Generic Medicine - Are They As Good As The Brand?

Are generic medicines just as good as the brand? In theory, yes generic medications are just as good when it comes to clinical effect and safety. But for some medications you can see differences in how they work for you.

When a new drug comes to the market, the Food and Drug Administration (FDA) gives the drug company a exclusive rights to produce and market the drug until their patent runs out. In order to do this, the new company has to show the FDA that their version of the drug is bioequivalent to the original.

Here’s a simplified version: a generic drug is bioequivalent if there is no significant difference in the way the active ingredient of the drug becomes available in your body if you take it at the same dose as the original. A significant difference is defined by bioequivalence limits which the FDA sets as 80% - 125%. These percentages refer to the range of the peak concentration of the drug and how much is absorbed over time.

Excipients are the inactive ingredients that are not held to the standard of bioequivalence. These inactive ingredients can make a difference in side effects and how the medication works for you. Some examples of excipients:
Fillers
Binders
Coating – enteric coating
Disintigrants
Sweetners
Vehicle – liquid formulation, example mineral oil
Disclaimer: All of the information on this channel is for educational purposes and not intended to be specific/personal medical advice from me to you. Watching the videos or getting answers to comments/question, does not establish a doctor-patient relationship. If you have your own doctor, perhaps these videos can help prepare you for your discussion with your doctor.

[bryanlagalo]

Imagine a patient getting a refill that affects them at 80%, and then a month later getting yet a different brand that affects them at 120%. Then the patient complains about side effects, but both the doctor and pharmacist explain it's all in their head.

[mattderusha]

I hadn't understood all of these differences you described. Thanks for making the video Dr. Marks!

[utubevideoful]

4:00 difference between concentration and absorption
4:51 different manufacturers can use different agents to produce the drug, and those different agents can make a difference in the side-affects that you experience

[JHabc]

This was a really helpful explanation. I knew that generics could be different, but never quite understood why or how they could get approved anyway. I take a very rarely used old medication for a Neuorological condition and started having a lot of side effects and returning symptoms after my pharmacy kept changing the brand of the drug. I had to go through quite a bit of trouble to find a pharmacy that would order the brand name for me, but I felt so much better. Then the company stopped making the brand name version and I had to go through a frustrating process to find a generic version that worked for me. I ended up looking at a pretty technical fda website that listed the fillers and showed a diagram of the chemical structure of all the different versions, and went to my pharmacy with a list of the ones that looked closest to the brand and found one that still worked well.

[BearMcBongwater]

Hi Dr. Tracy!!
I came here from your video on managing bipolar and I just wanted to hop onto a newer video so that you're more likely to see this

I just want to say THANK YOU SO MUCH. I rarely ever find people I enjoy listening to because I always feel like they sound like they're speaking to a child or they just don't have any qualifications to be speaking on the matter and your video is the first video I've watched start to finish, made notes on and even went and did some further research on the things you mentioned to add to my notes and I've just had such a wonderful day putting all my energy into this.
I love the way you speak and you have such a soothing yet firm voice. I would do anything to have you as my psychiatrist xD
Again, thank you so immensely

[TheNeoMosala]

I swear you have videos on every subject I need info on. Thank you!

[simplyme]

Thanks for the video. Dr, I hope you have time to talk to us about grief and psychological impact of grieving. Thanks again.

[Deba]

Wow! I'm an RN and I never heard this before! Thank you!

[IoSapsai]

Really late to the party but one thing I've noticed in my experience (pharmacist) is that it also depends on which country you live in. Generics, produced in my country tend to be of much lower quality due to the poorer QC. I constantly get complaints from patients that their meds don't work well or at all (!) compared to other generics/brand name.

I myself was burned while stopping escitalopram and went on a generic (from a Cypriot brand) which was 4 times cheaper than the Lundbeck brand name. The tablet was at least twice as large and I just couldn't stop it without side effects. Switched to brand name and tapering was much easier.

These days I try to go for brand name whenever possible or at least find the most reputable company that produces the generics. Sadly not everyone can afford it but *most* generics are of high enough quality (and they should be by law) to be proper substitutes.

[jacquelinelundberg]

Both me and my husband have Concerta and we have tried the generic brands of methylphenidate aswell. Most of the generic types had a huge difference in effect and some of them even gave us huge side effects compared to the main brand. My husband with one type got very angry when the medicine were going out of the system (which never happens otherwise) and another one gave us both the feeling of bad conscience and felt like we were avoiding something very important despite this not being the case. Very strange and interesting how ingredients outside of the active ingredient can affect us so much.

[SilentRunningRedux]

Well done as an introduction. For those allergic to the “inactive” ingredients or the solvents etc used to make different formulations, substituted manufacturers, or generic instead of brand, can lead to serious side effects and DEATH.

[leenaa]

Great video as always, Thank you!!
Finally I knew the reason why some meds haven’t worked as good as before and we thought it’s about tolerance. ❤️

[katymcfine]

Generics medicine regardless of manufacturer is same effectiveness. but sometimes Doctor preferred to prescribe Brand names medicine. why there is a huge difference on the price between Generic medicine and Brand medicine? we are not on the medical field so we can't understand how drugs works and metabolise on the body. we are only ordinary people and sometimes doctors preferred not to discuss important details of a course patients illness and including adverse effects of medications especially "maintenance" medications like hypertensive and diabetes medications. Thank You Doctor Tracey for discussing important details that are not normally talked or discussed in a clinic room. You made every topics clear, now it both saves patients and doctors time and consultations makes it possible because we are now fully aware that our illness is now curable now a days due to advance technology and medical research. Thank You for making This videos to reached out in every patients understanding regarding there scope of illness and how a doctor can help us patients and how a miracle drugs can change and transformed our lives. all your vids is mainly to educate and make public awareness especially People suffering from mental illness and there family. a Doctor can saves a persons life.

[jens]

Thank you. I’ve learned so much from your videos since I subscribed!

[jebconde]

Your anxiety videos help me a lot. Thank you Dr!

[natashiajohnson]

Hi Dr. Marks. I really appreciated the video. I will make sure when I find another good brand of the lithium to request it. As I mentioned before the lithium up north was more potent than the one in Central Florida. They hospital pharmacy that I went to up north a while back has closed so I'm not sure which brand to ask for. Anyway hopefully this new well known pharmacy is just as good. Thanks for the heads up.

[christineboegli]

very interesting, Tracey. I knew about those differences, but not in detail. Switzerland doesn't insist so much on those. Thanks anyway for your constant teaching. Appreciate it! Have a lovely week-end and splurge on the Omega 3! I will, , ,

[vezinam]

Very interesting Dr. Marks. I have a medication that will be generic starting later this month. I take other generics, so I’m not concerned. At least now I know what may be different, and look to see if side effects change. Who knows, the side effects may be less. 🤔🙂

[cuttingedgecool]

Excellent explanation of the differences between a generic and the original brand name drug.

[mangos]

Late to the game but I did find a difference with going from name brand to generic lexapro/escitalopram when that released. Kept getting told it was the same as name brand by my PBM. Name brand is on the PBM exclusion list now. I changed rx altogether. Thanks for sharing this information!