ADHD Medication: Are Generics The Same?
When 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.
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Written by Dr. Kenny Handelman - The ADHD Doctor
To find get a FREE special report on ADD/ADHD Medication, visit: Medication Mastery
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Technorati Tags: ADHD, Ritalin, Methylphenidate, generic medicine, Pharmaceutical Companies
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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?