Ask the Pharmacists

Generic Drugs

One of the most common questions we receive is, “Is my generic prescription the same as the brand name?” With the spiraling costs of medications and the restrictions of third party plans, this question is very relevant.

It would be wrong to come out and say, “All generic drugs are equivalent to their brand name counterpart.” It would also be wrong to say, “No generics are equivalent to the brand name.” We like to place brand name and generic medications into 3 groups: those that are fine to use as generics; those you should not switch back and forth between brand and generic; and those that you should not use generics.

The first group is medications that are fine to use generics. This is the largest group. It is for nearly all prescription medications. Medications for blood pressure, infection, pain, ulcer, allergy and most all other prescriptions are perfectly fine and pharmacologically equivalent with either the brand or generic.

The second group is medications that you should never switch back and forth from brand name to generic. This group is mostly composed of hormone replacement drugs such as thyroid hormone drugs (Synthroid), estrogen replacement drugs (Premarin and Estrace), and oral contraceptives (Ortho-Novum, Demulen and Desogen). The generics are as effective as the brand name, but sometimes the body can sense a difference between the two. More than once, we have been told “I feel different, “ or “I’m a little more nervous,“ when people switch from a brand to a generic or vice versa. With these medications, we suggest starting with a brand or a generic and sticking with that choice.

The last group is for medications that should not be used generically. There is a small handful. Dilantin (an epilepsy medication), Lanoxin (a heart medication) and Coumadin (a blood thinner) are medications that in our opinion should never be used generically. These drugs have shown to have potentially dangerous effects when used generically. Unfortunately, some third party plans require generics with these. In that case, your prescriber should be notified when generics are used.

Because of the tremendous cost savings with generics, we recommend using generics whenever possible unless you are taking one of the drugs listed in group number three or you have started with a brand name found in group number two. If you are unsure if a generic medication is right for you, ask you doctor or pharmacist. Ask them what they would take if they or someone in their family needed that medication.

November 2003