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Doctors' Answers to "Frequently Asked Questions" - Generics

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Question:Recently in a kinetics class, our professor revealed to the class that all generics are not the same. They differ in bioavailability, fillers, and the way they are compressed for example. I was confused about the subject, because all I have ever heard is that generics are exactly the same. So how do you answer patients when they ask. ( a very familiar question in a retail setting)

Answer: Your professor is correct about the subject. What makes a difference however is whether there appears to be clinical effectiveness at the same dose. For example, a generic blood pressure pill versus a brand name would be expected to keep the blood pressure at the same level of control. In general, I use generics whenever possible with minor exception. However, I recommend to patients to ensure that the effect and the side effects are the same. Currently, the biggest trend is towards patented release mechanisms for previously generically available drugs. The company releases a brand name in a new release mechanism which is not available in generic due to a second patent. Whether the new release format is clinically superior is the issue. Usually, one is ok with generics as long as you stick to the same company, then any variability will be minimized. Switching from company to company can cause problems in comparing the clinical effectiveness.
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