5 ms·

Welcome to medicine. I grew up the child of a doctor, and she always, ALWAYS, bought the generic. They're required BY LAW to have the same "active" ingredients;

by oddevan 10y ago

Welcome to medicine. I grew up the child of a doctor, and she always, ALWAYS, bought the generic. They're required BY LAW to have the same "active" ingredients; you just might be paying for a slightly different pill shape, packaging, or taste.

dtnewman 10y ago
As the second link I've referenced above points out, there's a possibility that two drugs have the same active ingredients but but they absorb differently. Or one company can have a pill and the other a tablet that dissolves in your mouth. But I imagine that the clinical difference is negligible or nonexistent in most cases. I almost always get generic when possible. But actually, one advantage of brand name drugs is that it could be easier to remember what they do. For example, sometimes I find old prescriptions in my medicine box (yeah, I don't have a good cabinet) and I don't remember what they are for. For example, I might see Zolpidem and and forget what is, but I'd be less likely to forget what Ambien is. But in general, this difference is worth very little to me and I usually get generics on principle.
- mikeash 10y ago
  Another potential difference is that the inactive ingredients can be different. Normally this doesn't matter, but there are rare occasions where people might have an allergy or other bad reaction to those. Of course, it's about as likely for the generic to be the better choice, so that's no reason to prefer the name brands, just a reason someone might want to switch.
- dvdhnt 10y ago
  This is something I've experienced often, not recognizing a generic drug replacement. My doctor, or at least the pharmacy I use currently, hast started putting the brand name my generic is replacing directly on the label. I've found it to be immensely helpful, especially, in cases where I've been working with my doctor to find the appropriate medication/combination.
  - alex_hitchins 10y ago
    I too have noticed this effect with one medicine in particular. I've had several different generics/brands and all worked fine, except this one make. I don't know what it was, but it just didn't work. Quite a strange experience.
- srtjstjsj 10y ago
  This is true, BUT there's no reason to assume that the brand name absorbs better than the generic -- it's specifically NOT been tested.
chimeracoder 10y ago
> hey're required BY LAW to have the same "active" ingredients; you just might be paying for a slightly different pill shape, packaging, or taste. Yes, but the margin of error of the amount of the active ingredient can be significant (up to 20% in either direction!). The inactive ingredients can be relevant. Some people have allergies[0], and sometimes the inactive compound can affect the absorption of the drug (which can vary from person to person). Generics are fine, but it's important to remember that they're not exactly the same as the brand-name drugs, and that can matter. [0] For example, a lot of drugs contain lactose-based compounds as inactive ingredients, which is one of the reasons that a lot of drugs can cause diarrhea as a side-effect.
- mrob 10y ago
  What's the mechanism of action for lactose causing stomach irritation? Lactase isn't found in the stomach so it can't be lactose intolerance (as in the common meaning of the phrase, ie. lactase non-persistence).
  - wahern 10y ago
    Microflora in your gut. That's what lactose intolerance basically means--it doesn't directly harm you, but when it's not taken up by the intestines because you lack the lactase enzyme it's consumed by microflora, which create gas and other issues. Kinda like beans which haven't been properly prepared and contain too much non-digestible starch. It's also why some people who are genetically completely lactose intolerant can actually consume quite alot of lactose, and conversely why people who are genetically lactose tolerant can suffer from gastrointestinal issues pretty easily from dairy products, especially if they haven't consumed them in awhile. The tolerance or intolerance boils down to how the microflora react, not specifically to whether the person produces lactase.
    - mrob 10y ago
      That happens after the stomach.
refurb 10y ago
There are examples of generics that were different than the branded versions. Wellbutrin is a great example. A few generic versions were pulled since they dissolved at a different rate and delivered much higher doses of drug and causes side effects. Same thing with a few version of valprolic acid for epilepsy. The law states the generic should be within 80% to 125% bio-equivalent of the branded version. Normally that's good enough, but for some drugs it causes problems.

by oddevan 10y ago

dtnewman 10y ago

As the second link I've referenced above points out, there's a possibility that two drugs have the same active ingredients but but they absorb differently. Or one company can have a pill and the other a tablet that dissolves in your mouth. But I imagine that the clinical difference is negligible or nonexistent in most cases. I almost always get generic when possible. But actually, one advantage of brand name drugs is that it could be easier to remember what they do. For example, sometimes I find old prescriptions in my medicine box (yeah, I don't have a good cabinet) and I don't remember what they are for. For example, I might see Zolpidem and and forget what is, but I'd be less likely to forget what Ambien is. But in general, this difference is worth very little to me and I usually get generics on principle.

mikeash 10y ago
Another potential difference is that the inactive ingredients can be different. Normally this doesn't matter, but there are rare occasions where people might have an allergy or other bad reaction to those. Of course, it's about as likely for the generic to be the better choice, so that's no reason to prefer the name brands, just a reason someone might want to switch.
dvdhnt 10y ago
This is something I've experienced often, not recognizing a generic drug replacement. My doctor, or at least the pharmacy I use currently, hast started putting the brand name my generic is replacing directly on the label. I've found it to be immensely helpful, especially, in cases where I've been working with my doctor to find the appropriate medication/combination.
- alex_hitchins 10y ago
  I too have noticed this effect with one medicine in particular. I've had several different generics/brands and all worked fine, except this one make. I don't know what it was, but it just didn't work. Quite a strange experience.
srtjstjsj 10y ago
This is true, BUT there's no reason to assume that the brand name absorbs better than the generic -- it's specifically NOT been tested.

chimeracoder 10y ago

> hey're required BY LAW to have the same "active" ingredients; you just might be paying for a slightly different pill shape, packaging, or taste. Yes, but the margin of error of the amount of the active ingredient can be significant (up to 20% in either direction!). The inactive ingredients can be relevant. Some people have allergies[0], and sometimes the inactive compound can affect the absorption of the drug (which can vary from person to person). Generics are fine, but it's important to remember that they're not exactly the same as the brand-name drugs, and that can matter. [0] For example, a lot of drugs contain lactose-based compounds as inactive ingredients, which is one of the reasons that a lot of drugs can cause diarrhea as a side-effect.

mrob 10y ago
What's the mechanism of action for lactose causing stomach irritation? Lactase isn't found in the stomach so it can't be lactose intolerance (as in the common meaning of the phrase, ie. lactase non-persistence).
- wahern 10y ago
  Microflora in your gut. That's what lactose intolerance basically means--it doesn't directly harm you, but when it's not taken up by the intestines because you lack the lactase enzyme it's consumed by microflora, which create gas and other issues. Kinda like beans which haven't been properly prepared and contain too much non-digestible starch. It's also why some people who are genetically completely lactose intolerant can actually consume quite alot of lactose, and conversely why people who are genetically lactose tolerant can suffer from gastrointestinal issues pretty easily from dairy products, especially if they haven't consumed them in awhile. The tolerance or intolerance boils down to how the microflora react, not specifically to whether the person produces lactase.
  - mrob 10y ago
    That happens after the stomach.

refurb 10y ago

There are examples of generics that were different than the branded versions. Wellbutrin is a great example. A few generic versions were pulled since they dissolved at a different rate and delivered much higher doses of drug and causes side effects. Same thing with a few version of valprolic acid for epilepsy. The law states the generic should be within 80% to 125% bio-equivalent of the branded version. Normally that's good enough, but for some drugs it causes problems.