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Old 03-05-2006, 10:10 PM
even sven even sven is offline
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Birth Control Pills- brand names vs. generics

So my "health plan" recently switched me from brand name pills to generics (specifically, Levlen to Levora). This was done with no fanfare- they just said "Oh, we're out of Levlen. This is the same thing, but the case is a little different". Now, my body isn't particularly sensitive to anything, but I noticed absolutely no difference and I'm pretty sure my doctor didn't expect me to.

I'm corresponding with another girl who is all up in arms because she's been switched to generics. She's got a whole tirade about "How are we supposed to know if we are supposed to use a backup method during the switch" and "OMG I'll get all kinds of side-effects" and "WTF this is going to wreak havoc on my body forever." She's got a lot of words for the people responsible for her health plan.

Now, this is a group of people who are likely to get worked up about all kinds of perceived wrongs and don't really have all that much better to do than rail against things- think of the worst stereotype of a passionate women's studies college students- but worse. They also happen to be some of the healthiest people on the planet and have all passed very comprehensive medical exams recently and have no history of major plumbing problems.

BS, I thought. I told her I was pretty sure the generics were chemically identical and switching to generics is probably not really a big deal. I basically got flamed back for being inconsiderate of women's needs and not understanding how PERSONAL (in all caps) this issue is and how all kinds of horrific things can happen if you switch to the generic.

Well, maybe I'm wrong. Am I?
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Old 03-05-2006, 10:38 PM
ftg ftg is offline
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Generics are supposed be effectively the same as the brand names. Of course, the main ingredient(s) should be the same in both form and amount. But a lot more goes into a pill sometimes. The extra "filler" can sometimes play a key role. How long it takes to disolve, how it effects absorbtion, buffering, etc. can significantly affect things in some cases. Little or no affect in most cases.

Even for a certain pair of versions, the two may effect one person the same but not work the same on another person.

So: No general rules on whether this is a bad thing or not. So: no one can say if this is bad for you or not. But if you get pregnant, you have a hellova lawsuit going for you.
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Old 03-05-2006, 10:38 PM
Whack-a-Mole Whack-a-Mole is offline
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Generic medicines are the same thing as the name brands as far as the active ingredient(s) go. A name brand might have a better coating to make swallowing them easier or a better binder (that holds the pill together) or somesuch but the bottom line is the generic will do the same thing as the name brand.
  #4  
Old 03-05-2006, 11:21 PM
Exapno Mapcase Exapno Mapcase is offline
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This gets asked a lot, with the answers similar to what's already been posted.

http://boards.straightdope.com/sdmb/...d.php?t=351838

http://boards.straightdope.com/sdmb/...ad.php?t=49026

http://boards.straightdope.com/sdmb/...d.php?t=127249

http://boards.straightdope.com/sdmb/...d.php?t=197734

http://boards.straightdope.com/sdmb/...d.php?t=248524
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Old 03-05-2006, 11:26 PM
even sven even sven is offline
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Thanks, I've been hoping for something specific to birth control (since they are so "deeply personal" according to the young lady, and ideally a quote from a doctor or something off this site that I could show her. I doubt it'd do much good, but I'd hate to see her spread her misinformation and get other people all worked up for nothing.
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Old 03-06-2006, 04:02 AM
Antonius Block Antonius Block is offline
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I think you've got an uphill task there, sven. Even if you manage to find cites that millions of women switch from Levlen to Levora with no side-effects, your correspondent doesn't sound like she'd accept a "proponderance of evidence" argument: all she'd need to do is find someone who had suffered a side-effect after the switch (even the effect was in fact not due to the switch but something else entirely), and she'd feel her indignation was vindicated.

Levlen®, Levora®, and Nordette® are all brand-name monophasic BCPs with identical active ingredients (30 mcg estrogen, 0.15 mg levonorgestrel). AFAIK, none of them are strictly speaking "generic", but Levora is definitely cheaper so is sometimes called generic since it's what insurance companies would rather pay for.

As others have said, the fillers and coatings are different between the brands and generics. People have been known to have differential side-effects (as evidenced in Exapno Mapcase's linked threads). So, I don't think you're going to find a cite for a doctor going on record as saying something to the effect that "Levlen and Levora are identical in every way for all patients" [Now watch Qadgop come in and prove me wrong!] I think that they tend to prescribe the lower-cost drug as per insurance company guidelines, then if some side-effect becomes apparent they can re-prescribe the original (more expensive) one, check the "no generics" box, and have paperwork to back up their decision if the insurance company pulls a hissy fit.

Be forewarned; your opponent is probably going to go to HealthBoards.com and find threads such as this:
Quote:
Levlen and Levora are supposed to be identical. But they are different brands and even though the active ingredients are the same things like fillers that vary from brand to brand or generics, can have an effect. I was shocked when there was such a big difference between the two for me. On Levlen - GREAT skin, NO sex drive, blood pressure fine. On Levora - Acne returns, Sex drive returns, blood pressure rises. My doc didn't comment on it at all. My insurance substitiuted Levora as a generic for Levlen but my doc said Levora is not a generic, it's a different brand of the same pill.
[Whether acne and high blood pressure are a good trade-off for a higher libido is going to vary from person to person, of course]. Here is a thread from Drugtalk.com attributing acne onset to a Nordette -> Levora switch.

So, your correspondent will undoubtedly find anecdotal evidence to support her position, even if differential side-effects are a rarity. Sorry.
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Old 03-06-2006, 08:47 AM
CookingWithGas CookingWithGas is offline
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I think your correspondent is overreacting before she even knows whether she might experience any side effects; she sounds as if she's been poisoned. But there are certainly cases of people who do have side effects. Mrs. Gas was switched to a generic birth control pill by the pharmacy because the doctor forget to check "dispense as prescribed." She then got terrible water retention, which subsided which she switched back.

I take a thyroid hormone, and my doctor reminds me not to accept a generic every time he prescribes it. Although the generic is the same on paper, the quality control and dosage precision are not as good as with the brand name.
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Old 03-06-2006, 10:21 AM
even sven even sven is offline
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Yeah, I've given up. Other people have chimed in saying the switch in almost all cases should not be a big deal. She claims the switch made here have month-long periods. What do I know? My body is the least sensitive thing around. I guess I'm just going to have to agree to disagree.
  #9  
Old 03-07-2006, 09:41 PM
Qadgop the Mercotan Qadgop the Mercotan is online now
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Quote:
Originally Posted by CookingWithGas
I take a thyroid hormone, and my doctor reminds me not to accept a generic every time he prescribes it. Although the generic is the same on paper, the quality control and dosage precision are not as good as with the brand name.
While that once might have been true, it no longer is. Retrospective analysis of the data on Synthroid vs. generic levothyroxine and others doesn't really bear out this claim so good. Lots of docs (myself included) were subjected to the pharmacy company hype about this claim over the years, and some of us still carry the scars. But if one's doc is checking one's thyroid function via blood tests regularly, I'd say one should take what they prescribe.

99+% of the generics in the US are as good as the name brands. Not exactly the same, mind you, but as good.

What that means is that for any given individual, the name brand and the generic should stand about the same odds of doing the proper job for the individual patient. Now, given that each person is unique (just like everyone else), some folks will tolerate one brand better than the other, or have certain side-effects from one over the other, but pretty much without regard to who the manufacturer is. In the great majority of cases.

As for women and BCPs, these meds are fraught with enough baggage that if a woman finds one that agrees with her, I certainly can see making extra efforts to stay on that one, especially if there is a track record of bad side effects on other products in the past. But that person will probably need to be ready to pay more to stay on their brand of choice. In these days of skyrocketing drug costs, that's just the way the system works.
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Old 03-07-2006, 10:23 PM
even sven even sven is offline
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Thanks Qadgop!
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