Brand vs. Generic Medications – Does It Matter?
February 23, 2011
Taking prescription medications can be cumbersome. It certainly challenges ones working memory skills to remember the names of medications we take, the dose, what time of day to take it, what the pill is for, the side effects, where we store it in the house so we can find it when we need it, when to call the doctor for a refill, the list goes on. To add more confusion to the mix, most prescriptions have two names, the brand name (like Benadryl) and it’s generic name (diphenhydramine). So I’ll share a question patients frequently ask me – does it matter?
Traditionally when medication is first approved by the FDA there is a patent placed on the newly “branded” drug. After a certain number of years the patent expires and any other company is welcome to make a copy-cat “generic” of the drug. Is there any difference between the original and the copy? Yes. Does it matter? That depends on who you ask. My opinion -ultimately it depends on the person taking the drug – the patient!
When generics are manufactured, the FDA allows a slight deviation from the amount of active ingredient compared with the original branded version of the medication. Maybe Brand X has 32% of the active ingredient and Generic X has 30%. Probably not a noticeable difference clinically for most people. But, where brands and generics differ the most are in the filler components – the stuff that literally holds the tablet together. These filler components can be completely different, resulting in the pill looking nothing like the original one. The size, shape, and color may be may be unrecognizable when you go to pick it up at the pharmacy. The name – the generic name – may be unrecognizable as well. This is a source of many frustrated phone calls to our office from patients worried that the pharmacy gave them the wrong bottle.
Rule of thumb is that most generics will work fine for most people. However, there are some exceptions so certainly let your doctor know if you are experiencing any change in symptoms or side effects when going to a generic. For example, you could be allergic to the red dye coating of generic Y that wasn’t in brand Y. Or your child may have trouble swallowing generic Z because it’s twice the size of brand Z.
Cost cutting is generally driving the substitution of generic medications in place of the brand. That’s good news if both drugs are equally effective for you. But if you have noticed differences in effectiveness or side effects, ask your doctor to contact your insurance company to do a “Prior Authorization” requesting coverage for the brand. It will usually take 3-5 business days for your insurance company to respond to the doctor’s request so patience and planning are helpful in these situations.
Link found between APGAR scores at birth and future risk of ADHD
February 14, 2011
According to a recent study in the Journal of Pediatrics, Neonatal Health Can be Associated With Risk For AD/HD.
ADHD is known to be highly genetic. Approximately 77% of the time someone diagnosed with ADHD has the condition because of the genes they carry. However, genes are not the only factor. Researchers are finding other issues can “correlate” with ADHD. In this recent study published in January’s Journal of Pediatrics researchers show that neonatal health is an important risk factor for ADHD.
An astounding 980,902 children born in Denmark between 1988-2001 were monitored. The baby’s health immediately after birth was measured by commonly used Apgar scores. Then all children were followed from age 3 until a diagnosis of hyperkinetic disorder, a first medication for ADHD, migration, death, or the end of 2006, whichever came first.
The results – The lower the Apgar score the greater the risk for the child developing ADHD. Compared with children with Apgar scores of 9 or 10 at 5 minutes, the risk for ADHD was 75% higher in children than with Apgar scores of 1 to 4 and 63% higher for those with Apgar scores of 5 to 6.
Doctors concluded from this study that a low Apgar score is associated with risk of ADHD in childhood. Perhaps low Apgar scores and ADHD share common causes, or a low Apgar score reflects at least one possible pathway leading to ADHD.
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