Hi all, picked up some very interesting stuff re: generics from a pharmacist on another thread, well worth a read:
https://patient.info/forums/discuss/generics-can-they-make-you-feel-this-bad--28893
Post by "sarah17507"
"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."