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Old 03-31-2004, 09:42 PM
conczepts conczepts is offline
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Who manufactures drugs, and what is the difference between generic and namebrand?

I'm trying to find the name of the manufacturers that make Ambien and Adderall. When I google up both of them I get sites like http://www.adderallxr.com/ and http://www.ambien.com/ which seem to go out of their way to avoid naming the company that manufactures them. Everyone knows Pfizer makes viagra, why is the main manufacturer of these two drugs hiding themselves from me? It almost seems like Herbalife or something.

As I understood it aren't generic drugs and name-brands supposed to be exactly the same, but under a different name? I could swear that the generic zolpidem I take nowadays works nowhere near as well as the Ambien tablets that actually said "Ambien" on them. Is this just my imagination?
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Old 03-31-2004, 09:56 PM
Thaumaturge Thaumaturge is offline
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Ambien seems to be made by Sanofi-Synthelabo. Adderallxr seems to be made by Shire, Inc.

Generic drugs would use the same active ingredients, but might not be exactly the same, due to concentrations of the active and inactive ingedients( which might be totally different). The only way to find out which works better for you is to try them both. Generic drugs are made by a different company, and might not be as effective....then again they might be more efective.

Is it your immagination that the brand name ambien works better? Maybe not, maybe so, and even if it [b]is/b] your immagination, the placebo effect can be powerful enough to make a difference. Especially for something that has a strong mental component like insomnia. Just use what works better for you for the cost.
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Old 03-31-2004, 10:11 PM
conczepts conczepts is offline
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Thanks a lot, Thaumaturge!

I've been given placebos before and knew what they were without being told. I don't think placebo could explain the distinct difference in effect.
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Old 03-31-2004, 10:29 PM
CrazyCatLady CrazyCatLady is offline
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Sometimes the branded version works better for some people, and sometimes the generic works better. It's insane, but it really seems to me that Equate naproxen sodium tablets work better than Alleve. (Actually, they're about the same for headaches, but Equate hits menstrual cramps way better.) For most things, there's not enough difference in the generic versus the branded version (or between different generic versions) to make any real difference, so nobody gets all whipped up about it. For some things, though, even a small difference is a big deal. Seizure meds, for instance. The branded version might not really work any better, but you know the branded version is always the same thing, whereas the pharmacy might have a different generic version every time they restock. The difference might not be enough to kick somebody into a seizure, but then again it might. Better to go with consistency than to take the chance in that sort of situation.
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Old 03-31-2004, 10:41 PM
Thaumaturge Thaumaturge is offline
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Your're welcome.

Don't discount the power of the placebo effect. In many cases it was found to be more powerful than the medication being administered. In other words, the effect of the medication was less than the effect of beleiving that you are getting the medication. Apparently we have some ability to heal if we believe we are being healed. If you somehow find out that the placebo is a placebo, then the effect dissapears. Also, it does not work for everyone in every case. It's rather mysterious. It might be that it doesn't work for you, or just doesn't work for you for what you received placebos for. However mysterious, it is a real effect that has to be carefully controlled for in any medication study.
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Old 04-01-2004, 07:44 AM
irishgirl irishgirl is offline
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CrazyCatLady, you make a good point that the branded version might work better for some people than the generic, but theoretically it shouldn't. If the label says 20mg active ingredient, then it HAS to contain that. The only difference might be in the agents used to carry or bind it.

In order to get a licence to produce generics the company must show evidence both that their version is molecularly identical to the brand, and that it has the same clinical effects.

Doctors are taught to write out prescriptions using generic rather than brand name (say fluoxetine rather than Prozac) so that the pharmacist can give the patient whatever they have in stock, at the lowest price. If the prescription says "Prozac" they can only dispense Prozac, which is a problem if they only stock another brand or a geneneric.

However, all the goodies given out by drug companies (pens, tourniquets, fluffy toys, post-it notes etc) are specifically designed to encourage brand recognition in physicians. If the pen you're writing the prescription with says Prozac, you're less likely to put Fluoxetine on the scrip.
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Old 04-01-2004, 08:16 AM
Sauron Sauron is offline
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Quote:
Originally Posted by irishgirl
Doctors are taught to write out prescriptions using generic rather than brand name (say fluoxetine rather than Prozac) so that the pharmacist can give the patient whatever they have in stock, at the lowest price. If the prescription says "Prozac" they can only dispense Prozac, which is a problem if they only stock another brand or a geneneric.
Are you sure about this? My pharmacy always asks me if generic drugs are okay with me if a name-brand drug is prescribed. I always say yes, because it's the same stuff, basically, and it's way cheaper.

I doubt pharmacists are required to fill the brand name on the scrip if the customer requests generic or agrees to a generic alternative.
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Old 04-01-2004, 08:38 AM
irishgirl irishgirl is offline
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Hmm, maybe it's just here and the UK then. But yup, pharmacists may only hand over what is written on the scrip, no changes, unless they confirm it with the prescribing physician, in person.
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Old 04-01-2004, 08:59 AM
Ferret Herder Ferret Herder is offline
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From what I've seen, at least some prescription forms in the US have a check-off box at the bottom with a phrase to the effect of "Generic equivalent acceptable." The physician might write out the prescription then as Prozac but check off that box and leave the patient the option of getting a bottle of fluoxetine made by some other company instead. I suspect that if this box was not checked but the patient insisted on a generic version, the pharmacist might have to call the physician to confirm.

I know that an ophthalmologist I work for has written prescriptions for the name-brand only of a certain type of eye medication; I've heard him telling patients that usually the generic is fine for most meds, but that this particular medication seems better in the name brand.

It is true that the various "filler" types of ingredients can differ between name brand and generic drugs. (In fact, I was at a research conference where a case was being discussed that showed that a generic version of a certain name brand drug was causing some serious issues due to a problem with one of those ingredients, and the generic was pulled from testing and reformulated.) Typically this does not affect how the drug works, but it can. If you notice a difference between drugs like this that are prescription, speak to your doctor. If you think you get a difference when it comes to OTC forms of drugs, use the one that works best for you.
  #10  
Old 04-01-2004, 09:09 AM
Jinx Jinx is offline
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FYI: For Future Reference

If you need drug info, Google on "PDR" or, "Physician's Desk Reference". Many larger libraries may have a copy in their reference section, too. It may not be the latest edition, but for most drugs, it will do. Still, even if tried and true, ask your pharmacist just to sure you're not missing any new info. Also, for OTC, there is a PDR for Non-Prescription Drugs, as well. These books will tell you who manufacturers what drugs, the side effects, contraindications, and such.

One note: These books are technical, but the side effects and contraindications are not too difficult to understand, IMHO.
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  #11  
Old 04-01-2004, 09:53 AM
Nametag Nametag is offline
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In many states, and under many insurance programs, a pharmacy is REQUIRED to dispense the generic equivalent unless the doctor specifies the name brand. This generally reduces costs, but causes problems for people who are sensitive to the difference in formulations.

The PDR is a piece of crap. There's nothing in it that isn't in the drug information sheet dispensed with the drug. If your library has "Facts and Comparisons," a drug reference written by and for pharmacists, you'll find that much more useful.
  #12  
Old 04-01-2004, 11:50 AM
suranyi suranyi is offline
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On the prescription forms my doctor uses there are two lines for his signature. He signs one or the other, not both. If he signs one, it means generics are acceptable. If he signs the other, it means generics are not acceptable.

Ed
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Old 04-01-2004, 12:33 PM
dnooman dnooman is offline
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Sometimes a doctor will write DAW (or check the box for it) on a scrip, meaning Dispense As Written. This means that only a brand name can be dispensed, unless, there is a money problem. For instance, some patient's co-pay might increase enough for them to ask the pharmacist to call their doctor and ask about the effectiveness of the generic.

Another case might be, after the scrip is filled and the patient's insurance co. recieves the "bill". They might have someone either call the doctor, or the benefit provider, and make sure that a generic is not acceptable. The people that finally end up footing the bill have a vested interest in having the least expensive meds prescribed.

Generics don't work for some people, also some people win the lottery. One person has a reaction to the generic, and suddenly it's poison to everyone. Aaaargh.
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