Epilepsy Foundation

Although some generics are better in regards to lesser side effects, if there is more than one company making another version of the generic drug you do not know what you will be getting.   I do not know as of know but back in 2002 the FDA allowed  up to +/-30 percent for a generic drug. Maybe it is +/-40 percent now.  Who knows.  Things are getting worse.  I don't know how long the patent of the original manufacturer is protected now.  It used to be 20 years before generics could be made.

I had problems in the past with generics throughout my years with epilepsy.  In 2002 I decided to go back to school and wrote a paper about generic drugs versus brand name drugs.  Although I already did research in the past and knew what to put in the paper, I still had to provide proof that I researched the information and was not making it up.  The references are within and at the end of the paper.

 

Overall, purchasing generics is a big risk.  Think of it as going to the dollar store.  You go in for toothpaste or a pair of socks that you previously purchased and were very pleased.  You want more but suddenly the dollar store has new brands of socks and toothpaste and doesn't have what you recently purchased.  Why?  Because they buy the cheapest products in bulk to make a profit, just like pharmacies that buy drugs in bulk with us not knowing what we are getting.  If you get a generic version that is controlling the seizures and you are happy with it, don't be surprised if you go into the same pharmacy and get another version of a generic.  This happened to me with Tegretol and to my husband with Dilantin  in the past.

 

See the attached paper.

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There is a generic Keppra it came out over the summer. The pharmacy keeps trying to push it on me, it's so bad my doctor writes on the RX "name brand only". I'm on a really low dose, im not risking a grand mal seizure so the pharmacy doesn't have to stock it (they usually tell me they have to special order it) If im paying for it, they can order it! I also take generic topamax, Topiramate as a back up for my headaches and to help with weight loss. That works fine.

Monica, 

   I am glad you are able to afford your brand Keppra.  I have heard several people who have problems with the generic, but I also have a niece who does very well on the generic.  

Just some information about the pharmacy.  I don't know what state you live in, but it is often not the pharmacies fault.  Many states have a law that the pharmacy must fill the generic or "cheapest" option if not specified by the patient or physician (called DAW 0).  You can specify that you want brand without your doctor, but you must usually do this each and every time, and insurance often doesn't pay anything for this kind of file (DAW 2).  I am glad your doctor understands and specifies brand name only (DAW 1).  As far as not stocking the brand keppra, that is often the decision people higher than the pharmacist you get to deal with.  Usually they have to have 4 or 5 patients before a medication will be part of regular stock.    



Matt said:

Monica, 

   I am glad you are able to afford your brand Keppra.  I have heard several people who have problems with the generic, but I also have a niece who does very well on the generic.  

Just some information about the pharmacy.  I don't know what state you live in, but it is often not the pharmacies fault.  Many states have a law that the pharmacy must fill the generic or "cheapest" option if not specified by the patient or physician (called DAW 0).  You can specify that you want brand without your doctor, but you must usually do this each and every time, and insurance often doesn't pay anything for this kind of file (DAW 2).  I am glad your doctor understands and specifies brand name only (DAW 1).  As far as not stocking the brand keppra, that is often the decision people higher than the pharmacist you get to deal with.  Usually they have to have 4 or 5 patients before a medication will be part of regular stock.    

I can't always afford to pay the brand name, my old insurance wouldn't cover it and I had to pay $250/month for it. However is much rather pay more money for my meds and eat cheaper than risk having a seizure driving 65mph on the beltway to work and risk killing someone else because I had a seizure. Not to mention myself.

Oh, my prescriptions say Brand name only. The insurance company still tries to switch it on me.

Atol said:

Hay Bethany.  What I was told by others with Epilepsy and generic or the orignal medication.  Is have the doctor mark the Prescription pad with brand name or a brand generic medication that works. like I am on Keppra Name brand medication.  But Trileptal Generic.  But make sure of is they can't Switch between differnt Trileptal generics.

 

A good website to know which Generics your taking.  is http://www.drugs.com/pill_identification.html

I think it more like 3% 5% on active ingredient and inactive ingredient it 10% for manufactures.  Both have a job to do. 

 

Active ingredient has the job of releasing the medication

Inactive ingredient help time the release of medication?

 

Do more research Erma Hampton and this epilepsyfoundation is not a Advertisement website.  When I went from Name brand medications to Generics.  I started having Seizures and Lost my Drivers License.  WHY? Because like a lot of people believed Name brand was the same dang thing.  It not the Drug in it self. It the Inactive ingredients that tend to have this issue.  Even my doctor believed I was wrong and wanted to put me on MORE medication.  I told her no.  I and ask to put me back on the name brand medication.  Once I went back to my medications.  My seizures stopped.  I had to wait 6 months then I could drive again.  

http://www.webmd.com/epilepsy/features/epilepsy-medications-when-is... & http://www.nbcnews.com/id/30627962/

The website above Talk about Name brand and Generics.  

I must take brand name only on Topemax. The first time I had the problem was when it came out in the Generics form. The insurance company does not even ask you anything that send it to you. Of course I had a accident. The next time I tried to get on it to save money because the co-pay went so high on the brand. My doctor was finally able to send a note to the insurance company that I must be on it. He said that it the fillers that mess you up. The older Doctors now more about what is going on then the newer ones.

My insurance company used a mail-in medication service that did great for awhile. Then one year, just randomly sent me Topermate (generic for Topamax). My prescriptions specially say, "Fill as written, Brand name only." I looked at the bottle, still do because I don't trust anyone now, and called them. Yelled at every level I could get my hands on. Said they are VERY lucky I wasn't in the ER because of them and that I didn't have a car accident. If I had, they would have been held responsible, I would have made SURE of it.

They told me that according to their records, we didn't fill out a form to override the automatic generic option. I told them that the prescription should do that and that they should tell me that there is a form BEFORE sending me the wrong medication.

It was this huge ordeal. So when my insurance switched to CVS, the first thing I did was contact them to find out if there were ANY forms we needed to fill out. I didn't want to go through THAT again...

Had the same problem Bethany. Lucky we had a extra month supply and I was able to get the right medications.  

Found another url that explain the issue with generics.  http://www.peoplespharmacy.com/2011/04/11/why-pharmacists-are-wrong...

My neuro won't prescribe generics anymore...I received them one time and I felt funny, weird, not all together...but he doesn't prescribe them for any of his patients...

Generics ARE NOT identical and DO NOT have the exact effect.

Antiepileptic drugs: the drawbacks of generic substitution

http://www.thelancet.com/journals/laneur/article/PIIS1474-4422%2810...

 a generic drug is deemed to be equivalent to a branded drug if the 90% confidence intervals for the mean of several key pharmacokinetic parameters for a generic drug are within 80—125% of those of the brand-name drug. However, such bioequivalence studies are done in small numbers of healthy volunteers and may not be generalisable to patients with epilepsy. Furthermore, the narrow therapeutic range of AEDs means that drug concentrations must be maintained within a narrow window to be effective. Variations from this therapeutic range, even by a small margin, can increase the risk of detrimental outcomes. Switching between different generic versions is particularly problematic: two different generic drugs could, in theory, have bioequivalence values at the two extremes of the 80—125% range, causing large fluctuations in serum concentrations if patients switch from one generic version to another

Epilepsy Medications: When Is It Safe to Substitute a Generic?

http://www.webmd.com/epilepsy/features/epilepsy-medications-when-is...

Leading neurologists say the attempts to cut costs by insurance companies that force patients to switch epilepsy drugs are misguided and counterproductive.

"Seizures are expensive," says Orrin Devinsky, MD, professor of neurology at New York University's school of medicine. "If someone's been controlled, having just one new seizure has huge costs, in employability, driving, their whole life," he adds. "That's not even to mention the possibility of injury, even death."

On a practical level, patients switching to generic epilepsy drugs also need increased blood level checks and more frequent doctor's visits, reducing any cost savings from the generic drug, according to French.

Generic substitution in the treatment of epilepsy

http://www.neurology.org/content/71/7/525.abstract



erma hampton said:

Generic drugs are bio-equivalents of brand drugs and they are identical and have exact effect as that of brand drugs. You can find the interesting fact on generics at (http://www.internationaldrugmart.com/news-section/generics-as-effec...International Drug Mart,  this is best place to shop generic drugs online too.

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