"Bullshit Drugmonkey." You are saying. "My customers are fucking psycho. The only people who worry about which particular generic they are getting are crackheads who want the same color promethazine with codeine syrup that the rappers sing about."
I hear you. Trust me, I hear you loud and clear. And the one thing I can tell you without the least bit of uncertainty is what you and I have both heard a million times: generic meds are the same thing as the brand name. The same ingredient put into your body in the same amount. Period. Without a doubt.
Now that we have that settled though let's play a little game. I call it "find the mile-wide loophole in what I just said." Read that last paragraph again and think it over. If you need some help think about extended-release products and what I didn't say.
If you need another clue here you go:
Didn't say anything about rate did I? This chart is from the FDA's own data regarding the anti-depressant Wellbutrin XL and a generic distributed by TEVA Pharmaceuticals sold under the name Budeprion XL. Look at the plasma concentration at two hours and five hours and tell me these meds are the same. The FDA put this out in response to numerous consumer complaints that the 300 mg TEVA generic led to relapses of depression and increased side effects. That wasn't a typo. The complaints were about the 300mg version and the FDA responded by studying the150mg tablets. "Because of the potential risk of seizures at higher doses, the 300 mg strength was not studied" said the FDA, which makes perfect sense in a bizarro alternate universe where you wouldn't study the thing you want to learn about out of safety concerns after you had already declared the thing you want to learn about to be safe and effective.
Someone actually did study the 300mg tablets people were actually complaining about though, and if you were able to sneak past the paywall of ConsumerLab.com and read their report this is part of what you'd see:
So... when someone actually took a look at the actual product people said affected them differently, and not a similar product used as a stand in by the FDA "for safety purposes," the differences were even greater than what the FDA found. Interesting. I won't say anyone was trying to hide anything, because I don't have any evidence for that. I will say that if you were trying to hide something though, what the FDA did might not be a bad way to go about it.
I also won't say that the differences the FDA and ConsumerLab found are clinically significant. It is entirely possible that what the FDA and ConsumerLab came up with, as striking as it may appear, would have no noticeable clinical effect.
I will say however, that when I dispense and you take a generic drug, we both expect it to be the same as its brand name equivalent, and that dumping 49% of a 24 hour dose over the course of four hours as opposed to 25% is not the same. It's almost twice as much. Which makes me wonder if maybe there's not a reason at least a few of my customers are so damn psycho.
It's also why I've started ordering Watson's version of Wellbutrin XL.