Generics, can they make you feel this bad?

Hi all

this is such an interesting problem. Here are a few views of a pharmacist, if it helps!

We pharmacists have a sort of standard answer when patients come back and say the cheap generic we've given them (because that's what's on their prescription) doesn't agree with them or doesn't work or gives them side effects.....we say all generic drugs have to be made to certain standards and must show 'bioequivalence' to the original product, I.e. Lustral brand in the case of sertraline, and we are unable to give you lustral due to costs, and we say this all in good faith, because in honesty, this is all true. BUT.....I for one, know that the reality is different to this, as we are all different! And all the generic copies are bound to be slightly different as other posters have said, the inactive ingredients DO contribute some activity, especially with regards to allergies to colourings.

So, I just wanted to say, I do have sympathy and wish I could give each patient exactly the brand they feel best on, but I cant!  If the script says 'sertraline' I can give any brand and will be reimbursed for cheap sertraline, a set price. If the script says 'lustral' I can only give you lustral, and as such will be reimbursed the set price of this.....a lot more than generic.  I have worked in loads of different pharmacies as I'm a locum, and can say that I advise you all to shop around, as different pharmacies vary in their ability to obtain your preferred generic make.....so always ask the pharmacist if it's something they can do.

your doctor will be under pressure to reduce their prescribing costs so it is unlikely they'll start prescribing you the brand of lustral, but I do know some patients seem to get lucky here, and seem to have persuaded their doctor to write lustral. Well done to them I say! Often, the hospital doctors will be used to writing the brand (effects of company drug reps are influential) so you start on lustral, then your GP takes over and of course you feel fobbed off with cheap drugs. I believe patients when they say a generic has caused their condition to worsen, but I can't do anything about it if you want the brand, only the prescriber can. But i can try and obtain a particular manufacturers generic for you. 

another point is, some large pharmacy chains DO supply you with lustral even if your script says sertraline, as they have a deal with Pfizer as they buy in large quantities, so just to add even more confusion, some days you may well receive lustral when you weren't expecting it! 

Ive had so many people specifically request Dr reddy brand of other drugs, eg., clopidogrel, saying it's the only one they feel works, and funnily enough, also loads of ppl saying 'never give me Dr reddys brand'......so what does this tell us!? We have so much choice in this country and our wonderful NHS gives us so much for free, we are very spoilt if we can choose the brand of our tablets. I believe Dr reddys are made in India though, and I can only imagine their GMP (good manufacturing practice) is shall we say different to the uk!

always bear in mind your condition can change, and it's very hard to prove causation, as it could always be coincidence, so don't always blame the generic drug, but that said, I do believe problems can be caused by generics and your doctor should listen to your concerns. Fakes and counterfeit drugs are a separate issue though, generics aren't fakes. They're legal and genuine and tested. Always report adverse effects via yellow card system.

sorry to have rambled on! Good luck all.

Im taking 30 ml citalopram (daily) and 5ml diazepam When required) for severe generalised anxiety disorder/ depression and agoraphobia.

My chemist often changes my citalopram from one generic to another.

My chemist seems to think that I am imagining that every time they switch generics on me I relapse.

I have experienced what I can only describe as withdrawal effects and side effects at the same time.

At christmas time I wanted to end my life because I had enough of feeling ill all the time. 

I felt better again up until a few days ago, I'm now experiencing mania and the only factor that has changed in my life is the brand of citalopram.

My chemist assures me that all generics are identical and the only difference is what each tablet is coated in.

I went to a diffirent chemist recently to ask him if he could guarantee a specific brand every month and that I specificaly did not want the Almus brand of citalapram. He told me that Almus dont even make citalopram, they just make the boxes!

Perhaps its not a specific brand thats making me ill, perhaps its just that I get used to one brand but then my chemist swaps me for another in order to save money.

I really feel as if Im loosing my mind.

This message is more or less copied and pasted in reply to Sarah, below... I originally posted my comment several weeks ago regarding an apparently Lustral generic called Aremis - the difference between this and standard generic Sertraline being the outer packaging which implied it was 'masquerading' as the genuine Prizer Lustral.  The blister pack was decidedly NOT Lustral, and the tablets themselves have Aremis embossed on them.  Although on the foil pack, there is a paper sticker stating "Lustral", and Waymade Plc.  I switched  over to Boots and the pharmacist there was wonderful, and immediately ordered the genuine article, as that was what my doctor stated on the script.  Another blip today though, and again the Aremis slipped in! It's the outer packaging which is worrying though, as it's very misleading...they have even spelt Pfizer wrong and its a much larger box, apart from being very similar.  I find this a tad concerning to be honest and urge everyone to be very careful about this. There most certainly CAN be an enormous difference in the efficacy of generic meds.  I'm living breathing proof of this.  And I am not hypochondriacal or neruotic - neither are any of the posters here I would wager!  I think if people following this topic and have had a bad experience with Generics, they should definitely go back to their GPs and if they know of a brand which they like, and is proven itself to be consistent in quality and suits them they should demand that the doctor writes that brand name on their script, rather than the generic Sertraline.  Many years ago, this is what happened to me - cost saving - he switched from Lustral to Sertraline and I trotted off happily, not worrying in the slightest.  Every month it seemed, my package was different ie a differnt generic.  But I was neither up nor down.  But THEN...the nighmare began.  I can barely describe how atrocious it was .... not just extreme anxiety, verging on suicidal, but physical horrors too -  hair falling out, severe sickness....I can't even bring myself to write down what I went through. It was hell, and I was immediately given diazepam and  referred to a phychologist.  Yet still my GP negated my assumption that 'maybe it's down to the different medication brands?"  I truly feel deeply that not enough is being done to address this problem, and it may be because we just don't know for sure how big it is!  Most patients, I assume, and their doctors are really not aware of the possibility that the reason why they aren't well, or were well and now relapsed, is that the quality of the drug is not up to scratch....or at best consistent.  Sorry to ramble, but this is such a major issue.  I think it should be highlighted in the mainstream media, and a national campaign run to raise awareness.  I would battle to have it brought to the attention of the public, because the pharma companies seem to have the upper hand.   Just how strict can the guidelines be adheared to, if your medication is manufactured in India?! 

Approx 10 days ago I collected my prescription from Boots and I've always insisted on having Lustral sertraline made by Phzer. I had a bad experience previously on a generic! (Although prior to Lustal I was on Dr Reddy and had no problems on them)

10 days ago boots insisted they were giving me Lustral but the packaging looked different and the tablet packaging had aremis on it. I queried it with the pharmacist and she assured me it was lustral and what I would normally have.

After a few days I noticed I wasn't feeling "myself" and my partner said I sounded flat but I didn't put 2 and 2 together until this weekend when I absolutely was unconslable and crying and crying. I'm as flat as a pancake and feel worse than before I was prescribed sertraline (although they've been a miracle for me).

My dr was great and today I've collected a new prescription of lustral just like my old ones. I hope in a few days I'll be back to myself.

Pinky Book thanks for your post - reading you'd had similar experience and phoned Phzer made me feel so much better,

Insist on th Lustal Phzer brand!