July 2008
Challenges to generic drugs
Soon after the antidepressant bupropion XL came on the market last year some patients complained on the Internet that it didn't
work as well as the brand-name version, Wellbutrin XL. Others reported similar problems with metoprolol XL, the generic version of Toprol XL, a drug that lowers blood pressure. The Wall Street Journal and other organizations then publicized those concerns. Should
you be worried?
Generic drugs must have the same active ingredients as their original versions, but can contain different inactive ones. That can alter how they look and taste, which some people don't like. A small number of people may also have unexpected reactions to those inactive ingredients. And switching from any medication-brand to generic, generic to brand, or brand to brand-should be done with care, since even minor formula changes might have unexpected and potentially harmful effects in some individuals
But evidence suggests that generics, including generic bupropion XL and metoprolol XL, are still safe and effective. A re-analysis from the Food and Drug Administration, reported in April, concluded that the generic and brand-name versions of bupropion XL differed from each other no more than different lots of the brand-name drug typically do. And while the FDA hadn't reviewed metoprolol XL by the time we went to press, the Prescriber's Letter, a respected publication for pharmacists, concluded in May that despite the anecdotal reports there was no "evidence that these drugs differ in efficacy."
We recommend starting with a low-cost generic whenever possible. That not only makes switching later on unnecessary but also allows you to enjoy cost savings sooner. If your pharmacist recommends switching from a drug that you're already on, talk with your doctor first. He or she might have good reasons to keep you on the original medication or might need to monitor you extra carefully after a switch.
This article first appeared in the July 2008 issue of Consumer Reports on Health.
Generic drugs must have the same active ingredients as their original versions, but can contain different inactive ones. That can alter how they look and taste, which some people don't like. A small number of people may also have unexpected reactions to those inactive ingredients. And switching from any medication-brand to generic, generic to brand, or brand to brand-should be done with care, since even minor formula changes might have unexpected and potentially harmful effects in some individuals
But evidence suggests that generics, including generic bupropion XL and metoprolol XL, are still safe and effective. A re-analysis from the Food and Drug Administration, reported in April, concluded that the generic and brand-name versions of bupropion XL differed from each other no more than different lots of the brand-name drug typically do. And while the FDA hadn't reviewed metoprolol XL by the time we went to press, the Prescriber's Letter, a respected publication for pharmacists, concluded in May that despite the anecdotal reports there was no "evidence that these drugs differ in efficacy."
We recommend starting with a low-cost generic whenever possible. That not only makes switching later on unnecessary but also allows you to enjoy cost savings sooner. If your pharmacist recommends switching from a drug that you're already on, talk with your doctor first. He or she might have good reasons to keep you on the original medication or might need to monitor you extra carefully after a switch.
This article first appeared in the July 2008 issue of Consumer Reports on Health.
