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Generic Versus Brand-Name Drugs: Are You Taking the Right Meds?

Generic Versus Brand-Name Drugs: Are You Taking the Right Meds?

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By    |   Friday, 03 March 2017 11:20 AM

When Jennifer Watson switched to the generic version of a brand-name painkiller she had been taking — an opioid prescribed for chronic pain caused by an auto accident — the results were disastrous.

“I was like a zombie,” said Watson (not her real name). “I could barely move from my bed. The drug I’d been using for 20 years successfully had been changed to a generic form and my doctor insisted that it had the same ingredients and would not switch me back. I was devastated and in pain once again with no recourse.”

Her story is one echoed across the country as Big Pharma and insurance companies try to cut costs by switching to cheaper medications.

“There are biological differences between name brands and generic brands,” North Carolina-based cardiologist Dr. Kevin Campbell tells Newsmax Health. “In many cases one doesn’t have an advantage over the other but switching between these different preparations can have adverse health effects.”

Campbell says that in an effort to cut costs insurers often force patients to switch back and forth between different preparations and this can cause significant health risks.

“Many medications have specific effects and oftentimes generic formulations do not work exactly the same way,” he says.

Here are some examples of eight types of medications you need to talk to your doctor about before switching.

1. Medications for underactive thyroid. The thyroid is such a sensitive gland that even a small change in the dose of your thyroid medication can have a major effect on the amount of thyroid hormone in your blood. Switching between brand name and generic drugs can cause an imbalance because the delivery system may differ.

2. Asthma inhalers. In the case of asthma inhalers, those cannot be legally changed at the pharmacy level without the physician’s approval, Dr. Andy Nish, of NGPG Allergy and Asthma in Gainesville, Georgia tells Newsmax Health. “Although the exact same medicine such as albuterol is being administered, there may be changes in the delivery system or force of puff,” he says. “With any change the physician or pharmacist should make sure the patient and family are taught correct use.”

3. Digoxin for heart failure. Experts say that the differences between brand name Lanoxin and the generic version of digoxin have not been well studied so it’s best not to switch.

4. Theophylline for asthma and COPD. The inactive ingredients for this drug vary per manufacturer and this affects how quickly the medication is absorbed in your body. Also theophylline products come in controlled release or extended release forms which release the active ingredient at different rates than the brand name versions.

“Changes should be made very carefully,” notes Nish. “Serum levels of theophylline should be checked soon after any changes. Too high levels of theophylline can cause significant medical problems.”

5. Certain diabetes medications. For many years insulin was the only type of diabetes medication that came as an injection, but that is no longer the case. We now have liraglutide (Saxenda or Victoza), dulaglutide (Trulicity), albiglutide (Tanzeum) and pramlinitide (Symlin)—all injectable diabetes medications that are not insulin. People may confuse these drugs with insulin and should understand that they work differently. They also may have different side effects so you need to discuss any medication changes with your doctor.

6. Anticoagulant warfarin. Generic medications often do not work the same way as brand name drugs, says Campbell. “A prime example is the brand name Coumadin versus generic blood thinners,” he says. “They have a very narrow therapeutic window and once the patient is stable on one type the dosing may not translate exactly one to one with a brand name and a generic.”

7. Eye drops for glaucoma. Generic eye drops were approved in 1962 and generally have the same active ingredients found in brand names. However since the inactive ingredients may differ, the generic drops may be especially vulnerable to shelf life and temperature changes that can hinder their effectiveness. Ask your doctor what to expect before swapping.

8. Seizure medications. Both extended relate and controlled release versions of seizure medication are designed to keep drug levels stable in the blood over a period of time to reduce the risk of seizure. However, once again the inactive ingredients in generic forms of these lifesaving medications may alter those drug levels in your body which could make you more prone to seizures.

Tests by ConsumerLab.com showed that generic versions of extended release drugs have to use a different technology than the brand name since that formulation is often under patent so they need to develop different pathways of delivery which are not equivalent to the brand name drug.

“It is crucial that patients understand their medications, why they are taking them and what possible side effects could occur so they must talk to their doctors if the pharmacy or insurance company forces them to switch,” says Campbell.


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Generic drugs are often pushed over brand-name meds because of the monetary savings, as doctors and insurers aim to hold down health care costs. But sometimes that's not a good idea because some generics don't work as well or carry other downsides.
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Friday, 03 March 2017 11:20 AM
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