Generic Meds

[tednlou2]

I got to thinking about something today.  I was thinking about generic HIV meds.  I know generic meds have made it possible for more people to have access. 

Having said that, I remember when I had back surgery and my pharmacy switched from one generic company to another on the same pain medicine.  I remember thinking this new generic didn't seem like it was working.  When I went for a refill, the pharmacist asked me what I thought about the medicine.  He said he had gotten several complaints.  He said while generic drugs are required to have the same active ingredients, the other ingredients can be different.  He said even though it has the same active drug, it may not break down in your body the same.  He wasn't trying to push brand name drugs.  He said drugs can have several generic companies.  He said some generic companies are better than others.

I suppose if the generic wasn't working, we'd know it from bloodwork.  I guess I'm thinking about those who have posted they are puzzled why their meds aren't working like they use to.  I read an article that the FDA doesn't do testing to see how effective the generics are.  They are just concerned that it has the same active drug.  It could just sit in your stomach because of the fillers in the pill and not get absorbed very well.  I asked a family member who is an OBGYN doc about this.  He said this is why most prescriptions have "Do not substitute" on them.  He said this is a little known fact about generics.  They make work great, but some may not work as well.   

Just putting that out there....  has anyone ever experienced something like this?  Again, I realize if the generic wasn't working it would be known.  I'm talking about people where the meds aren't working good enough--not getting viral load totally undetectable.     

[Assurbanipal]

Few of the "good" HIV drugs are available as generics in Western countries yet, so for most of us this is still a moot point.  Quite a few will become available in the next 5 years though, so the issue will become more important.

The potential for the "filler" in a generic to affect absorption is a known item and if you look around pharmacy manager publications you can find some discussions.  And frankly, the generic might well work better in some people than the brand name -- it is not all a one way thing. 

Don't think your ob/gyn friend has the numbers right on DNS prescriptions though -- I had to look into this for a project at one point and I believe the overall number is more like 10%.  But, of course, medical practice in the US varies dramatically from doctor to doctor, practice to practice and city to city.

[tednlou2]

I meant to say the paper prescription has the option for the doctor to say "Do not substitute."  I can't think of a time when a doctor has actually checked that box on a prescription.  You right about the generic may work better for some.  It all depends I suppose.

[stephenhoward]

These drugs are available now online for most all of the HIV drugs.  (www.aids-drugs-online.com).  They are made in India, where a number of your regular generic drugs and non-generic drugs are manufactured.  (if for manufacturer it says Dr. Ready that is India, Teva is Israel, etc.  You can always tell where they are made by checking the company name online and the drug store can tell you the manufacturer.)

For those taking any generics the real test, as you mentioned, is the result. For HIV meds, if the load stays undetectable and the T-cell count and percent remain at a good level as was the case for you when you took the brand, then it must be fine.  One thing to keep in mind with any drug, they all have some kind of fillers and they all can react differently with each person.  What works for someone else may work not work for you.  I know some people on the HIV generic who are doing just as well as when they were on the Brand.  I would say, though, that they are on generics of drugs that have been around for awhile.