Hi @tristram,
I found an article on the FDA (Food and Drug Administration) regarding generic medications. https://www.fda.gov/drugs/frequently-asked-questions-popular-topics/generic-drugs-questions-answers

It states that “Generic medicines use the same active ingredients as brand-name medicines and work the same way, so they have the same risks and benefits as the brand-name medicines. The FDA Generic Drugs Program conducts a rigorous review to ensure generic medicines meet these standards, in addition to conducting inspections of manufacturing plants and monitoring drug safety after the generic medicine has been approved and brought to market. A generic drug may have certain minor differences from the brand-name product, such as different inactive ingredients.”

However, reading further into the Q & A on this article it does state that there can be small differences in absorption into the body between generic and brand name medicine as found in this quote from the article:

“For example, a very large research study1 comparing generics with brand-name medicines, found that there were very small differences (approximately 3.5%) in absorption into the body between generic and brand-name medicines. Some generics were absorbed slightly more, some slightly less. This amount of difference is expected and clinically acceptable, whether for one batch of brand-name medicine tested against another batch of the same brand, or for a generic tested against a brand-name.”

While 3.5% isn’t a significant difference I wonder if it’s possible that this is enough to tip the scales for you in noticing the change in performance for you with the generic as opposed to Revlimid.

If you’re seeing a marked difference in your health between Revlimid and the generic, it’s worth talking to your doctor. You don’t want to upset the apple cart! Have you brought this up to your doctor? Have they mentioned anything about the change in your blood results?