With Big Pharma hiking the prices of over 200 U.S. drugs this week, many folks are wondering whether they should switch to generic drugs over brand names. In some cases, it's not a wise move.
"There are biological differences between name brands and generic brands," North Carolina-based cardiologist Dr. Kevin Campbell tells Newsmax. "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 often times generic formulations do not work exactly the same way," he says.
Here are some examples of medications you need to talk to your doctor about before switching:
- 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 systems may differ.
- 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. "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."
- 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.
- 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."
- 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 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, says Dr. Daniel Lorber, a noted endocrinologist.
- 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."
- Eye drops for glaucoma. Generic eye drops were approved in 1962 and generally have the same active ingredients found in brand names. However, because 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.
- Seizure medications. Both extended release 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 that 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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