Question:
Anyone reading tried both the brand name and generic Prozac? Noticed any difference? (Question also applies to doctors who have prescribed both, or pharmacists who have heard feedback from customers.)
Response:
> Anyone reading tried both the brand name and generic Prozac? Noticed any > difference? (Question also applies to doctors who have prescribed both, or > pharmacists who have heard feedback from customers.)
They are identical. All generic brands must be bioequivalent to the original. There are a couple of medications, like morphine, for which different brands have genuinely different properties, but not fluoxetine (prozac).
Response:
> They are identical. All generic brands must be bioequivalent to the > original. There are a couple of medications, like morphine, for which > different brands have genuinely different properties, but not fluoxetine > (prozac).
Ahh…but the pretty packaging and higher cost of the Prozac(tm) will exert a nice placebo effect of its own, moreso i suspect than the generic fluoxetine… They should definately make the capsules bigger too or coat them in a really bitter tasting goo just for fun. Regards, Andrew Austin. — NLP, Neurology, Schizophrenia: http://www.23NLPeople.com
Response:
>> They are identical. All generic brands must be bioequivalent to the > original. There are a couple of medications, like morphine, for which > different brands have genuinely different properties, but not fluoxetine > (prozac). >Ahh…but the pretty packaging and higher cost of the Prozac(tm) will exert >a nice placebo effect of its own, moreso i suspect than the generic >fluoxetine…
Or you could pay top dollar for Serafem…
Response:
> They are identical. All generic brands must be bioequivalent to the > original. There are a couple of medications, like morphine, for which > different brands have genuinely different properties, but not fluoxetine > (prozac).
Of course the active ingredient is identical. But can’t there be a difference in the fillers, excipients, etc. used in the tablets, and couldn’t that make a difference in absorption, etc.? With time-released the difference could be greater, no, as there could be a different method of time-releasing the med to the bloodstream?
Response:
Here is what Lilly says about generic prozac on their web site: "Generic fluoxetine is not identical to brand name Prozac in appearance. The generic prescription you pick up at the pharmacy won’t look like brand name Prozac. Receiving medication with a different color or shape may be unsettling or cause concern." So is the therapeutic effect of prozac due to its color and shape? Is it just a placebo effect after all? Also, the sarafem web site says nothing about sarafem being equivalent to prozac. Apparently, they don’t want the sarafem users to know that actually they are taking an antidepressant! cem
– Hide quoted text — Show quoted text ->> They are identical. All generic brands must be bioequivalent to the >> original. There are a couple of medications, like morphine, for which >> different brands have genuinely different properties, but not fluoxetine >> (prozac). >Ahh…but the pretty packaging and higher cost of the Prozac(tm) will exert >a nice placebo effect of its own, moreso i suspect than the generic >fluoxetine… > Or you could pay top dollar for Serafem…
Response:
> "Generic fluoxetine is not identical to brand name Prozac in appearance. The > generic prescription you pick up at the pharmacy won’t look like brand name > Prozac. Receiving medication with a different color or shape may be > unsettling or cause concern."
This is actually true. The expensive brands say that ’substitution causes confusion’, and it actually does in my experience. I’d still prescribe generically, though. > So is the therapeutic effect of prozac due to its color and shape? Is it > just a placebo effect after all?
Placebos can cure 1/3 of people who are cured by antidepressants.
Response:
> Of course the active ingredient is identical. But can’t there be a > difference in the fillers, excipients, etc. used in the tablets, and > couldn’t that make a difference in absorption, etc.?
It could, yes. That’s why almost all medications must have the same pharmacokinetics to be approved for sale. > With time-released the difference could be greater, no, as there could be a > different method of time-releasing the med to the bloodstream?
Yes, definitely. Some anti-inflammatories and narcotics are available in such preparations.
Response:
>This is actually true. The expensive brands say that ’substitution causes >confusion’, and it actually does in my experience. > How much confusion? Difficulty finding the right word? Forgetting > where you live?
I find that many patients – in the order of 40% – cannot name their medications and doses. And a similar number don’t know what their meds are for. Given this, I doubt very much that these patients are in fact taking their meds properly. Changing the colour and brand name on a packet every time they fill their prescription is just going to make this worse.
Response:
> I find that many patients – in the order of 40% – cannot name their > medications and doses. And a similar number don’t know what their meds are > for.
That is amazing. If true, quite sad. > Given this, I doubt very much that these patients are in fact taking their > meds properly.
Yes, that could be dangerous. Hard to believe it’s true, though. > Changing the colour and brand name on a packet every time they fill their > prescription is just going to make this worse.
Why would the color change each time? If they are regularly taking the generic equivalent, wouldn’t it be the same each time?
Response:
I have not noticed any difference at all. Jackie Davidson
– Hide quoted text — Show quoted text -> Anyone reading tried both the brand name and generic Prozac? Noticed any > difference? (Question also applies to doctors who have prescribed both, > or > pharmacists who have heard feedback from customers.) > They are identical. All generic brands must be bioequivalent to the > original. There are a couple of medications, like morphine, for which > different brands have genuinely different properties, but not fluoxetine > (prozac).
Response:
the requirements on generic also include release time, the fillers may be different but they still have to come close to putting out the same dose at the same time in the same manner, although ive read w/ some meds just that extreemly brief difference could cause problems if your allready conditioned to one or the other for a long term and then try to switch….but this was said to be rare…
– Hide quoted text — Show quoted text -> I have not noticed any difference at all. > Jackie Davidson > > Anyone reading tried both the brand name and generic Prozac? Noticed any > > difference? (Question also applies to doctors who have prescribed both, > or > > pharmacists who have heard feedback from customers.) > They are identical. All generic brands must be bioequivalent to the > original. There are a couple of medications, like morphine, for which > different brands have genuinely different properties, but not fluoxetine > (prozac).
Response:
>> I find that many patients – in the order of 40% – cannot name their > medications and doses. And a similar number don’t know what their meds > are > for. > That is amazing. If true, quite sad.
From my experience, I’d say its a bit lower. Maybe around 20% in my neck of the woods, but still staggeringly high. I sure as hell wouldn’t be popping pills just ‘cuz the doctor said so. > Given this, I doubt very much that these patients are in fact taking > their meds properly. > Yes, that could be dangerous. Hard to believe it’s true, though. > Changing the colour and brand name on a packet every time they fill > their prescription is just going to make this worse. > Why would the color change each time? If they are regularly taking the > generic equivalent, wouldn’t it be the same each time?
Not necessarily. Where I work, the corporation must be constantly reevaluating and renegotiating purchasing contracts. They frequently switch manufacturers for many of the generics, so not only do we confuse the patient when going from brand to generic, but also when the generics used are switched from one manufacturer to another.
Response:
> From my experience, I’d say its a bit lower. Maybe around 20% in my neck > of the woods, but still staggeringly high. I sure as hell wouldn’t be > popping pills just ‘cuz the doctor said so.
Check this – i used to nurse in cardiac surgery. I guess it`s the age group we typically dealt with but the first question on admission i`d ask all patients was, "Tell me why you think you are here" to check their understanding of what was going on. At least once a week i`d have a patient who honestly didn’t have a clue – "Well, Son," they`d say, "my doctor thought it was best that i came in, i`ve been having trouble you see." Ok, i`d say, so any idea what we are going to do for you? "To get me some more of those tablets, right?" Wrong. One guy came in for cardiac angiography didn`t have a clue – his doc gave him the appointment, he came in. Never occured to him to ask, never occured to his doctor to explain. Strange, strange world. Mind you, we had one lady who asked for one of those big jelly tablets for her constipation. A suppository? I asked her. "No, one of those big jelly things in a plastic wrapper." Turns out she`d been swallowing her glycerin suppositories for about 4 years. Apparently, it works quite well that way. Just a ramble. Regards, Andrew Austin. alive in Southampton, UK. — NLP, Neurology, Schizophrenia: http://www.23NLPeople.com
Response:
says… – Hide quoted text — Show quoted text -> Of course the active ingredient is identical. But can’t there be a > difference in the fillers, excipients, etc. used in the tablets, and > couldn’t that make a difference in absorption, etc.? > It could, yes. That’s why almost all medications must have the same > pharmacokinetics to be approved for sale. > With time-released the difference could be greater, no, as there could be > a > different method of time-releasing the med to the bloodstream? > Yes, definitely. Some anti-inflammatories and narcotics are available in > such preparations.
What does "pharmacokinetics" actually mean in plain English? I’m asking because I’ve definitely had different reactions to generics and brand name drugs with things other than ADs and I don’t really understand it. For example, one time I had a special fungal cream for a rash. The DAW was fine and caused no problems. Then my doctor wrote a prescription without DAW and I got a generic. Perhaps it was the same active ingredient but the cream was loaded with perfume – it irritated the skin and therefore, the generic cream was not only useless, it was actually making things worse. Supposedly they were the same thing but even the pharmacist recognized the problem and exchanged it for me. Louise
Response:
> What does "pharmacokinetics" actually mean in plain English?
Doctors differentiate between ‘pharmacokinetics’ and ‘pharmacodynamics’, and it’s a bastardization of the language. Suffice to say, they’re a description of how a drug interacts with the body. Specifically, how much of it is absorbed, how fast, how it is eliminated, how fast,whether it has active metabolites, etc. > ingredient but the cream was loaded with perfume – it irritated the skin > and therefore, the generic cream was not only useless, it was actually > making things worse. Supposedly they were the same thing but even the > pharmacist recognized the problem and exchanged it for me.
When you’re talking about creams and things, it’s likely that companies will branch off and add their own ingredients. People tend to buy over-the-counter medications on the strength of everything except its pharmacological value.
Response:
I have asked quite a few people taking various meds, what exactly are you taking? Their response was "I don’t know, I just take them cause I need them for my problem" It seems to me that most people are just to lazy to investagate or ask the Doctor what they are taking. They just like the idea of a quick fix to their problem, like the so called majic bullet and go on with their life.
Response:
>Here is what Lilly says about generic prozac on their web site: >"Generic fluoxetine is not identical to brand name Prozac in appearance. The >generic prescription you pick up at the pharmacy won’t look like brand name >Prozac. Receiving medication with a different color or shape may be >unsettling or cause concern."
I remember a hospitalized schizophrenic man who was given generic Thorazine instead of his usual brand name, and then next day he told us he had been given "Thorazine in Spanish" and refused to take anymore.
Response:
>>Here is what Lilly says about generic prozac on their web site: >"Generic fluoxetine is not identical to brand name Prozac in appearance. The >generic prescription you pick up at the pharmacy won’t look like brand name >Prozac. Receiving medication with a different color or shape may be >unsettling or cause concern."
Comment: Not if you look at it first in the bottle it usually comes in. You’ll notice that Barr has done an *unusually* clever thing with their generic fluoxitine. The Barr product comes in capsules identical in shape to Prozac, but done in blue and light blue. When viewed through the yellow anti-UV of the standard pill bottle, these look EXACTLY like yellow-green brandname Prozac. SBH — I welcome email from any being clever enough to fix my address. It’s open book. A prize to the first spambot that passes my Turing test. .
Response:
> Of course the active ingredient is identical. But can’t there be a > difference in the fillers, excipients, etc. used in the tablets, and > couldn’t that make a difference in absorption, etc.?
Generic brands must be *bioequivilant* – which means that there should not be a significant difference in absorption, etc. I’ll give you a little example. If you’re prescribed Prozac in Australia you can purchase Lovan, which is a generic brand on the Prozac prescription, providing that the doctor hasn’t checked the "Brand name only" box. There are propoxyphene tablets in Australia under the brand name of "Digesic" which contain 32.5 propox HCl and 325 mg paracetamol (acetaminophen.) The generics, Capadex and Paradex contain the SAME concentration of propoxyphene and paracetamol and yet cannot be purchased on a "digesic" script owing to the fact that the generic preparation is more bioavailable. > With time-released the difference could be greater, no, as there could be a > different method of time-releasing the med to the bloodstream?
With fluoxetine, I don’t believe this is an issue as there is only generic immediate release fluoxetine on the market (where I reside at least). The pharmacokinetics of fluoxetine (ie: its long half life, etc.) also make any difference owing to a change in the speed of absorption pretty irrelevant. -Mike — "Understand that legal and illegal are political, and often arbitrary, categorizations; use and abuse are medical, or clinical, distinctions." — Abbie Hoffman
Response:
> Also, the sarafem web site says nothing about sarafem being equivalent to > prozac. Apparently, they don’t want the sarafem users to know that actually > they are taking an antidepressant!
A short note on: http://www.sarafem.com/can_sarafem.html "Sarafem contains the same active ingredient as Prozac(R)" So the question is – are people (and the prescribing physicians) stupid enough to pay top dollar for a drug where there are generics available for cents a capsule? -Mike — "Understand that legal and illegal are political, and often arbitrary, categorizations; use and abuse are medical, or clinical, distinctions." — Abbie Hoffman
Response:
I had problems immediately with generic Prozac. I had also been on Celebrex for 1 year and had been doing fine with the combination of Celebrex and brand name Prozac. As soon as I started generic Prozac, I haddaily problems with nausea. Cut out the Celebrex and I was OK. Also, recently, I went into a bad depression. Doc asked me how long I had been on generic Prozac. I told him several months. He said to up my dose of generic, from 80 mg. to 100 mg. daily. (He said, however, the best solution was to go back on brand name Prozac. I told him there was no way I could do that ($$$).) I increased the generic Prozac and I’m feeling better. (Doc had also told me that 1 out of 4 of his patients have had problems with generic Prozac not being as effective as the brand name.) Editor
– Hide quoted text — Show quoted text -> Anyone reading tried both the brand name and generic Prozac? Noticed any > difference? (Question also applies to doctors who have prescribed both, or > pharmacists who have heard feedback from customers.)
Response:
> I had problems immediately with generic Prozac. I had also been on Celebrex > for 1 year and had been doing fine with the combination of Celebrex and > brand name Prozac. As soon as I started generic Prozac, I haddaily problems > with nausea. Cut out the Celebrex and I was OK.
Celebrex has more of a reputation for causing stomach trouble than Prozac. > 100 mg. daily. (He said, however, the best solution was to go back on brand > name Prozac. I told him there was no way I could do that ($$$).) I > increased the generic Prozac and I’m feeling better. (Doc had also told me > that 1 out of 4 of his patients have had problems with generic Prozac not > being as effective as the brand name.)
I seriously doubt that statistic. In order for the generic stuff to be licensed, it must be demonstrably identical to Prozac in every chemical property.
Response:
Keep your chin up! Jay – Hide quoted text — Show quoted text -> Thank you, Jay, and everyone else who replied. I think my response to > Ultracet (Ultram) was quite similar to yours. After about a week my > body simply rejected the stuff (this has happened to me before – side > effects worsen until I can’t tolerate the med any longer, rather than > acclimating to it). Then, when I stopped it, I had one day of the bad > reaction to the drug, followed by a few days of – I don’t know, I > guess it still being in my system or getting out or withdrawaing - > got me. I was ill for a few days, none as bad as the first. And what > makes me think serotonin was implicated is I had radical mood swings > and terrible nightmares over those few days. No energy, so lots of > sleep and lots of nightmares. One days I was depressed and suicidal, > the next day I was irritated and anxious, and at times I felt > everything was absolutely fine. I developed a rash one night that I > think was more anxiety than drug related, but as soon as I saw it I > freaked, which made it worse. > I was also extremely thirsty, my body telling me to flush out the > med, I’m assuming. > Thank you for telling me your story. It helped me understand. > Btw, the med worked wonders on my pain and I’ll hold onto it for an > as-needed crisis. Perhaps not being on a regular dose it will be > tolerable. Only time and my readiness to try will tell, though. > It’s extremely hard for me to find medications I can tolerate – > everything from antibiotics to antidepressants. Bummer, having so > many medical problems and all… but, life is unfair I suppose. I do > what I can. > Thanks again. I wanted to check in a respond since everyone was so > kind in taking the time to answer my questions. > Jen