Are Generic Meds Exact Copies?

IF they have the same chemical formulation, then they can have the same generic name. A physician cannot ethically prescribe a substitute unless he/she advises you that the effect is going to be the same.

For example, any over-the-counter medication purporting to be 'acetaminophen' can have whatever brand name they chose, but the formulation must meet the standard formulation for 'acetaminophen'. They can be Life Brand, Tylenol, and so on, but they must all have the same formulation and proven function.

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?

Thanks for the response. The minute I saw the blood numbers, I told my doctor I'd like to go back on Revlimid. I was making progress with 10mgs, while 15mgs of the generic left me going bakwards. I should hear from my doctor this week.

My thoughts only......Why did your physician switch to generic from the brand? Maybe only to see if you would continue to gain benefit at a lower cost to you? If your "numbers" have declined then I would definitely have him take you back to the Brand and re-check you numbers. The proof will be in the results of your lab work! Payment for the Brand Name is between you and your insurance, possibly Medicare, so why should he be concerned? He's not paying for it. The proof is in the blood count! Generic medications get complicated.....due to the "not exactly" same composition inactive ingredients, absorption %, then you have the differences in all the different drug companies producing the drug, most of which are out of country ie India, Mexico....so all the variables increase. Not a strong proponent of generic drugs from way back!

The FDA comment is interesting but I have often found generic OTC meds to be far less effective than brand name meds. Those available by Rx only do seem to be as effective as the original meds but there have also been a few exceptions. I am usually willing to try a generic Rx med but would definitely talk with my physician if I noticed any difference in performance.

Yes, this is important. The doctor will use a rule of thumb at the very least to prescribe a certain dose, or a dose within a defined range, say for body weight, or maybe for age, even for sex, and in concert with other drugs prescribed that the patient ought to be taking routinely. So, if a generic brand fails to provide the relief or remediation that is intended in the prescription, the prescribing physician MUST BE apprised of that result. If nothing else, this is an ethical orientation to other patients who are also relying on the drug, and who may also not be deriving the intended, even life-saving, benefit. The company purporting to back their product needs to know, or to be sanctioned, even prevented from selling their product. It's what the FDA is meant to do for Americans.

Hi Lori:
I don’t know anything about generic medications other than with antidepressants. I take Effexor XR for over 15 yrs. and it’s expensive so I decided about 10 yrs ago to try the generic brand and it was a disaster. I suffered with chronic anxiety and the generic brand didn’t help at all. So I went back on the Effexor. My doctor said it can make a difference. He had other patients with the similar experiences. I just thought I would share my experience.

Thank you for sharing your experience. I personally think there is a differnce between some generic meds and branded. My daughter was taking an anxiety med for a while and there seemed to be a huge difference in her health from one to the other! She was physically ill with the generic. When she was switched back to the brand name drug she felt fine again. The pharmacist mentioned binders and fillers that could be the culprits!

Our adult child used fluticasone RX until doctor told him to use OTC Flonase bc it’s the same. He bought and used it then got anxiety attacks went to counselor to figure it out. First thing she asked was his meds so he told her his recent switch and she said she had another client who got anxiety from Flonase so he switched back to RX and anxiety disappeared. She said its bc it has different inactive ingredients.