Why Do Different Manufacturers Of Pills Have Varying Effects

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Maggie Says:
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Does anyone know if you get a different looking pill from another pharmacy of the same medicine but a different manufacturer makes it, would it make you feel different? I know that question doesn't make sense but I don't know how else to word it. *I revised my question a little different. I went to a different pharmacy to get my prescription filled the pills were different looking and from a different manufacturer. Would the pills make you feel funny if not from the same manufacturer you had been taking for years?



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Verwon Says:

Hello, Maggie! How are you?

Yes, your question actually does make sense, so please don't worry, or feel the need to apologize.

Under the Hatch Waxman Act of 1984, generic medications are allowed to differ from the name brand, in the amount of the active ingredient, by as much as plus or minus 20%, this was done to help bring generics to market faster, to create competition, and try to keep prices lower. However, they do not have to measure against each, only against the name brand. Thus, one generic could vary from another. For example, if you were taking a 100mg tablet of any given medication, then receive one manufactured by a different company, that new one might match the original exactly, or range anywhere from being as low as 80mgs, or as high as 120mgs, in the amount of the active ingredient(s).

Thus, overall, the answer is yes, it could make you feel different, either due to increased side effects, or due to withdrawal effects, depending on the fluctuation involved.

Is there anything else I can help with?

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Kay Says:

They can. My pharmacy switched suppliers for my generic tranxene & the new pills do not work as quickly or as well for my anxiety. I talked to the pharmacist & he just shrugged his shoulders. Said he couldn't get it from the other supplier. BTW the 2 suppliers are Mylan and Taro. Taro is the inferior one.

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Topazthecat Says:

Here is a great April 2019 TV news interview with former FDA associate commissioner Peter Pitts about generic drugs and the problem of many pharmacies constantly switching to different generic brands and how they have different inactive ingredients that cause many people side effects and how most of the US generic drugs come from overseas and how this can allow mistakes to be made including the recent recalls of high blood pressure medicines like Valsartan etc being recalled because of having cancer-causing substances.

nbc25news.com/news/healthy-you/generic-drugs-can-come-with-risks

I had used some generic brand that I don't remember many years ago of Metatropal for heart palpitations with no side effects, and last year my nurse practitioner prescribed it to help lower my recently diagnosed high blood pressure, and I felt sick as soon as I took it, and I took it for days hoping my body would get used to it and adjust to it, but it didn't!

Then I asked for a different generic and I felt 100 times better, but it wasn't lowering my blood pressure that much so the nurse practitioner prescribed 50mg of Losartan with 12.5 HCTZ, but this wasn't lowering my blood pressure enough, and I tried 100 mg but it was too strong and upset my stomach and made feel sick, so I asked the nurse practitioner to prescribe 25 mg of Losartan without the diuretic, in addition and that only lowered it a little more.

And my pharmacy first had given me the generic brand Alembic for the 50 mg of Losartan, which was a softer different shaped pill, and I can't swallow pills, and this pill doesn't have a line that I can cut with my pill cutter, so I have to wet it with a drink and bite it into two pieces, and then my pharmacy switched to another brand, I don't what it is because they just have the abbreviation of the name, but it's a much harder pill so it's harder to bite it, I have to wet it longer in my mouth, and the pharmacy says they can't get the other brand anymore.

I had hardly slept at all in several months after being diagnosed with high blood pressure and the medications not lowering it enough, I was terrified that I was going to have a stroke or heart attack in my sleep. Finally the doctor who works in the same home MD practice came and met with me only once in February 2019 and he prescribed 25 mg of a beta blocker, Atenolol in addition to both Losartan medicines, and at first after taking it for a little while it reduced my blood pressure down to normal where it used to be not that long before when I had normal blood pressure without any medicine.

I had no bad side effects taking this, until my pharmacy switched to another generic of Atenolol made by Zydus which made me sick, so I asked them to please get the first brand and they did and they even told me this is the brand they usually get.

My blood pressure has gone up a little though since I had first started taking it.

Just very recently after I had been taking the 25 mg of Losartan of the brand Aurobindo for 3 months which was a light green pill, and my pharmacy had switched generics to a white pill that made me feel sick as soon as I took it, but I took it several days alternating with the other brand that I had about 2 weeks worth left of, hoping my body would adjust to it, but this never happens.

I have since found out that the FDA wrote a warning letter to Aurobindo too for doing bad practices including having rust on the equipment they manufacture their drugs etc!

fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/aurobindo-pharma-limited-577033-06202019

It turns out that this is the same brand of Losartan, the Indian company Camber including 25 mg, with the same exact NDC number, and including a 90 day supply, that the FDA recalled just months before in February 2019 for having a cancer-causing ingredient NMBA!

fda.gov/safety/recalls-market-withdrawals-safety-alerts/camber-pharmaceuticals-inc-issues-voluntary-nationwide-recall-losartan-potassium-tablets-usp-25-mg

Camber Pharmaceuticals, Inc. Issues Voluntary Nationwide Recall of Losartan Potassium Tablets, USP, 25 mg, 50 mg and 100 mg Due to the Detection of Trace Amounts of N-Nitroso N-Methyl 4-amino butyric acid (NMBA) Impurity found in the Active Pharmaceutical Ingredient (API) FDA

This recall was prompted due to the detection of trace amounts of N-Nitroso N-Methyl 4-amino butyric acid (NMBA) a possible process impurity or contaminant in an active pharmaceutical ingredient...

fda.gov

And so has Zydus...

fiercepharma.com/manufacturing/zydus-cadila-injectables-plant-slapped-fda-warning-letter-over-cleanliness-issues

So I called the pharmacy and told them about this and asked if they could please get the other brand back, and they said to call back in a few days after the pharmacist I spoke with said she would ask the woman who is in charge of ordering the medicines, and when I called days later she told me that they can't get this brand anymore and suggested I call other pharmacies and see if they have it and they would transfer my prescription over to them.

So I called CVS who I used to go to for years and who are only about a walking block away, and they do carry this generic, so I had to call my nurse practitioner and get a new prescription since it was already recently filled for a 90 day supply. But my insurance company said it was too soon to refill it, and they did this for me before when I had a situation like this, so I called my nurse practitioner and asked her to please call my insurance company and explain the situation and get an override for the new prescription, but she actually refused and said it's my responsibility to call, and that's not really true, most of the time the insurance company needs to have the doctor call about this.

And this is even after the nurse practitioner had just been at my house days before checking my blood pressure, and she told me the same thing she told me before when I felt sick on the other generics, that she believes me because one of her patients was taking the same pain medication for years that was helping her with her pain, and then the pharmacy switched to a different generic and it did nothing for her pain.

And just recently before she said I should tell the pharmacists that they should make a note of what generic brands make me sick, and I said I already did this, and she said big pharmacies don't really care about this, private pharmacies care more. I even had told her that CVS and my insurance company said they can't fill the new prescription with the other generic until November 5, and this was October 1, so she actually expected me to take a generic medicine for a month and 5 days that was making me feel sick, and it's a necessary medicine that I have to take to lower my blood pressure!

So I called CVS back and I asked them how much it would cost to pay for this prescription, and the woman I spoke to said a 90 day supply would cost a 100$ which I can't afford, so she said do you want me to check a 30 day supply, so I said yes, she told me it would be 44$ so I asked isn't there any discount? And she checked something with a card, and found me in their system from years ago, and said yes, there is and a month supply is 11.88 so I had to buy it out of my own pocket which is really wrong.

My nurse practitioner had called my insurance company many months before and said she was on the phone with them almost 3 hours to get the brand name of Benicar for blood pressure because my father has been taking it for 20 years and it really lowered his blood pressure, but unfortunately, it caused my IBS to act up bad and I had to go back on the Losartan, this was before the doctor had prescribed the Atenolol in addition to the Losartan medicines.

I recently asked my pharmacy to get a different generic of Xanax because it was making me feel not well, and they did get a different brand but I only felt a little bit better, I never had a problem with other generics of it from different pharmacies in the past. Also I have IBS for 26 years now off and on with bad pain, which goes away for 4 or 5 months, but unfortunately comes back, and that's the only symptom I ever got from it, well a GI doctor prescribed the only medicine that finally took my pain away, it was the Mylan brand of Bentyl which I took for years, and then when pharmacies switched generics I tried 3 others including a liquid and none of them took the pain away like the Mylan brand did, and I used to open up the little capsule and mix it in sugar-free flavored water because I can't swallow pills,( although recently I have been able to swallow the little capsule) and only the Mylan brand dissolved in the water.

But the Mylan brand has been on backorder for the Bentyl for so long, first, they told me in January of this year they were going to have it by February, then I call in February and they now claimed they were going to get it in September, so I forgot about them and luckily I tried a new brand that also really helps with the pain, and I really hope that my pharmacy continues to get it in, they said they usually get that brand.

Some pharmacists I have spoken with act as if they don't know or understand that it's a reality and fact that different inactive ingredients do have different side effects on many people, and or are not effective, but I had spoken to several pharmacists in the past who did say they know that certain fillers and inactive ingredients in different generics can do this.

It's really wrong and terrible that pharmacies can and do, do this to patients! I'm no longer seeing this nurse practitioner and I need a primary care doctor now. I also spoke with a pharmacist at the FDA yesterday who disturbingly didn't really know or understand that much about this.

How Differences Among Generics Might Effect Your Patient's Response by psychiatry and pharmacy professor Vicki L Ellingrod University Of Michigan

mdedge-files-live.s3.us-east-2.amazonaws.com/files/s3fs-public/Document/September-2017/0905CP_SavvyPsych.pdf

Can different manufacturers of the same generic drugs have different side effects? Absolutely!! It's difficult to find information confirming this, but I can speak from personal experience in saying that with some medications I have noticed differences in efficacy and side effects when I have had to change to a different pharmacy that uses a different manufacturer for their generics.

How can the same prescription drug made by different manufacturers cause different side effects? - Quora
While the active ingredient remains the same, different manufacturers use different inactive ingredients as the binders and fillers. Different manufacturers may also use different colorings and coatings, all which could cause different side effects...

All Generics are not Created Equal - Valisure The Valisure Notebook
valisure.com/blog/valisure-notebook/all-generics-are-not-created-equal

All Generics are not Created Equal: Variability in generic drugs between manufacturers is an industry-wide problem and patient complaints about generics could be related to variations in dosage and formulation.

Here is a new New York Times great important best selling book by award-winning journalist Katherine Eban:

Bottle Of Lies: The Inside Story Of The Generic Drug Boom

Many Patients Got Bad Side Effects When Switched From 1 Generic Brand To Another!

npr.org/sections/health-shots/2019/05/12/722216512/bottle-of-lies-exposes-the-dark-side-of-the-generic-drug-boom

'Scary World' of Generic Drug Manufacturing, revealed the majority of generic drugs are manufactured overseas, and "the [US Food and Drug Administration] FDA was essentially regulating on an honor system," Eban told Medscape Medical News. The agency ...

"Many have hailed the widespread use of generic drugs as one of the most important public-health developments of the twenty-first century. Today, 90 percent of our pharmaceutical market is comprised of generics, the majority of which are manufactured overseas." - Katherine Eban

Is there anything I can do about this?

Thank you!

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Archie Says:
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It's simple,it's the strategy to outdo other brands,bec some manufacturers use less amount of ingredients to produce a tablet which makes it not effective 100%.hence it also depends on the level of deaseas or infection.

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