Originally Posted by wanderer
The hamster also acknowledges that the "inactive" ingredients in any given formulation which seem to vary widely from manufacturer to another might also affect the quality of the medication. Also, "inactive" ingredients may have their own effects when combined in the generic methylphenidate
This whole discussion regarding generic methylphenidate versus brand name Ritalin
, has got the hamster wondering about the effectiveness of other medications. He's wondering whether some generics are more effective than others.
Back when I was on the pain clinic & was prescribed methadone
tablets, I noticed a HUGE difference between the 2 different generics my pharmacy carried. The small round tablets were FAR more effective than the larger round tablets (which have since been replaced by rectangular tablets). I don't remember who made the "good" tablets", but Mallinkrodt made the "bad" ones. With the smaller tablets, I could take my morning dose & feel it kick in gently and it would last me all day - I'd often forget to take my afternoon dose (methadone for pain is often dosed 3x a day) because I wasn't in pain. During the months I'd be given the bigger tablets, they didn't work nearly as well; I'd have to take an extra 5-10mg with my morning dose & would definitely have to redose, especially if I were out & about.
The pharmacy & doctors told me it was all in my head, of course. But that's when I did a little searching around & found that paper that said that although generics were required to have the same amount of active ingredient, because of the binders/fillers/etc, the bioavailability of the medication could vary as much as 80% of the name brand to 125% of the name brand - & that this was acceptable! That's just crazy! Can you imagine, what if someone were getting, say, a generic alprazolam
that had 80% bioavailability for a while, then their pharmacy got a different generic that was 120% bioavailable compared to the name brand? That's a huge difference!
Unfortunately, in Massachusetts, the pharmacy is required BY LAW to fill the prescription with a generic formulation unless the doctor specifically writes NO SUBSTITUTIONS on the prescriptions. Naturally, insurance doesn't cover the name brand if there's a generic available. *growl*
IIRC, I had some success with dissolving the tablets in water & letting it sit for a few minutes prior to ingestion, but this was a number of years ago now & I don't recall exactly how much success I had. It's funny, because I'm on a methadone clinic now, where I get the "cherry" liquid dose made by Mallinkrodt (the ones who manufactured the "bad" tablets), but it holds me similarly as the "good" tablets did back in the day. However, I think this is down more to the fact that I take a much larger dose at once now than I used to; I do still feel it wear off & all. Even more amusing is that Mallinkrodt is the main manufacturer of methadone & the ones who provide the methadone to the company that made the "good" tablets! So, it's OBVIOUSLY something about the fillers/binders & not, say, a different manufacturing process to make the methadone.
Generics are a very odd subject.