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The diagnosis on generics.

If you're thinking of switching from a brand-name prescription medication to a generic one, you are not unlike millions of people who have realized they may save thousands of dollars annually. So what do you need to know about this choice? In most cases, taking the generic version of a brand name drug is safe, and no different. However, there are a few exceptions worth exploring here.

As you most likely know, generic drugs are cheaper because their brand name counterparts take years of research and development to produce, after which for a given period of time the drug in question is protected under patent. When the patent expires, generic versions of the drug begin to appear. Far less expensive to produce than the initial drugs, generics are often made by the very same companies that produced the original drug. Competition from other manufacturers then drives the price of the generic even lower.

Unless your doctor has written "do not substitute" or "dispense as written," it is quite common for your pharmacist to substitute the generic in place of the brand name drug on the prescription. Generic drugs are required to contain the same active ingredients in the same dose as the brand version, though they may contain different inactive ingredients. Generics may not vary by more than 20% from the original in their ability to be absorbed by the body over a given time period. Usually, this small difference in absorption is not an issue; the exception here is for drugs with a narrow therapeutic index (NTI). These drugs require a very exact dose to work well and ensure the least side effects. You should have a conversation with your doctor about whether switching to a generic is feasible if you are taking a drug with an NTI, and are doing well on it.

Some examples of NTI drugs include anticonvulsants, thyroid medications, some asthma and COPD drugs, blood clot prevention drugs, drugs treating heart failure, and immunosuppressants taken after organ an transplant.

A second type of generic drug choice is sometimes presented to patients. When no generic option is available, some insurance companies advocate asking your doctor for a therapeutic substitution. This means switching to a generic drug of a brand name drug that is similar to the brand name drug you are currently taking. First and foremost, be sure this new drug is in the same drug class--not all cholesterol-lowering drugs work in the same way, for example. A more powerful drug could cause more side effects; any new drug regardless of strength could complicate other drug interactions or require different food restrictions.

For lists of generic alternatives to brand name medications, or

(Health After 50, 2009, Vol. 20, No. 12, pp. 6-7)
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Publication:Running & FitNews
Geographic Code:1USA
Date:Mar 1, 2009
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