Generic Medicine – Are They As Good As The Brand?



our generic medications just as good as the brand I'm gonna talk about why you may notice a difference when you take certain generic medications I'm dr. Tracy marks a psychiatrist and I published weekly videos on mental health education and self-improvement so if you don't want to miss one click subscribe and notifications so to cut to the chase in theory yes generic medications are just as good when it comes to clinical affect and safety but for some medications you can see differences in how they work for you and I've seen the this variability most with bupropion which has the brand-name wellbutrin and that's what I'm gonna use as an example in this video when a new drug comes to market the FDA gives the drug company exclusive rights to produce and market the drug until their patent runs out GlaxoSmithKline lost their patent protection for wellbutrin in 2006 paving the way for other companies to come in and make bupropion in order to do this the new company has to show the FDA that their version of the drug is bio equivalent to the original wellbutrin what does it mean to be bio equivalent there's a very complex definition of that on the Code of Federal Regulations website in I have a link to that in the description if you want to read through it and have fun with that here's a very simplified definition according to the FDA a generic drug is bio equivalent if there's no significant difference in the way that the active ingredient of the drug becomes available in your body if you take it at the same dose as the original there's a couple of key words here that get to the heart of how generic medications can work differently the first is no significant difference this is not saying that the drugs have to be identical they just can't be significantly different so what's considered significant difference a significant difference is defined by bio equivalence limits which the FDA as 80% to 125 percent these percentages refer to the range of the peak concentrations of the drug and how much of it is absorbed over time for you science enthusiasts that would be the area under the curve so let me show you what I mean this is what a drug activity curve looks like you take the medication it's digested and goes into your bloodstream then it goes to the part of the body that it's supposed to be used for in this case our brain so looking at this curve after the drug gets into your bloodstream it reaches a maximum concentration in your blood then as a drug is metabolized and broken down the levels drop with bioequivalence let's say wellbutrin reached a concentration of a hundred in five hours then drifts down to a really low levels in 24 hours this section here is how much stays in your body and for how long the generic can come along and reach a peak that's 25 percent higher than wellbutrin or 20% lower how long it takes to get to this maximum can also fall in this window do these differences matter maybe it depends on your sensitivity to the drug it could be that this is just what you need to have enough in your system but then the next time the pharmacy uses a different manufacturer and your curve looks like this this lower concentration may be just enough difference to change how it affects you alternatively the next month you get another manufacturer and you your curve looks like this this higher spike may give you more side-effects okay so maybe you aren't that sensitive to that twenty percent difference in concentration and absorption here's the main reason though that I think you could see a difference in the generics the rule of bioequivalence refers to the active ingredients bupropion is the active ingredient but with all medications there's lots of inactive ingredients and they're called excipient these in active ingredients are things like fillers to bulk up the medication coatings flavorings disintegrates which are the agents that help dissolve it another active ingredient is called the vehicle the vehicle is the substance that you used to get it down so an example of this would be the liquid form of a medication a common liquid used is mineral oil so different manufacturers can use different agents to produce the drug and those different agents can make a difference in the side effects that you experience and how it's absorbed in your body so does this mean your generics aren't as good no it doesn't for many drugs there just isn't much difference between the brand and the generic so you don't want to just insist on brand for every medication just because you think that it's going to be that it's not as good and this goes for over-the-counter medications as well because you can end up spending a lot of money unnecessarily but if you've been taking a medication for a while and you notice that you don't feel the same on it or you have new side effects check to see if the pills look different or if you have a different manufacturer than you have before you can usually see what company made the drug if you look on the label it's typically at the bottom of the of the bottle and I'll say MFG sometimes you can request a certain manufacturer you can still get the generic price but sometimes the only way to control for side-effects or effectiveness is to request the brand only and some insurances will pay for the brand but just make your co-payment higher last tip there's an online site called good Rx and they have an app if you prefer using an app on this site you can use you can get coupons for discounted medication and you don't even need to register with the site it's also good for seeing how much medications cost at different pharmacies you can enter your zip code and the medication and then see how much the price is from pharmacy to pharmacy so it's good for checking on prices even if you don't want to use the coupon share this video with someone who you say could use it and like the video if you like it thanks for watching see you next time

31 comments

  1. 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,,,

  2. 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.

  3. Thanks Dr. Tracey, in New Zealand we have had major issues with the generic version of EFEXOR-XR which is now the only version funded by Pharmac, the governing Dept. controlling what drugs are funded. Fortunately the original is still available, for those that can afford to pay for it.

  4. There IS SOMETIMES A BIG DIFFERENCE (in terms of concentration of useless chemical isomers/enantiomers of the active ingredient as well as effective absorption), and I have (unpleasantly) experienced them! Isomers are chemically similar to the original ingredient and often ignored in quality tests, but are different enough to make them often have a different or no effect.
    Pharma companies in the U.S. apparently no longer have show country of manufacture on their label.
    Pharmacies and Insurance Co.s make higher percentages of profit selling the CHEAPEST version of a drug.
    And the name brand medicines are often beyond expensive. Too bad? Don't expect our government to care about protecting consumers from polluted medicines…not anymore.

  5. @Dr. Tracey Marks great video, this was the most informative video I've seen so far on the subject of generic vs. brand name prescription medication differences. What about the potency and purity of the active ingredient? For example, generic fluoxetine 50 mg tablets compared to brand name Prozac 50 mg tablets. If someone tested these two different tablet forms of fluoxetine 50 mg in a chemistry lab using sensitive equipment, would they find the exact same quantity of the fluoxetine molecule inside each tablet, 50 milligrams in both, or is there a molecular purity tolerance range?

    Does the 80% to 125% range only cover the materials and methods used to package the active drug molecules in a tablet with inert ingredients to change metabolism and blood concentration over time (e.g… Fluoxetine HCl vs. Fluoxetine Bitartrate)? In other words, is the 80% – 125% acceptable range only for blood concentration or does it apply to quantity/mass of the active drug molecule? Thanks!

  6. Interesting. I get my medication through the clinic for $7. If I was to get my medication from a pharmacy such as walgreens or cvs through no low income assisted program. The medication would cost I assume several times more.

    And perhaps the medication would be of different brand and quality

  7. 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

  8. 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. 🤔🙂

  9. Okay so my meds don't feel right. When I take it(lamotrigine) it makes me feel like I'm floating and weak and dizzy. Kind of like I'm high.

  10. You try to do this video scientifically.. the easiest way to say is yes generic drugs and brand-name drugs are different.. the reason is because of the fillers that are used and are not regulated by FDA.. there you go sums it up

  11. 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.

  12. I take Latuda, and I hope 🤞🏽 a genetic comes out. It is soooo expensive , my insurance won’t cover it 😢. I get samples now till January where my insurance will after I pay $500.00 kickin. But the Latuda 80mg causes my legs to cramp so bad, I have started cutting them in half. Taking 1/2 in the morning, and 1/2 in the evening.

  13. Great information. It confirms what I have noticed when taking the brand vs generic of the Proton Pump Inhibitor, Rabeprazole. When taking the brand I can get by with around 2-3 a tablets week, it lasts for ages in my system. I can stop it and I'll only start getting symptoms returning after 2 weeks of stopping it. When taking the generic I have to take it every single day and if I miss a day, I notice symptoms returning pretty quickly. A stark difference for something that is advertised as being "equivalent". Very misleading, but this video clears it all up for me and confirms that I am not imagining things. Thanks for the content.

  14. Hello Dr. Tracey
    When i take SSRIs after a while they make my feelings numb this feeling made stop taking it and stop seeing a doctor and keep switching meds and doctors.. when i discuss this with my doctor they deny that this meds made this feeling. . I've been on prozac, celexa, lexapro and now zoloft. Why SSRIs make me lose my feelings and motivation and make me dull? Right now I'm barley holding my self not to quit therapy again.

  15. Great response, I've been asking myself this question for ages!
    Please tell us why half life matters? I mean, why do some medications like Effexor only exist (I believe) by prolonged delivery?

  16. 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

  17. I have to take name brand lamictal and not Lamotrigine because the Lamotrigine dissolves too faster which causes me to throw it up so it never gets in my system. So for me Lamictal name brand is very necessary

  18. My doctors okay generic on all my meds, including the ones for my bipolar II disorder, except for my thyroid medication. They specify Synthroid brand for that. Of course it costs a lot more. I need to ask about it. My Lamictal generic recently started coming from a different manufacturer & it freaked me out a little. My lamotrigine has never been that color or that shape. It matched the description on the bottle but it still made me uneasy not being 100% sure I had the correct tablets. Thanks for the information. I think I'm going to watch this video again!

  19. Good info. Pharmacists should send patients to this video when they raise the question.

    A bit unrelated to this topic, I was wondering what was your opinion on the new trend of online therapy. A step in a good direction?

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

  21. Thanks Dr. Tracey for this video. I went to the pharmacy to pick ip my medicine and the young guy tried to tell me that the generic is the same. I made this joke that is not what i learned on sesame street. It is not the same. Lol. So i did not take the medicine instead had to go to another pharmacy to get the brand. And another visit to the same pharmacy the manufacture name changed. So i said this is bot the one i have been taking. So they gave me the the medicine from the previous manufacture. I asked them why did they change it. Again. It is not different. Of course. Now i am going to opt out and also get that drug in brand. Yes i am one of those who have sensitivity to drugs. A children Claritin works for me than the adult. If i am going to be on a drug for a long time. I told my doctor. Lets stick to the brand. That away i don't have to go through too many manufactures and i can have fewer side effects. I always ask why was i so sleepy on one med this time and not the other time. My doctor told me it don't make me sleepy. I look at him and said i am not you. And you probably not taking the off brand. He looked at me. Again he put no generics. I am finding it hard to get brand names from pharmacies. Unless it is on line. What do you think about the online pharmacy. It was not my favorite at first. This is the only way i get my brand unless i want to drive to the good neighborhood where my friend tell me to g and then it become a we don't carry it. So i am doing online now. And i am happy with it. Sorry so long.

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

  23. Hi doctor.. looking forward to watch video on a anxiety symptom" feeling like loosing mind/ going crazy" . Please

  24. Yeah it is I’ve used generic medicine forever so had my family. Non generic is just more expensive to make you broke and make greet people more wealthy.

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