I’m often asked if generic drugs are as safe and effective as brand-name drugs. The answer is yes — for most people.
Many individuals choose generic drugs over brand names because they can save a significant amount of money. Sometimes the cost difference may be just pennies or a few dollars on each refill, but for those with a chronic condition, the annual savings can be hundreds of dollars.
If you’re currently taking a brand-name drug, or if your doctor suggests a new prescription, ask if there’s a generic alternative.
On the safety issue, the Food and Drug Administration requires that all generic drugs have the same active ingredients in the same amounts as the brand-name counterparts.
Generic drugs must also be “bioequivalent” to brand-name drugs. That means that the drug has to perform the same way in the body as the brand medicine.
However, the main difference between generic drugs and brand-name drugs is in the binders, fillers and coatings.
Those other ingredients can have a big impact depending on the individual. About 3 percent to 5 percent of the population cannot tolerate generic drugs because of the binders, fillers and coatings used. Roughly 5 percent of people do better with generics for the same reason.
Be very careful if you’re taking a drug with a “narrow therapeutic index.” Drugs in this category have a very narrow range between what is safe and effective and what is toxic. In this case, your doctor may want you to take only the brand name, especially if it’s working well for you.
For specific drugs used for heart, thyroid and seizure conditions, it is recommended that you stick with the same brand name (Lanoxin, Synthroid or Dilantin, for example) every time you fill your prescription.
Those who are able to tolerate a generic should always use the same manufacturer. Please communicate with your pharmacist so that your prescription is filled in this way every time.
If your doctor doesn’t want you to switch to generics for medical reasons, make sure that the “no substitutions” box on your prescription is checked and the pharmacist fills the prescription exactly as written.
Choosing a generic versus a brand-name drug is most important for those with chronic conditions that require long-term prescriptions. In these cases, it’s best to be consistent in using the same pharmacy.
When you’re a regular customer, the pharmacy will have a record of all of your medications and can best advise you of issues that may come up, such as adverse drug interactions, and when it’s time for a refill.
— Bruce Read, Pharm.D., is pharmacy clinical coordinator at Cottage Health and Santa Ynez Valley Cottage Hospital. The opinions expressed are his own.