I admire your optimism that Moonriver is as interested in learning as in asserting that s/he is right.
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I hope these are more than just your ‘rules’ but are explicitly stated in the boarding contract a boarder signs with you, correct?
FWIW, at the same time a drug moves from prescribed to OTC, the strength may change or the actual “contents” (don’t know the correct term) may change; learned that Lomotil is a controlled substance but imodium, which is OTC, is missing the component that makes Lomotil controlled so imodium is not (this is from my PCP).
For many drugs part of the “fine line” between Rx drugs and OTC is the availability of additional safety data that is collected during the drug’s use as an Rx drug. The reason that some drugs are never made OTC, even after becoming generic (when the patent expires) is that for patient safety reasons, the drug should only be used while under the care of a physician. This is to prevent self-diagnosis that may be in error or misuse of potentially dangerous drugs.
Sometimes a drug can be marketed OTC at a lower dose than available by prescription . Sometimes it may be reformulated for branding or cost reasons.
The active ingredient in Lomotil is a different compound than the active ingredient in imodium, and the active ingredient in Lomotil is similar to other controlled compounds and can elicit opioid withdrawal symptoms after long term dosing with high doses (40-100+ times the standard dose).
Sometimes the drug’s brand name preparation is what makes it work for some people, but in the generic form it doesn’t work the same.
That is because the drug patent itself may have expired, but how it is formulated is propietary information and important to how it works.
The generic lacks that distinct preparation, so it doesn’t work quite the same.
This is not quite true. The formulation of a drug has no impact on “how it works” at the cellular level - the active drug compound must be the same, and therefore will act the same at the molecular target.
The formulation can potentially impact drug absorption, however generic versions must demonstrate comparable bio-availability to the innovator product, either through clinical testing (in humans), or in very limited cases, through laboratory in vitro testing. This is a requirement, even if the patent hasn’t expired. The innovator company can develop a new formulation while under patent and will still be required to show bio-equivalency to the original formulation.
The fact that some people experience different results with generic vs branded medications can be explained two ways. One is simply the placebo effect - the patient believes, therefore it is. The other, is that clinical and in vitro testing of formulations provides an average result of bio-availability, and is not perfectly predictive of the results for a single patient. That patient may have differences in bio-availability, or metabolism, etc. that make the therapeutic effect of the generic different than the innovator drug.
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Tell that to my cardiologist.
He is the one that was upset when the pharmacy, on the request of the insurance company, without asking him or letting me know, changed the arrhythmia medication from the brand name to the generic.
Why?
They assumed it was for blood pressure regulation, which at the minimal dose I was on they should have questioned that use, but for blood pressure they both work the same.
For arrhythmias, not so well.
The pills look the same, just the imprint on them is different, if you use a magnifying glass to check which one they are.
I was getting sick again, we could not figure why.
Finally thinking it was a bad batch of pills, we found out about the change when he requested a new batch from the pharmacy.
Maybe with some medications you are right, with others, maybe not quite true.
I am sorry for your experience. IMHO pharmacies should not be able to make changes to generic without physician notification and/or authorization.
However, I stand by my statements as a pharmaceutical chemist who studies and develops drug formulations. The active ingredient is the same in both innovator and generic formulations. There are instances of individuals havingdifferent responses to medications based on bio-availability differences between individuals. Generic formulations are required to meet bio-equivalency standards with the innovator product for an average population in order to get approval. Unfortunately, probably very few, if any, of us are actually represented by the “average” population.
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I have heard since from others that had similar problems.
Granted, anecdota, not data.
Something didn’t work with that generic, when the brand name does.
Been on that medication now almost 14 years.
Only time I was sick was that one time.
A curious concidence if it was not something wrong with those pills that were switched without our knowledge.
Nice to know that, in general, generics should work the same, chemically speaking.
