Switching from brand-name to generic meds
DEAR DR. ROACH: My 81-year-old father takes 100 mcg of Synthroid. Due to the high cost of insurance, and the need to change his Medicare policy, we are trying to lower his prescription costs.
One way is to get the generic. His doctor told us today that the Food and Drug Administration allows a 40 per cent variability in the generic, so he must stick with the same manufacturer.
We are hesitant to switch, based on many of the reviews I have read about people not having the same results with the generic. What are your thoughts on this?
ANSWER: Of the many questions I get on generic versus brand-name drugs, it’s Synthroid that generates the most concern.
I often hear concerns that the FDA allows a high variation, but in fact, until 2007, the variation allowed was plus or minus 10 per cent.
This means that the pill must contain between 90 and 110 per cent of the amount stated for the active ingredient.
This standard is the same whether the drug is brand name or generic.
However, because thyroid hormone levels need to be more precisely regulated than other drugs (too much or too little, and the person can have symptoms), in 2007 the FDA changed the regulation for thyroid preparations in particular to between 95 and 105 per cent of stated potency throughout a product’s shelf life.
Because of this, a generic prescription is a reasonable option, in my opinion.
For people who want to be extra careful after changing to a generic, the level should be checked several times frequently following the switch, and I recommend working with your pharmacist to make sure you get the same generic manufacturer with each prescription. Most pharmacists are willing to do this. Some people insist that only the brand name makes them feel right. I am never sure whether this is due to a difference in the amount of hormone, its ability to be absorbed or by the expectation that a generic is not going to be as good.
Most physicians, including myself, choose generics for themselves and their families.