and you need to know these differences before considering generic alternatives for you and your family.
There Can Be Drastic Differences in Dosages
The FDA only requires that generic drugs contain 80 percent to 125 percent of the active ingredients of the name brand version. But this doesn't mean that all the generic versions of a particular drug contain equally low or high amounts. It means that you might get a generic alternative for your medication this week that's only 80 percent strength, and your refill next week contains 125 percent, meaning you unknowingly went up on your dose by 45 percent in a single week. Or, you could refill your prescription next month and suddenly be taking 45 percent less of the drug than your body is used to. This is particularly dangerous for certain drugs in which dosages are so critical, including:
- Thyroid medications
- Anti-seizure medications
- Blood thinners
- Asthma medications
- Immune suppressants
Inactive Ingredients Can Vary Tremendously
Most of the pills and capsules we take have a small amount of active ingredient and the rest is filler or binder. These can be quite different from the fillers and binders used by name brand drug manufacturers. Some patients who have no sensitivity or allergy to the ingredients in the name brand do have such reactions when taking the generic versions. This is particularly important when taking extended release capsules because the generic may break down much faster than the name brand, meaning your system is flooded with large doses of the drug quickly, instead of absorbing it slowly over time. Ask your quick care physician if he is prescribing an extended release capsule.
Generic Drugs Don't Undergo the Same Testing
Testing of brand name drugs is intensive, and lasts for years. The generic, however, only undergoes a "bioequivilence" test, which checks to see if the generic contains the same active ingredients in roughly the same amount. This test doesn't always uncover serious problems. A recent lawsuit involving Andrew Richards and other plaintiffs highlighted the serious flaws in these bioequivilence tests. Richards suffered seizures after taking the generic version of his antidepressant Wellbutrin XL.
Labels in Generic Packaging are Incorrect
The labels on generic medications contain the same data as the pharmacokinetics sheets included with the name brand drug, even though the dosages and filler content are entirely different. This often leads to patients misunderstanding exactly what they're taking or what side effects to expect. Some patients claim their side effects are markedly more severe on the generic alternatives. When visiting urgent care centers, patients should ask the doctor whether the generic alternative is suitable.
Generics Are Considerably Cheaper
Generic drugs are often many times cheaper than name brands. With 50 million Americans paying for doctor's care and medications without the benefit of health insurance, generics are an attractive alternative to costlier name brands. In the majority of cases, patients are just as happy with generics and claim to have no more or worse side effects. However, if you're taking one of the medications on the list above, you might want to do additional research before considering the switch to generic.
Ask your doctor or pharmacist if you're in doubt about generic versions of your medications.