6 ms·

Kind of bizarre that the author won’t entertain the most obvious explanation given the documented problems with many generic drugs [1]. I guess the difference i

Kind of bizarre that the author won’t entertain the most obvious explanation given the documented problems with many generic drugs [1]. I guess the difference in this case is that the patients can tell right away. [1] https://www.npr.org/sections/health-shots/2019/05/12/722216512/bottle-of-lies-exposes-the-dark-side-of-the-generic-drug-boom https://www.npr.org/sections/health-shots/2019/05/12/7222165...

Waterluvian 4y ago
The difference in Concerta and its generic is chocolate and vanilla to me. The brand one slow releases very evenly while the generic just slams me with the calm, focused joy followed by a significant emotional low for hours. Completely unsurprised if an Adderall generic had just as significant impacts.
- luckydata 4y ago
  the generic concerta all have a KNOWN issue with manufacturing. The slow release mechanism is mechanic, not chemical, and only ONE generic is manufactured the right way. https://www.goodrx.com/concerta/certain-generics-are-no-longer-equivalent-to-brand-name-concerta https://www.goodrx.com/concerta/certain-generics-are-no-long...
  - joezydeco 4y ago
    It's literally a plastic capsule with microscopic holes drilled in it. A sponge on one end absorbs moisture and swells at a fixed rate, slowly pushing the methylphenidate out the other side.
- deleted 4y ago
  [deleted]
- RyJones 4y ago
  That is exactly my experience. The brand-name Concerta is a smooth push all day, the generic is terrible.
- guluarte 4y ago
  same, generic vs concerta fells very different, the generic fills like a bomb while concerta it's slow and steady.
- freeflight 4y ago
  > The brand one slow releases very evenly while the generic just slams me with the calm, focused joy followed by a significant emotional low for hours. Prolonged-release of an orally drug taken in pill form is a "special feature", it's the difference between regular Adderall and Adderall XR. There are patented techniques involved to make it work like that, generica manufacturers probably don't have access to those/leave it out to save manufacturing costs. You can try taking the generica in smaller dosages, to compensate for their lack of prolonged-release, as the symptoms you describe sound like you are overdosing by taking too much in too short of a time. Concerta doesn't need such manual dosage management, as it also has prolonged-release just like Adderall XR.
  - metadat 4y ago
    How often do you casually dispense medical advice to strangers? Especially without qualifying yourself as a SME expert (or non-expert), or at the very least providing reference sources or other supporting documentation? Edit: @djmips: Are you familiar with the differences between medical and non-medical advice? The potential repercussions of you following my potentially bad advice on programming are vastly different from the possible fallout from encouraging someone to mess with their medication dosing. The responsible thing to do is refrain, because some people are on a very specific regimen for good reasons. In a medical context, sharing one's own experience (and qualifying it as such) is often appreciated, however this is not how I would characterize the structure of the parent comment. I hope this helps, I only wish the best for you and others. Edit 2: @freeflight: Thanks for following up.
    - djmips 4y ago
      I see you are dispensing advice. I'd like to see your advice dispensing certification please.
    - freeflight 4y ago
      > How often do you casually dispense medical advice to strangers? Semi-regularly, as I work in palliative healthcare. I'm just not sure why that would be relevant to "medical advice" like "If you experience too intense sympthoms, try lowering the dose" and explaining the differences between instant and prolonged-release drugs? Some might consider that common sense, which shouldn't need to be pointed out. But life is hectic and complicated, leading to a lot of overthinking, sometimes we just need a reminder of the simpler and straight forward solutions.
- yamtaddle 4y ago
  Two of our kids are on Concerta and can confirm that the first time we got generics it was very fucking obviously working quite differently (in our case, it manifested like them barely working at all). Took us a little bit to put two and two together, but sure enough, the change was just as we switched (well, got switched) to generics. Be great if the FDA would ensure that a generic is actually the same damn thing.
  - kranke155 4y ago
    I’ve found the generic of quetiapine doesn’t work at all. Certainly not in the same way.
  - the_mar 4y ago
    Slightly off topic, I found out generic of my birth control pill is not mono-cycle, meaning not every pill in the pack has the same dosage, it fucked me up for months. It's not documented anywhere
- novok 4y ago
  That sounds like your generic is not extended release but an immediate release version, which sound like different medications overall. Maybe split the dose in half and take the second half 4 hours later which is what they usually do when people are taking immediate release? Whoever your doctor is should understand this dynamic...
- bananaportfolio 4y ago
  The FDA allows generics to be sold within much looser tolerances than the brand product (variances allowed of +/- 20% of active ingredient per dose.) If you've ever noticed a "brand medically necessary" checkbox on a prescription a doctor has given you, that's what it is there for.
  - bick_nyers 4y ago
    There's no way that the variance allowed is +/- 20%. That's insane. Does that also imply that a 30mg Adderall could come out as either a 24mg or a 36mg? In reality that is likely easier for the manufacturer to detect than the individual weights of the active ingredients in a random mixture, but still.
    - pseudalopex 4y ago
      They measure maximum blood concentration and other parameters. Not just how much of the primary ingredient. But the variance allowed for those parameters is 80% to 125%.
      - bick_nyers 4y ago
        I see, that makes much more sense
brianjking 4y ago
The brand name worked significantly better when I took seizure medication with fewer side effects. The differences between the brand name and generic medications were very pronounced.
suzzer99 4y ago
I've been on 4 different brands of generic Ritalin. I'm sure I can tell them apart by taking one. 1. Normal (the first one - don't remember the manufacturer - was extremely hard to break in half) 2. Actavis - strong, but slow to hit 3. KVK - strong and hits fast 4. Mallinkrodt - weak For years Mallinkrodt was the only brand my drug store would get. Now they switched back to KVK and it's like night and day. I only have to do half as much.
- weaksauce 4y ago
  i've worked in the biotech industry and have been to some generics manufacturing plants and they are "up to code" but also a whole hell of a lot jankier than the big name brands.
- daniel-cussen 4y ago
  [dead]
Reptur 4y ago
Not that bizarre when you look at NY Times shareholders.

Waterluvian 4y ago

The difference in Concerta and its generic is chocolate and vanilla to me. The brand one slow releases very evenly while the generic just slams me with the calm, focused joy followed by a significant emotional low for hours. Completely unsurprised if an Adderall generic had just as significant impacts.

luckydata 4y ago
the generic concerta all have a KNOWN issue with manufacturing. The slow release mechanism is mechanic, not chemical, and only ONE generic is manufactured the right way. https://www.goodrx.com/concerta/certain-generics-are-no-longer-equivalent-to-brand-name-concerta https://www.goodrx.com/concerta/certain-generics-are-no-long...
- joezydeco 4y ago
  It's literally a plastic capsule with microscopic holes drilled in it. A sponge on one end absorbs moisture and swells at a fixed rate, slowly pushing the methylphenidate out the other side.
deleted 4y ago
[deleted]
RyJones 4y ago
That is exactly my experience. The brand-name Concerta is a smooth push all day, the generic is terrible.
guluarte 4y ago
same, generic vs concerta fells very different, the generic fills like a bomb while concerta it's slow and steady.
freeflight 4y ago
> The brand one slow releases very evenly while the generic just slams me with the calm, focused joy followed by a significant emotional low for hours. Prolonged-release of an orally drug taken in pill form is a "special feature", it's the difference between regular Adderall and Adderall XR. There are patented techniques involved to make it work like that, generica manufacturers probably don't have access to those/leave it out to save manufacturing costs. You can try taking the generica in smaller dosages, to compensate for their lack of prolonged-release, as the symptoms you describe sound like you are overdosing by taking too much in too short of a time. Concerta doesn't need such manual dosage management, as it also has prolonged-release just like Adderall XR.
- metadat 4y ago
  How often do you casually dispense medical advice to strangers? Especially without qualifying yourself as a SME expert (or non-expert), or at the very least providing reference sources or other supporting documentation? Edit: @djmips: Are you familiar with the differences between medical and non-medical advice? The potential repercussions of you following my potentially bad advice on programming are vastly different from the possible fallout from encouraging someone to mess with their medication dosing. The responsible thing to do is refrain, because some people are on a very specific regimen for good reasons. In a medical context, sharing one's own experience (and qualifying it as such) is often appreciated, however this is not how I would characterize the structure of the parent comment. I hope this helps, I only wish the best for you and others. Edit 2: @freeflight: Thanks for following up.
  - djmips 4y ago
    I see you are dispensing advice. I'd like to see your advice dispensing certification please.
  - freeflight 4y ago
    > How often do you casually dispense medical advice to strangers? Semi-regularly, as I work in palliative healthcare. I'm just not sure why that would be relevant to "medical advice" like "If you experience too intense sympthoms, try lowering the dose" and explaining the differences between instant and prolonged-release drugs? Some might consider that common sense, which shouldn't need to be pointed out. But life is hectic and complicated, leading to a lot of overthinking, sometimes we just need a reminder of the simpler and straight forward solutions.
yamtaddle 4y ago
Two of our kids are on Concerta and can confirm that the first time we got generics it was very fucking obviously working quite differently (in our case, it manifested like them barely working at all). Took us a little bit to put two and two together, but sure enough, the change was just as we switched (well, got switched) to generics. Be great if the FDA would ensure that a generic is actually the same damn thing.
- kranke155 4y ago
  I’ve found the generic of quetiapine doesn’t work at all. Certainly not in the same way.
- the_mar 4y ago
  Slightly off topic, I found out generic of my birth control pill is not mono-cycle, meaning not every pill in the pack has the same dosage, it fucked me up for months. It's not documented anywhere
novok 4y ago
That sounds like your generic is not extended release but an immediate release version, which sound like different medications overall. Maybe split the dose in half and take the second half 4 hours later which is what they usually do when people are taking immediate release? Whoever your doctor is should understand this dynamic...
bananaportfolio 4y ago
The FDA allows generics to be sold within much looser tolerances than the brand product (variances allowed of +/- 20% of active ingredient per dose.) If you've ever noticed a "brand medically necessary" checkbox on a prescription a doctor has given you, that's what it is there for.
- bick_nyers 4y ago
  There's no way that the variance allowed is +/- 20%. That's insane. Does that also imply that a 30mg Adderall could come out as either a 24mg or a 36mg? In reality that is likely easier for the manufacturer to detect than the individual weights of the active ingredients in a random mixture, but still.
  - pseudalopex 4y ago
    They measure maximum blood concentration and other parameters. Not just how much of the primary ingredient. But the variance allowed for those parameters is 80% to 125%.
    - bick_nyers 4y ago
      I see, that makes much more sense

brianjking 4y ago

The brand name worked significantly better when I took seizure medication with fewer side effects. The differences between the brand name and generic medications were very pronounced.

suzzer99 4y ago

I've been on 4 different brands of generic Ritalin. I'm sure I can tell them apart by taking one. 1. Normal (the first one - don't remember the manufacturer - was extremely hard to break in half) 2. Actavis - strong, but slow to hit 3. KVK - strong and hits fast 4. Mallinkrodt - weak For years Mallinkrodt was the only brand my drug store would get. Now they switched back to KVK and it's like night and day. I only have to do half as much.

weaksauce 4y ago
i've worked in the biotech industry and have been to some generics manufacturing plants and they are "up to code" but also a whole hell of a lot jankier than the big name brands.
daniel-cussen 4y ago
[dead]

Reptur 4y ago

Not that bizarre when you look at NY Times shareholders.