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Old 09-30-2019, 05:31 PM
 
21,382 posts, read 7,940,989 times
Reputation: 18149

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Quote:
Originally Posted by mike1003 View Post
Amen Doc, thanks for posting.


It amazes me how many people just don't get it

They are not the same. Keep believing falsehoods for whatever reason you are hanging onto it. And you are a pharmacist?

Ibuprofen
200mg
BROWN tablet
https://www.drugs.com/imprints/ip-140-11469.html

Ibuprofen
200mg
ORANGE tablet
https://www.drugs.com/imprints/ip-143-13302.html

Ibuprofen
200mg
WHITE tablet
https://www.drugs.com/imprints/i-2-13596.html

Ibuprofen
200mg
BLUE capsule shape
https://www.drugs.com/imprints/a-77-18844.html

Ibuprofen
200mg
RED tablet
https://www.drugs.com/imprints/g-2-19759.html

Do you believe that the EXACT same ingredients can be used to make a pill white or brown or red or orange or blue? Even a 5 year old knows that's not possible.

Take special care to read the disclaimer at the bottom of the white, red, and orange tablet pages:
Note: Inactive ingredients may vary.

I don't claim that brand names are better than generic or that generic is better than brand name. Or that a generic is better than another generic.

But they are not the EXACT same thing. Unless you believe blue = white = red = brown = orange?

This is just one example of how the same drug has different ingredients when made by different companies.
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Old 09-30-2019, 05:35 PM
 
21,382 posts, read 7,940,989 times
Reputation: 18149
Quote:
Originally Posted by markjames68 View Post
The active ingredient is exactly the same. Which is why generic acetaminophen and brand name Tylenol work the same. It's not true that generics and brand name products are exactly the same product.

The fillers and exact delivery mechanism for sustained release medication might be different, which might mean the onset profile and duration differs a bit. But they'll likely differ even more between individual patients.

As I mentioned earlier, while the actual drug in Concerta is the same (methylphenidate), the brand name (and authorized generic - i.e. relabeled brand name) uses a patented osmotic delivery system while the generics use other sustained release mechanisms which may kick in the same or not. But if you measure the medication in blood plasma hours later the results are all supposed to be within the FDA acceptable range.
Right, the medication is NOT the SAME.

People can have different reactions because of the formulations. There are posters in another section of the board who say flat out that they have it on record with the pharmacy to ONLY use the generic from XYZ manufacturer NOT the one from PDQ manufacturer.

Why? Because they aren't the same. And each person may have a different reaction.

It's astounding to me that people are arguing this.
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Old 09-30-2019, 08:25 PM
 
14,394 posts, read 11,241,937 times
Reputation: 14163
Quote:
Originally Posted by newtovenice View Post
Right, the medication is NOT the SAME.

People can have different reactions because of the formulations. There are posters in another section of the board who say flat out that they have it on record with the pharmacy to ONLY use the generic from XYZ manufacturer NOT the one from PDQ manufacturer.

Why? Because they aren't the same. And each person may have a different reaction.

It's astounding to me that people are arguing this.
I do think though that there is a nocebo effect for some. Switching to a generic makes them expect a different outcome.

The only way to test this would be to have every version look exactly the same and then do double-blind testing.
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Old 10-01-2019, 06:27 AM
 
21,382 posts, read 7,940,989 times
Reputation: 18149
Quote:
Originally Posted by markjames68 View Post
I do think though that there is a nocebo effect for some. Switching to a generic makes them expect a different outcome.

The only way to test this would be to have every version look exactly the same and then do double-blind testing.
Doubt it. There are some people who prefer a specific generic instead of another generic.

And no one wants to pay high prices for brand name drugs.

Do you like hohos, Swiss rolls or yodels? They are all the same right? McDonald's or Burgerking? Same thing right, it's just a hamburger.

Products aren't the same.
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Old 10-01-2019, 10:36 AM
 
Location: Out there somewhere...a traveling man.
44,625 posts, read 61,603,272 times
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My doc says the primary difference between generics and brand name is the fillers and their absorption rate.
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Old 10-01-2019, 11:27 AM
 
14,394 posts, read 11,241,937 times
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Quote:
Originally Posted by newtovenice View Post
Doubt it. There are some people who prefer a specific generic instead of another generic.

And no one wants to pay high prices for brand name drugs.

Do you like hohos, Swiss rolls or yodels? They are all the same right? McDonald's or Burgerking? Same thing right, it's just a hamburger.

Products aren't the same.
Calm down, I've said exactly what you said before you posted.

My point was that without doing a double-blind test it's impossible to know for sure.

And note what I said about generics - there are some "authorized generics" which are the exact same as the brand name, just marketed/labeled differently. If someone was to request those they would get the same exact effect as brand name.

Lastly, unless there is an adverse reaction to the fillers, anything that doesn't depend on time of onset will be medically equivalent. If there was still such thing as brand name amoxicillin it would work exactly the same as any generic version - it's the blood plasma level that counts, not that it takes 30 vs. 45 minutes to get there.
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Old 10-01-2019, 11:46 AM
 
21,382 posts, read 7,940,989 times
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Quote:
Originally Posted by markjames68 View Post
Calm down, I've said exactly what you said before you posted.

My point was that without doing a double-blind test it's impossible to know for sure.

And note what I said about generics - there are some "authorized generics" which are the exact same as the brand name, just marketed/labeled differently. If someone was to request those they would get the same exact effect as brand name.

Lastly, unless there is an adverse reaction to the fillers, anything that doesn't depend on time of onset will be medically equivalent. If there was still such thing as brand name amoxicillin it would work exactly the same as any generic version - it's the blood plasma level that counts, not that it takes 30 vs. 45 minutes to get there.
Kind of like how hohos, Swiss rolls and yodels are the same thing. Tastes exactly the same. People will accept each as a substitute and never know the difference.
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Old 10-01-2019, 12:45 PM
 
Location: NJ
23,866 posts, read 33,545,704 times
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Quote:
Originally Posted by newtovenice View Post
Right, the medication is NOT the SAME.

People can have different reactions because of the formulations. There are posters in another section of the board who say flat out that they have it on record with the pharmacy to ONLY use the generic from XYZ manufacturer NOT the one from PDQ manufacturer.

Why? Because they aren't the same. And each person may have a different reaction.

It's astounding to me that people are arguing this.

We're having this same discussion in the thread //www.city-data.com/forum/healt...erstaffed.html

I totally agree with you that they're most certainly not the same. Add someone like me where fillers make you sick; generics can be totally different.

Back in 2005 they had generic Oxycontin that made me throw up. My dad who was fighting cancer at the time, also threw up from them. To make sure it had to be the medication, I gave him one of my brand name ones, he was fine. The only time he got sick was when taking the generic. The generic Oxy's were discontinued and up until last year, there were no generic Oxycontin.

I was given the generic last year, I didn't know it was the generic the pharmacist gave me until the pill made me throw up. My pharmacy is an "old time" one where they don't even have an app, nor do they text. If you need a refill, you have to call them. I told the pharmacist that it made me sick, he couldn't believe it. He not only told me and showed me the 2 bottles that it was by the same maker, it had the same lot number on it, he told me it was made on the same run as the brand, their lot numbers and everything were the same except one said generic. He said they were the exact same pill. I told him that they couldn't be because of how sick it made me. I suspect it had cheaper fillers in it. It seems that these fillers make me sick.

I don't think he even stocks them any more because they're not much cheaper then the brand Oxy's.

Quote:
Originally Posted by newtovenice View Post
Kind of like how hohos, Swiss rolls and yodels are the same thing. Tastes exactly the same. People will accept each as a substitute and never know the difference.
I like the Hostess Yodels the best but will eat the "generic" Swiss rolls.
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Old 10-01-2019, 01:03 PM
 
1,625 posts, read 1,355,564 times
Reputation: 3050
My understanding is that the brand manufacturer releases only the active ingredient to the generic manufacturers. They do not release the details of the entire formulation, i.e. the recipe of "inactive" ingredients used in the brand-name version. So the generic manufacturers are left on their own to add whatever other ingredients they want to come up with their own formulations.

Therefore, the only thing in common between the brand and the generics is the active ingredient. All the other so-called "inactive" ingredients can be, and most likely are, different.

In addition, the generic formulations are not tested for efficacy to see if they actually work. They are ASSUMED to work because the other ingredients are ASSUMED to be "inactive".

But people have experiences such as brand working better than generic, or generic A working better than generic B — which is evidence that the so-called "inactive" ingredients actually do affect the active ingredient's efficacy.

I previously had this ASSUMPTION that all generics were alike, until I had the experience of generic A worked great while generic B did nothing at all and brought a return of my symptoms. I was expecting that generic B would work just like generic A. I was quite surprised when my symptoms returned within 2 days, and I then had to get a refill from a different pharmacy that stocked generic A.
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Old 10-01-2019, 04:22 PM
 
Location: NJ
23,866 posts, read 33,545,704 times
Reputation: 30764
Quote:
Originally Posted by noodlecat View Post
My understanding is that the brand manufacturer releases only the active ingredient to the generic manufacturers. They do not release the details of the entire formulation, i.e. the recipe of "inactive" ingredients used in the brand-name version. So the generic manufacturers are left on their own to add whatever other ingredients they want to come up with their own formulations.

Therefore, the only thing in common between the brand and the generics is the active ingredient. All the other so-called "inactive" ingredients can be, and most likely are, different.

In addition, the generic formulations are not tested for efficacy to see if they actually work. They are ASSUMED to work because the other ingredients are ASSUMED to be "inactive".

But people have experiences such as brand working better than generic, or generic A working better than generic B — which is evidence that the so-called "inactive" ingredients actually do affect the active ingredient's efficacy.

I previously had this ASSUMPTION that all generics were alike, until I had the experience of generic A worked great while generic B did nothing at all and brought a return of my symptoms. I was expecting that generic B would work just like generic A. I was quite surprised when my symptoms returned within 2 days, and I then had to get a refill from a different pharmacy that stocked generic A.
That's how one generic compazine is for me. The red one by Mylan works great, the yellow one who I'm not sure makes it doesn't work for me. My daughter has an allergy to the yellow one.
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