ADHD Medication: Are Generics The Same?
ByWhen a new medicine is developed, it is under patent for a number of years. When the patent expires, that medicine can be made by other manufacturers. The original medicine is called the ‘trade name’, and the later one is called the ‘generic’.
For example: “Kleenex” is the trade name of a brand, but “tissue” is the generic term.
Another example: “Tylenol” is the trade name, and “Acetaminophen” is the generic.
To use an ADHD example, Ritalin is a trade name, and Methylphenidate is the generic medicine.
Why is a medicine under patent?
The medicine is protected under patent for a number of years to allow the Research and Development Pharmaceutical Companies (i.e. the companies that develop the medicine and do all of the research and testing to bring it to market) to market that medicine exclusively, so that they can recoup the investment that they have made into the development of the drug.
It costs approximatly $900 million USD to bring a medicine to market now. That is a lot of money – and means that the company should be given time to earn income due to their extensive investment.
After the patent runs out, other companies can make the same medicine, as a generic. In the same way that many companies can make tissues, but only one can market under ‘Kleenex’.
What is the immediate benefit of a generic?
Mainly, it is the same medicine and it is cheaper.
In Canada, one can buy trade name ‘Ritalin’ (with a prescription, of course), or alternatively, one can get ‘Apo-Methylphenidate’, or ‘Novo-Methylphenidate’. The ‘brand’ of medicine which is given is often determined by the insurance that pays for the pills. Often the insurance will specify that if the generic is available, then that is what they will cover (because it is cheaper and will save them money).
Are generics the same as the trade name medicine?
The rules for generics are:
- they have to be the exact same chemical
- they can only have a 20% variance in the amount of active medicine getting into the blood stream.
The difference in absorption from one preparation to another has to do a lot with the ‘binders’ in the tablet, etc.
Generally, if someone is started on one generic preparation and then stays with that generic, it is not a concern.
The issue comes if someone’s pharmacy or drug plan changes the generic – there could be a swing of a maximum of 40% difference in the amount of medicine hitting the blood stream.
For example, if someone is on Methylphenidate A, and the amount that gets into the blood stream is 20% higher than Ritalin; and then the pharmacy switches the generic Methylphenidate to Methylphenidate B, and methylphenidate B is 20% lower than Ritalin, the patient could be on the same dose, and end up with a 40% change in medication in the bloodstream.
In general, the changes are much more minor with generics, and most people have little if any problem or issues with them.
However, this can be a real problem for some people who are more sensitive to medicine.
If you find that a change in the trade name or generic medicine is a problem, speak to your pharmacist and your doctor. Your doctor can write 2 words on the prescription to force the pharmacist to stick to a specific preparation of the medicine.
Those two words are: “No Substitution”. That means that the pharmacist has to dispense the exact medicine written by the doctor, and cannot substitute it for a cheaper generic form of the medication. You will need to check with your insurance, though – as they may refuse to pay for the more expensive version.
Which ADHD medication is generic?
In general, the longer a medicine has been out, the more likely it is generic.
Ritalin and Dexedrine are generic. Newer preparations like Concerta, Metadate, Adderall XR and Strattera are not generic. Neither is Focalin, Ritalin LA, etc. These will likely go generic in approximately 10-20 years.
Have you had experience with this? Maybe trouble with generics? If so, please share your experience by posting a comment on this blog.
Technorati Tags: ADHD, Ritalin, Methylphenidate, generic medicine, Pharmaceutical Companies
27 Comments
November 22nd, 2006 at 2:50 pm
Here in New Zealand we are changing from Ritalin SR to Rubifen LA. Apparently this is not used in many countries – I am not to concerned now because on the Ritalin SR my son is having major highs and lows so on our next appointment am hoping we can change to something else as apparently Ritalin SR is known for this … is that correct?? What is the most “popular” drugs over there which has had the best results???
November 24th, 2006 at 9:39 am
Thank you, Jackie for your question.
I have to say that I don’t know ‘Rubifen LA’. I presume it is just a generic form of Ritalin SR.
Ritalin SR is not a very good preparation of a long acting methylphenidate.
In my experience, only a small percentage of kids benefit from it.
Many only get 4 hours of medication coverage, some less.
In Canada, there are other long acting preparations of methylphenidate – inlcuding Concerta (which is excellent) and Biphentin (which is new and I am just testing out).
In the US, they also have Metadate CD, Ritalin LA, Focalin XR (and I may be missing one or another).
The benefits of these newer ones is that they deliver very steady doses of methylphenidate throughout the day.
The drawback is that they are generally 3x as expensive.
I used to work in New Zealand for 6 months in 2001 (at the Starship Children’s Hospital), so I understand how only certain medicines are funded.
It is worth asking your doctor if your son could be moved onto a newer medicine if the old ones aren’t working.
June 22nd, 2007 at 2:08 am
Hi. My son has had a very bad experience using Rubifen SR. His behaviour got far worse than before, aggressive, aggitated, irritable, lack of focus, argumentative, distracted. When on the same dose of Ritalin his appetite would be suppressed until 5/ 5:30pm. He would be hungry at 3pm on Rubifen.
I had an article posted in a local newspaper, which can be viewed on http://www.stuff.co.nz/stuff/sundaystartimes/auckland/4091471a6016.html
after that article, I have had many parents phoning to say they have experienced the same problem, primarily aggression. All have had to pay for the non-subsidised alternative. Many adults have reported that Rubifen is in-effectual for them. The ADHD association here (in New Zealand) is starting a petition to try and get Ritalin to be subsidised for those people that Rubifen is having bad side-effects.
June 23rd, 2007 at 6:57 pm
Hi Ms. Di Celliers,
Thank you for sharing your story.
And kudos for getting some press on it.
I did work in Auckland in 2001 – at the Starship Children’s hospital for 6 months, so I have some familiarity with your system.
You describe a perfect example of how a generic preparation can lead to a real problem. In this type of situation, getting the name brand is very important.
I hope that your ADHD organization can do well with your advocacy.
Just for your reference, there is a Canadian parent advocacy organization called: CADDAD – http://www.caddac.ca
Good luck!
Dr. Kenny
July 9th, 2007 at 8:07 am
Hi
Since the first article was published in the local papers about the adverse effects of Rubifen in NZ a month ago, many people have contacted me. I have 22 people who hve written about how their child has been severely affected by the drug switch. Mostly a huge increase in aggression and dangerous behaviour to themselves and others. Articles are appearing in newspapers around the country and MPs are being contacted more and more regularly. There are written questions for the Health Minister to answer this week in parliament about the adverse affects of Rubifen. The ball started rolling and is now gathering momentum. Lets see if Pharmac are prepared to admit that this controlled drug should have actually been tested and monitored on young people before letting it loose on the unsuspecting patients. What are they going to do to help the many people who have been badly affected and simply cannot take this drug? young people’s education have been severly affected. Families are now having to pay substantial amounts of money to help their children stay focussed in class.
Thanks for this very informative website.
Regards
Di
July 21st, 2007 at 8:28 pm
Di,
Thank you very much for keeping us up to date.
I am so impressed by your advocacy for your own family, but also for others.
Keep up the great work!
Dr. Kenny
July 30th, 2007 at 11:02 am
Hi– I was just switched to the new generic focalin (dexmethlphenidate 10mg by Teva) by Walgreen’s after having been on the same dosage of the brand-name Focalin for over a year. It does not seem to have the same effect (it seems weaker) and I wanted to let you know. I am contacting my psychiatrist to see if we can switch me back and still have it covered by my insurance. I seem to be having to use more of it for the same effect, which is difficult since it is a controlled substance, and I will likely run out of it before I am allowed a refill. If you have any experience or advice here I would appreciate it.
And if anyone else has been switched I would appreciate comments as to whether this is all in my head—
thanks, scott
July 31st, 2007 at 2:40 pm
Hi Scott,
Thanks for sharing your experience. Sorry it’s not working out.
I don’t have any direct experience with Focalin – as it is not available in Canada (where I work and practice as a Psychiatrist).
However, your issues with generic focalin are quite consistent with what happens to many people who go onto a generic.
Basically, as described above, the generic has to be within 20% as strong (either stronger or weaker) to get approved.
For you, the generic focalin seems to be weaker.
Best to talk to your doctor about it and see if you can get the brand name.
Doctors can write prescriptions for that by means of writing: ‘no substitution’ on the prescription. The question is then will your insurance cover it?
All the best,
Dr. Kenny
October 16th, 2007 at 3:21 am
Hi, to Scott S. and this general website: I too just switched from focalin (5mg) to the generic. I consulted 3 pharmacist who told be that the active ingredient is the same as the brand name version. I have had a very similar experience with the generic as Scott S. The effect of the medicine seems so different it may as well be an entirely different medicine. Aside from it’s apparent “weaker” effect on my system, it upsets my upper G. I. and seems to act in a more acute manner and then quickly the medicine ceases to have any beneficial quality- only adverse effects which include very pronouced feelings of nervousness and just an all around “bad” feeling. Im seeing my guy in 2 days and am going to ask him about this- I am certain that has nothing to do with my imagination- i’ve been taking the stuff consistently for a while and know that this generic differers dramatically from the brand name.
December 31st, 2007 at 8:39 pm
I have been taking Focalin for narcolepsy for about 4 years and never had a problem with it. Well, my wonderful insurance company convinced my doctor to write my new scrip for the generic “equivalent”, Dexmethylph (phenidate?). OMG, what a difference. It is a dirty, nasty drug. I had anxiety from it so bad, I could hardly stand it. Also i had heart palpitations and felt just plain lousy. I got so stressed out from it, i ended up more tired than i was to start with! How dare them call that an equivalent.
April 15th, 2008 at 3:48 pm
I was switched to a new generic of adderall about 3 months ago now and I have felt it is significantly less effective. However, I am also Bi-Polar so have been unsure if I am experiencing mixed episodes or if it is in fact the switch. I’m glad I read this though because I will be bringing this up with my doctor just in case this is the issue. I even rear ended someone about 8 weeks ago because I was totally in another space in my thoughts- this never happened before
November 15th, 2008 at 10:00 pm
I once came across a website that had a great example of ADD. It made you try and read while images faded in and out in the background. Does anyone know where to find this?
May 6th, 2009 at 2:57 pm
I just started on the generic Adderall XR 4 days ago – not liking it AT ALL. Does not seem to have the same effect…I can’t focus, can’t get anything done, head feels shaky…I just don’t like it. Apparently, my insurance won’t cover the regular AddXR – so, I will have to pay $160+ for it if that is what I want.
May 10th, 2009 at 9:38 pm
I too am having a bad experience with the new generic form of Adderall XR. Have been on it for 3 weeks now and it has been rough.
This weekend, I found 4 brand name Adderall XR capsules in a travel bag, thankfully. And, by switching back, I feel back to normal. No aggitation, edgeiness, insomnia, stiffness, etc.
I hope my insurance won’t balk when my doc checks the “NO SUBSTITUTIONS” box on my next Adderall XR 20 MG prescription!
@Stac: Maybe your doctor and/or employer can help work with your insurance to get it covered? Good luck!
May 23rd, 2009 at 5:12 pm
I have been recently switched from the real adderall xr to what I call garbage. I have taken adderall for 11years, not 1 side effect. Now with the fake adderall, not only is my add worse, I have severe side effects. And as most people its the insurance company,that dictates what the doctor can prescribe.Generic adderall should not be allowed to be sold. I had the same problem with ritalin as a child. This is really infuriating to me. The generic drug companies need to leave the add drugs alone. Is’s bad enough having add, and I have a full bottle of this garbage. The cost of the generic adderall shows what it is worth $4.00. People with real add, are already sensitive to drugs, this was the only one that didn’t make me feel like I was dying.
June 1st, 2009 at 10:19 pm
I recently switched from Adderall XR to the generic version, and I am very displeased. I didn’t realize that it was generic until I began to experience vertigo, nausea, cramps, and cloudy, disconnected thoughts. I checked the label of the medicine and realized that it wasn’t Adderall XR; it was generic.
I noticed a -huge- difference in the quality and effectiveness of the medicine. I thought that I was coming down with some kind of illness until I did some research and realized that the generic version was allowed to be so much different.
I agree wholeheartedly with the other comments here; the quality and effectiveness of the generic Adderall XR are virtually non-existant. I’d rather not take anything instead of taking the generic.
I will be switching back promptly. It’s 40 extra dollars a month for me, but the worth is incomparable.
June 4th, 2009 at 10:02 am
I think that what’s interesting here is that there do appear to be consistent variation in the effectiveness of generic medications across different medications themselves. My understanding is that amphetamines are innately more likely to have food effects (acidic foods reduce absorption). There are some generic dexedrine formulations that are widely considered less effective than brand (e.g. Barr) and others that appear to be comparable (Mallinckrodt).
With Ritalin, however, I haven’t seen any variation between different generics, and I am untroubled if I am prescribed generics.
June 18th, 2009 at 5:00 pm
I have been using Focalin (10mg) for several years after a number of years on Ritalin, all without incident. A few months ago, our drug plan removed Focalin from its formulary list and sent me the generic equivalent. While I did notice a drop in effectiveness (which any Ritalin or Focalin user would detect), I was determined to make the best of it. Within a few weeks of changing over to the generic, I began to feel unusually drowsy during the day, which I attributed to a cold-type virus that I was suffering around the same time. I could not shake the feeling of drowsiness and my doctor could find nothing wrong with me. I am not depressed nor has my sleep been affected but I found myself fatigued and almost unable to function normally at work. It was my wife who suggested that it may be the generic Focalin. Sure enough, when I stopped the generic and started taking the few pills left over from my previous scrip, the drowsiness disappeared like a curtain being lifted. Has anyone else had a similar experience with this side-effect? Is there an explanation?
June 22nd, 2009 at 9:51 pm
I’m 51 and just diagnosed with ADD. My insurance (Blue cross/Anthem) does not cover anything related to ADD for anyone over age 18 which seems like illegal age discrimination to me.
My doctor prescribed Concerta 36 mg but OMG, the cost is $140 for 30 pills at Costco. I explained my situation to the doctor and she gave me Ritalin. After 3 weeks of taking generic Ritalin and realizing that I was having side effects such as bad headaches, nausea, blurred vision and the crash and burn when the drug wore off, I contacted my doctor who is now prescribing Concerta again.
My insurance won’t even pay for the monthly doctors visit if it is to check on my medication. I can’t afford $100 per month doctors visit and $140 medication out of my pocket. Any suggestions?
June 22nd, 2009 at 11:58 pm
Hi,
I’m not sure what the answer is. Maybe generic Adderall XR can be an option. I am a Canadian doctor – so I work in a completely different healthcare system. Maybe one of the blog readers can share a suggestion as to how you can get coverage and help.
Best,
Dr. Kenny
August 5th, 2009 at 4:23 pm
On Friday 7-31-09, I picked up me script and “assumed” it was my brand name Adderall XR 30mg.
In the last 5 days I have experienced swollen ankles and feet (I’m 33 and have never had swollen ankles before and I play soccer.), nausea, headaches, cramps, dizziness, poor concentration and disconnected thoughts and I’m extremely aggravated. I NEVER have had these side effects on the brand name Adderall and I have been on Adderall for 6 years.
Wallgreen’s pulled a switch and did not advise me that they gave me the generaic CRAP! I’m furious and in HELL!
September 3rd, 2009 at 8:50 pm
This afternoon I was made aware of the difference between real Adderall XR and generic. I’m a college student…diagnosed with ADHD my senior year of high school. I’ve been taking 60mg of Adderall for the last three and a half years now and my life has turned around completely. I was close to not graduating high school due to my poor grades, but in college I have been on the dean’s list nearly every quarter thanks to my medicine. About a week ago I used up one bottle and my mom gave me the new one (we get them in the mail). I kept taking them just like always, but this entire week I have been finding it impossible to do things and have been putting off everything. It finally got to the point today where I just broke down and lost it because I haven’t felt like this since high school and I didn’t know what was wrong with me and why everything was falling apart. Then my mom remembered seeing that this new bottle was generic, but she didn’t think it made a difference so she didn’t mention it. But as soon as we figured that out we realized that was it. So many of the things I have done (or not done) and thought and said can be explained perfectly by this HORRIBLE GENERIC WORTHLESS CRAP.
And to the person up there who said it’s purely psychological, you are completely wrong. Maybe in some cases it can have an affect on how you perceive the effects of your medicine, but I have always been VERY aware of all the different medicines I take and their effects on me, and am very in tune with myself and my reactions and side effects to each and every one. I had NO idea this medicine was any different, and was fully under the impression that something was wrong with me and that I was a failure and that everything had suddenly changed somehow for some inexplicable reason. I was totally unaware of the switch that had been made and yet the effects were huge and now in retrospect I can now see just how obvious it all was. I am one quarter away from graduating, and have been doing sooo well. In just this one week (the week before finals) I managed to completely cause myself to fail a class. Now, because of this awful generic “medicine” i have to retake this class and my graduation has been pushed back an entire quarter. All the extremely hard work I put in to this class these past nine weeks has gone down the drain because of the lack of effectiveness of this fake drug. I might as well have been taking nothing this entire week.
I detest insurance companies and our country’s immoral health care policies. I can’t wait until things change.
October 2nd, 2009 at 3:28 pm
I completely agree with the Grace’s post above! Them same thing just happened to me! GENERIC ADDERALL XR IS WORTHLESS! I was diagnosed with ADHD in 2nd grade. I used to take dexedrine (which worked great, by the way). Then I was switched to adderall xr while in junior high. The name-brand adderall works great! I’ve always been an A/B student, and succeeded in everything I do.
For reference: I took 40mg of Adderall XR in 8-12 grade. Since graduating high school, my dosage has fluctuated between 45-50mg.
II’m a Mechanical Engineering Senior in college now and have managed to keep a cumulative 3.51 GPA. I was just switched to the generic crap! I’m pissed!
Initially, I had NO idea this medicine was any different; I was unaware of the generic. But I could tell the INSTANT I took it that it was NOT the same (after the medicine started working). I thought it could be time for another dosage increase. Then my mother told me my prescription was filled with generics. I can’t seem to focus enough to get my work done. This entire week I have been finding it IMPOSSIBLE to do things and have been putting off everything. I feel half scatter-brained.
I’m double pissed because this happened at the beginning of the Summer and I spoke with my doctor and told him the generic doesn’t work for me. My prescriptions have been noted as “DAW” (dispense as written) and were being filled with the name-brand Adderall XR. Then, for some reason, this month the were filled with the generics. Now I’m stuck with this crap for 30 days! I would rather have NO pills for one or two days knowing my name-brand prescriptions are on the way than get stuck with 30 Days of generics!
After reading other posts above,
BOTTOM LINE: NAME-BRAND ADDERALL XR IS MORE EFFECTIVE THAN GENERIC.
October 23rd, 2009 at 2:01 am
I told my boyfriend to put the pill in my mouth without me knowing which one I was taking–it was between Adderall XR and the Teva generic ER. The deal was he wasn’t supposed to tell me ’till the end of the day which one I had taken so that I could make an unbiased analysis. However, I knew within the hour that it wasn’t the real stuff. He finally admitted I was right, it was the generic. So, I took the other half of my 40 mg prescription.
Usually I take 20 mg in the morning & the other 20 mg about 5 hours later. With the generic, I took all 40 within 2 hours. Nothin. I thought maybe I just had gotten enough sleep the night before, and I was just really tired. I took the Adderall XR the next day & gave the generic another try today. I am tired; I’ve been irritable all day, and I really haven’t gotten much done. I slept 10 hours last night, but I’ve been ready to go back to bed all day. After reading the other reactions on here–spacey-ness; foggy memory; depression–I am afraid to continue taking the generic. Unfortunately, I only have enough of the real stuff for about a week, and I have no idea when I can another real prescription. I don’t know how I’m going to last a month with this bullshit.
I’ve been taking Adderall for 4 years. It’s like someone suddenly took my medication away.
October 25th, 2009 at 12:46 pm
[...] Adderall XR went generic in the US in April 2009. I wrote an initial blog post about it here: Generic Adderall XR. You can also review the nature of generic medicines in an article here: Are Generics The Same?. [...]
November 5th, 2009 at 5:46 pm
Hi, I’m a college student and I’ve been taking Concerta for around a year now. I was on…I’m not actually sure what I was on before because it was my mother who always gave me the medicine, and now I take it myself because I’m abroad. But either way, they changed the brand of my medicine because I was recommended a higher dose as I grew older (I’m not sure why, but anyhow this is what happened). If I can remember correctly, my dosage is around 74 mg at the moment, and Concerta works very well for me. I find no side-effects, except of course those days when I take the medicine too late and have trouble sleeping later at night. Concerta is said to last about 12 hours, I’ve found this true, although I can’t really tell myself the effects. My grades have risen higher and I concentrate better, I used to be very depressed sometimes and aggressive–I no longer am. It does suppress my hunger sometimes, but I eat a big breakfast meal before I take it so it’s fine. And also it does keep you up if you take it too late– recommended to take it in the morning. So I guess I’m saying Concerta is a really good brand, at least in my experience
January 28th, 2010 at 4:34 pm
I have been on 20 MG XR of Adderall for the past year and I just 2 days ago got my RX filled at the walgreens and it was generic. I have never had any problems with generic brand medication in my life, when I took it about 30 minutes later, it was like I was in a daze. I could not go to sleep, i ended up staying awake until 4 am and woke back up at 6am because I could not stay asleep. I have been on the generic for about 3 days now and everytime I take it I get very jittery and get very sick to my stomach. If I could afford the 250 dollars a month to get it filled it would be worth every penny, I would rather not take this generic crap, it does not work for me at all. I never had any jitters or shakiness or problems eating when I was on the name brand medication, hopefully I will be able to get back on to the name brand because otherwise I don’t know what I am going to do.