Why do my pills look different each time I fill the same prescription?

Consumer Reports News: May 25, 2012 08:58 PM

Q: I've been refilling the same generic drug prescription at my pharmacy for months without incident, but this month, I was given pills that are a different shape and color. The pharmacist says are the same medication. Isn't this confusing? Why does it happen?

A: Yes, it is confusing, and unfortunately, it's fairly common. The same generic drug, made by a different manufacturer, can indeed look different. Due to certain patent laws that govern brand-name medications, generic drug manufacturers are not allowed to copy how a brand-name pill looks in terms of its shape, its color and its size. Additionally, generic drug manufacturers can also take it a step further by producing generic pills that look different from another manufacturer's generics pills.

Then, because pharmacies often change suppliers—or their wholesalers do—a pharmacy's own stock of a particular generic drug may continually rotate. The result is that you might receive different looking pills from month to month, even though it is for the same generic medication. "The ideal situation is that your medications stay standard and constant, but we know that's not always possible," says Allen Vaida, PharmD, executive vice president of the Institute for Safe Medication Practices.

Sometimes, insurance companies or pharmacy benefit managers are to blame. Either group may change the generic drug companies they work with, which could also result in receiving pills that are a different color, shape or size, says Vaida.

Many people don't inspect drugs they've purchased until they get home. Seeing unfamiliar pills could be problematic—you might call or return to the pharmacy for answers. "This confusion could be resolved if a person takes a look at his or her medication before they leave the pharmacy," Vaida says.

If you're tech-savvy, you can determine whether you've got the right medication with Drugs.com's Pill Identifier. Search by shape or color, the drug's name or the letters or numbers that appear on it, also called an imprint.

Problems might still occur even after you've confirmed that the unfamiliar pills are the correct ones. For narrow-therapeutic-range medications such as blood thinners, antiseizure drugs or thyroid medications, our medical consultants recommend staying on a generic drug made by one manufacturer. That's because there can be very small variations among the same generics with different manufacturers. Although it is allowed by the FDA, it could affect some people's response to the medication. (These sorts of differences can sometimes even be found between the same brand-name drug that is manufactured at different times.) Our medical experts say talk with your pharmacist if you are concerned about this issue to assure that you are able to receive your medication from the same manufacturer each month.

A different looking generic drug can also be dangerous for those who mix several pills in one bottle. "They're depending on color or shape to differentiate, such as 'The white pill is for my heart, and I take it in the morning. The pink one is for high blood pressure, and I take it twice a day,'" Vaida says. "If people get into that groove, and then there's a switch, that could confuse them."

Rather than mixing, organize drugs in a weekly pill box. Your pharmacy may be able to help with this—and some may even offer it as a special service.

Lisa Fields

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