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Prescriptions: Generic vs. Name

post #1 of 25
Thread Starter 
I've been having a heck of a time getting my colitis back into remission since January. I was taking Colazal but it's pretty expensive so the doctor had me try sulfasalazine but I had an allergic reaction it, so it was back to the Colazal. When I picked up my new prescription it was Balsalazide- the generic for Colazal and much cheaper. However, I just read on a discussion board for UC where the people who tried it said it wasn't anywhere near as effective as the actual Colazal.

Could this be true? Can some generics not be as effective?
post #2 of 25
To my knowledge a drug company holds a patent on the formula for a number of years. That means that no one but that drug company can produce that medication.

When the patent runs out, the competitors can then start producing the same medication, using the same formula as the original medication.

So "generic" is the same as the original, and the effect should be the same.
post #3 of 25
Thread Starter 
Quote:
Originally Posted by Natalie_ca
So "generic" is the same as the original, and the effect should be the same.
Thanks, Linda.

That's what I thought. I have been on the same medication for a couple of years. Could that be why it's not working as well for me as it did? Colazal is used for mild to moderate UC, could it be time to switch to something else?
post #4 of 25
That is absolutely true - some generics are not as effective. I use a steroid creme for hives I get as allergic reactions. The generic version did nothing, and I mean nothing. My pharmacy orders the brand for me.

Gary's been on pain killers. He got one batch that seemed like they weren't working. We asked the pharmacy to get a different generic - they weren't able to (have to get whatever central sends them), so we went to a different pharmacy. They gave us a different generic - it didn't work so well either! Gary began to think it was just his tolerence was going up. About a month later, it turned out there was a recall on almost ALL brands of generic in that drug - REALLY respectable pharmaceutical companies were selling generics that had never been approved by the FDA and were using improper manufacturing standards and there was a problem with "batch consistency." So we found a pharmacy that would order the brand.

Generics are theoretically chemically the same (though they may use different inactive ingredients) - and they supposedly deliver the same drug the same way.

Here's another example of what you're experiencing: http://articles.latimes.com/2007/dec/17/news/OE-WAX17

So as you already know, you're not alone if your brand was working and your generic isn't. Sadly, it's all too common - and often with approved generics.

Laurie
post #5 of 25
Generic drugs have to go through bioequivilancy trials to prove that the drugs is at the same level (within range of error) and is processed the same (however that particular drug is processed). However, far as I'm aware there's little to prove the efficacy is the same for treating whatever the drug treats, since that's often very subjective (less pain, more pain, etc.)
post #6 of 25
post #7 of 25
Quote:
Originally Posted by Natalie_ca View Post
So "generic" is the same as the original, and the effect should be the same.
It isn't the same, they are allowed to have up to a certain percentage of different ingredients.
that is why generics work for some, but not for others. Everyone is different and just a small change may not work for some, but might not be noticed for others.
post #8 of 25
Laurie was spot on. Some generics are just not as effective or may even have some inactive ingredients that bother some people.

A big example of one that can cause a lot of people problems is metoprolol, while toprol (the brand name one) causes less side effects for some. This can be very dangerous when someone is taking this drug to control arrhythmias and it makes them worse. Then there's the flip side to that and the people that do better on the generic because it's weaker...
If no one believes me on that, it should be very easy to find problems with metoprolol online. Though it seems to be a more recent problem (past year and a half or so) so something must have changed at some lab.

If you feel a medication is not working or is causing some reactions, you can ask your doctor to write out the prescription as needing the brand name for medical reasons.


O/T What type of UC do you have?
I'm currently a bit paranoid that I might have something going on - either inflammatory or the C.diff has overgrown again and is causing a type of colitis.
post #9 of 25
Sorry to hear you have bouts of UC also. I'm on and off sulfasalazine and thrilled I don't battle with any allergic reactions.

for your UC to go back into remission.
post #10 of 25
Quote:
Originally Posted by strange_wings View Post
O/T What type of UC do you have?
I'm currently a bit paranoid that I might have something going on - either inflammatory or the C.diff has overgrown again and is causing a type of colitis.
I'm thinking Essayons has the same type I do which is Pancolitis (the entire colon) since this is one of the types of colitis that is treated with oral meds. The other types can be treated with local stuff through the back end with enemas and foams. Pancolitis must be treated with oral meds so that active ingredients can reach all of the affected parts of the colon.

I'd definitely talk to your doc.
post #11 of 25
Thread Starter 
I didn't have any prior knowledge that I was allergic to sulfa based medications until I tried the sulfasalazine.

My doctor has been calling it "unspecified" ulcerative colitis because he hasn't nailed down exactly which type I have but I'm guessing it's Pancolitis like lil maggie said. I'm probably due for another colonoscopy soon. When I have abdominal soreness it's pretty much across my entire abdomen. I have an appointment in a couple of the weeks. I'm going to talk to him about different medications including not using the generic for Colazal.

I'm still trying to get over my flare up that started the Sunday before last. I went through 28 rolls of tp in a week. Other than feeling like I live in the bathroom, it's the constant fatigue that drives me nuts.
post #12 of 25
Does this mean you're posting here on your laptop in the bathroom? J/K of course. I hate UC flair ups, along with abdominal cramps and spending tons of time in the potty room, I also get nauseous and sometimes give back whatever I just ate. Sometimes I don't know whether to sit or stand Well, THAT was embarrassing! lol

Edited to add: How do you tell if the fatigue is a side effect? I get fatigued also and wondering if it's colitis or the medication.
post #13 of 25
Thread Starter 
I think the fatigue is a side effect of the colitis. I feel more fatigued if I miss/forget to take my medication.
post #14 of 25
Fatigue is a common side effect of so many diseases.

Back in August, before my C. diff infection was diagnosed, due to symptoms my GI doc was all geared up to do a colonoscopy on me. They figured it out before that was done and I had hoped I'd dodged having to go though that...

Is a colonoscopy that bad? I know if I call the doctor and mention blood he'll want to do one.
post #15 of 25
Thread Starter 
A colonoscopy is an easy procedure, I've had two of them, they aren't bad at all. The worst part is the prep the night before. You have to drink something that will clean out your bowels, you pretty much live on the toilet for a while that night. For the procedure you're put under. I faded in and out of consciousness during both of mine, and even watched them remove a polyp. If you do you will feel a bit uncomfortable. I remember saying that I needed to go to the bathroom. I didn't have to, it was the air they fill you with during the procedure that gave me the feeling of need to go the bathroom. I feel back asleep after that and didn't wake up again until I was in recovery.
post #16 of 25
Newer colonoscopys I hear are easy , Mom had them every few yrs and said it was easier than when I had mine done... I had a couple as a child and well I wont have another ....

Diet made the difference for me and no it was not the high insoluble fiber one the dr kept pushing


http://www.stronghealth.com/services...ycare/domd.cfm for those wondering about the difference
post #17 of 25
I take generics for everything except my ashtma inhaler and my GERD medicine because there aren't any available for those two. For the rest though I take generics and have never had a problem, only a little saved $
post #18 of 25
I take a generic (but its always been the generic) and a name brand for my migraines--topamax has no generic--and its expensive (especially without insurance)

Leslie
post #19 of 25
Quote:
Originally Posted by Jack31 View Post
I take a generic (but its always been the generic) and a name brand for my migraines--topamax has no generic--and its expensive (especially without insurance)

Leslie
I don't know why Mylan's not on the market with it yet, but Mylan received FDA approval for their generic topiramate (which is what Topomax is) in 2006. I think the last patent (to Johnson & Johnson with the brand) expired in Feb 2009. So I'd expect there'll be a generic available soon. (I hope).

Laurie
post #20 of 25
Quote:
Originally Posted by strange_wings View Post
Is a colonoscopy that bad? I know if I call the doctor and mention blood he'll want to do one.

As with any procedure, there will be some that have had a bad experience. No, normally there's nothing to it. Like Bryan said, the only bad part is the night before. It's a lot of Miralax and Gatorade and spending the entire night in the bathroom. Make sure you have plenty of reading material and toilet paper
I was put under for my colonoscopy and woke up in the recovery room. I never felt a thing during or after and I could swear that they hadn't even started the procedure.
So if your doc suggests you get one, please have it done.

Sorry, a little off topic
post #21 of 25
Thread Starter 
I have a list I'm putting together of things to ask the doctor. I also think a second, and perhaps, a third opinion is in order.

I'm going to plan on getting another colonoscopy this summer but the first thing I need to do is straighten out my meds. I believe it's time to go on something stronger. I'm going to call my pharmacy get prices for the medications (with my insurance) so I know how much I'll need to set aside every month or two.

Miralax...gotta love it!
post #22 of 25
I know that generics are supposed to be the exact same formula, but I've had some bad experiences with generics. I prefer generics simply because of the price, but I take it on a medication by medication basis. I had some really bad emotional side effects to a generic once, which I didn't have on the "real" thing.
post #23 of 25
It seems the debate is still out on whether or not generic drugs are actually less effective than name brands. I'd say for most people and most drugs, the effects are the same regardless of name brand or generic; however, I know from personal experience that my endocrinologist marks "brand name medically necessary" on my Rx for Synthroid. Not sure if that's because the generic isn't as good, or if it's because she gets a kickback for prescribing the name brand. Either way, it works and my insurance covers most of it, so I am lucky in that regard.
post #24 of 25
Quote:
Originally Posted by firedancer722 View Post
I know from personal experience that my endocrinologist marks "brand name medically necessary" on my Rx for Synthroid. Not sure if that's because the generic isn't as good, or if it's because she gets a kickback for prescribing the name brand.
That's because if the pharmacy messed up and gave you generic, now, it could make you sick. Once you go on a particular thyroid med it's not recommended that you switch around.
I don't know about other peoples pharmacies, but all the ones I've use occasionally get the same generics but from different labs. Even that little of a switch could be a problem for someone with thyroid problems.
post #25 of 25
Quote:
Originally Posted by firedancer722 View Post
It seems the debate is still out on whether or not generic drugs are actually less effective than name brands. I'd say for most people and most drugs, the effects are the same regardless of name brand or generic; however, I know from personal experience that my endocrinologist marks "brand name medically necessary" on my Rx for Synthroid. Not sure if that's because the generic isn't as good, or if it's because she gets a kickback for prescribing the name brand. Either way, it works and my insurance covers most of it, so I am lucky in that regard.
Some of the generics for synthroid have different dosing schemes, changes can be difficult and possibly have bad effects...
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