Generic Adderall XR – New Formulations
ByAdderall 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?.
While my initial thoughts were that the generic Adderall XR was very similar to the trade brand (made by Shire), the comments on my blog post made it clear that many people are finding that the generic version of Adderall XR just doesn’t work as well as it is supposed to.
As DS writes:
“After the first week, I really felt a difference, but tried to put it out of my mind. My shoulder and rib cage is sore, I don’t sleep and I am snapping at people all day, all night. This is not the same drug mixture/compound. It cannot possibly be. I feel tired from the lack of sleep, moody/agressive/weepy (not me!), sore (for no apparent reason) and just plain out of sorts.
Has anyone had any luck figuring out why some of us are feeling this hell-ish effect from the generic version?
- Sleepless (and crabby) in Seattle
The original generic Adderall XR was produced by the pharmaceutical company Teva.
Now, two more pharmaceutical companies will be joining the production of Adderall XR:
- Impax Pharmaceuticals will begin to ship its own version of Adderall XR at the end of 2009/early 2010. You can read more about this here.
- Sandoz Pharmaceuticals just settled a law suit with Shire (the original makers of Adderall XR) to allow them to make a generic version of Adderall XR as well. It is not clear when their production and distribution will begin. You can read about this here.
Why Are These Generics Coming?
When a pharmaceutical company creates a new medicine, they get a patent for a certain number of years. They spend hundreds of millions of dollars to get their drug to market, and then they have a number of years to profit from their medicine, before it goes ‘generic’ and other pharmaceutical companies start to manufacture the medicine (and they sell it for less).
Even when a medicine is within its patent, the generic pharmaceutical companies start law suits to challenge the patents – i.e. to see if they can start to market the drug earlier, and increase their profits. It seems that the companies that are now manufacturing and selling generic Adderall XR have pursued the legal process to challenge Shire’s patent, and they are now in the position to start to manufacture and profit from this medicine.
What does this mean to you?
Well, although I initially thought that the generic Adderall XR wouldn’t cause problems for people – there are 94 comments on my original blog post which essentially prove me wrong – i.e. many people are struggling with the generic form of the medicine.
Here is where it gets complicated.
If you used to be on the Shire Adderall XR, and then the Teva generic comes out – your pharmacy or insurance gives you the ‘cheaper’ version. Let’s say it doesn’t work as well for you, but because of the finances, or your insurance’s policy, you work with your doctor, adjust the dose and make it work.
Now, your pharmacy, or insurance company may make a deal with Impax – to get their new version of generic Adderall XR. Now, the formulation is slightly different again. Translation – you may have a different response or reaction to the new version of the generic than you did to the first one. You’ll need to go to your doctor, advocate at your insurance, and see if you can get on the medicine which works best for you.
Of course, if you can afford it – you can always ask your doctor for a prescription for Adderall XR – No Substitution (this means that your doctor is insisting that you get the original adderall xr only). The thing is that your insurance can refuse to pay for it, even if your doctor is that specific.
This can be complicated for you, or your child if you take Adderall XR. Best to monitor your symptoms, and work with your doctor to find the best solution for you.
Please share your thoughts and comments below. Your input is tremendously helpful to thousands of other people who come to this blog and learn from your experience.
All the best,
Dr. Kenny
26 Comments
October 25th, 2009 at 1:19 pm
Adderall XR was wonderful when I had good prescription coverage. Then I had to go to generic Adderall, which was okay, until they removed the Barr version and gave us Core Pharma. It was a nightmare and I am not the only one – everyone all over the internet have made big complaints about this nasty pink pill. I kept finding pharmacies who distributed the Barr version but now it has been discontinued. I have been hoarding the last few, breaking them into pieces and suffering with severe ADD. I am wondering if these XR generics are any good. I just don’t know what to do and my psychiatrist doesn’t seem to know much about ADD so I have to do the research myself. But I’m really confused about what to try. I could pay a ridiculous price for the real thing and try to fight my insurance company for payment, but I doubt I will get anywhere. Any ideas on this stuff?
October 25th, 2009 at 1:58 pm
I would suggest trying Adderall XR – it is once per day, lasts 12 hours, and a great medicine. The issue now – is – around which generic version is available to you.
November 1st, 2009 at 9:28 pm
I was taking Adderall XR through their patient assistance program for nearly 3 or 4 years when they suddenly cancelled the program and I was forced to take the generic regular Adderall which for me does not work as well. I have to pay for the Adderall XR myself and when I tried to get the generic I found that the cost was still way too high for me to pay ($375.00 for 60 ct, 30 mgs) could you please look and see when the cost will finally come down and why is still so expensive?
Thank you sincerely, loribeth
November 3rd, 2009 at 11:53 am
I had switched over to 30mg of the generic a few months ago, and hadn’t consciously noticed a difference. After reading this post, I dug out a couple spare non-generic Adderall XR, and tried them Sunday and Monday. I could immediately tell the difference. I was now calmer and more patient. At work, yesterday, I was able to focus WELL past 4pm, which is where I had been dropping off. Upon reflection of the last few months, my performance at work had dropped, and I can think of several incidents where I had inappropriately lost control.
I’m wondering if the generic formulation is simply coming up short, for me. My experiment, though brief and hardly scientific, has convinced me to switch back to the name brand.
November 4th, 2009 at 4:15 am
I had good luck with amphetamines, but always felt like a robot. So I switched to nicotine.
November 11th, 2009 at 6:15 am
not to get into too much detail on my past, but yeah i used to snort more than that all the time, the first time I ever did was a 30mg and then proceeded to do like 5 more one night… you should be just fine.
November 18th, 2009 at 11:19 pm
The first time that my son received the generic, right after Teva’s Adderall XR generic was approved in April, he tried to jump out of my car while driving down the highway and told me he was going to kill me. My son was in Kindergarten. His behavior had dramatically declined the week and a half that he was on it. I returned it to the pharmacy, told them what had happened and they exchanged it for Shire’s brand name for me. Well, maybe exchange isn’t exactly the correct word since they charged me the difference in price.
Since then, we’ve asked our Pediatrician to only prescribe the brand. Every time we get a refill RX, we have to get it corrected for brand name only. This time the pharmacy dispensed the wrong medicine. That’s what I get for sending my husband to do an errand for me.
We couldn’t figure out why his behavior started to change. Thank God it wasn’t as bad as before, but school and his before and after care program complained and life pretty much stunk at home. Supposedly its been marked in his chart again at the pediatrician’s office and his ‘profile’ has been flagged at the pharmacy as “Brand Name Only”. It’s a good thing he is not deathly alergic to something. Its interesting that CVS won’t provide us with a copy of the original prescription. Its also interesting that they do not track the lot numbers of the medication that they distribute. I need to look into that. Can that really be legal? How would they handle a class 1 recall? It might be time to change pharmacies and send an email to the FDA.
November 20th, 2009 at 12:20 pm
I am taking generic Adderall XR (an orange capsule)and it is manufactured by Barr. I know the first person was taking Adderall by Barr and this is the XR, so maybe this is the only Adderall this company now makes. It seems to work well for me.
December 3rd, 2009 at 12:08 pm
I have been on Adderall XR 60 mg daily for the past 6 years. When the Generic (Barr) came out, I continued with the same dosage. Within two weeks my concentration was lacking, as if I had stopped taking the medication. Additionally, by 2:00 pm I was dead tired and actually ready to crawl in bed. (My work is pysical.) I begin to become unreasonably angry and even enraged at fellow coworkers to the point of initiating aggressive confrontation over the least little thing. I joined the ranks of “road rage drivers”. This was not me.
I called my doctor’s office and left her a message. She had a new prescription for No Sub written up which I picked up and took to the pharmacy.
The pharmacy said that my insurance company refused to fill it because I had just picked up a supply. I explained the situation and the pharmacy said that I would have to wait until the time period for the supply expired and then resubmit the prescription.
I took it for two more weeks. When I went to the pharmacy they could find no record of the prescription. I called the dr’s office who faxed a copy to the pharmacy, but the pharmacy said that they only accepted originals for controlled substances.
I went back to the doctor (took 5 days to get an appointment so I was without medication) and she was upset at the entire thing. She wrote a letter to the insurance company and gave me a new prescription. The pharmacy said that the insurance company needed a preapproval from my doctor to consider it, so I called the dr’s office and they called the insurance company. Five weeks after I ran out The pharmacy called and said my prescription was filled in name brand.
The first dose was night and day difference. I had my old level of concentration back, could juggle two or three things simultaneously, and my energy level was strong into early evening. I also found my depression lifted. Even though I take 450 mg daily of Wellbutrin XL I had become more and more depressed. The end of the month came and the insurance company refused to refill the name brand again. They wrote my dr and said that she could appeal to an arbitrator and try to establish just grounds for the name brand and what they called extraneous dosage level. They only want to pay for 30 pills for any med. I tried taking three and four of the generic and my concentration level did increase, but my agitation, anger and aggression were just too much to handle. We are appealing to an arbitration board (comprised of insurance company employees) but don’t expect much success. And I am on Social Security disability for bipolar I, so it’s not like there isn’t a history for justification. Sorry I got carried away into the insurance thing so much. To sum it up, I have to say the generic I have experience with has a formula compounded of chemicals that induce depression in order to combat the levels of aggression, anger, and agitation the medication produces, and the entire formula seems weak compared to the brand name.
December 4th, 2009 at 3:04 pm
Hi Daniel – thanks for sharing your story. That’s unbelievably complicated. I hope you and your doctor can get that sorted out!
December 5th, 2009 at 8:06 pm
By the way…, Dr. Handelman, your blog and contributions to the topic of ADHD are very much appreciated. The subject is complex from a medical and scientific standpoint and (often in despair) consumers have needed such accessible advocacy. It’s long overdue… proper treatment of these conditions can be positively life changing.
Oops, back to the topic… I’ve been treated with Adderall for nearly 5 years (XR, 20-30mg BID). I no longer have insurance (IP) and can not afford even generic XR (which my IP switched me to upon it’s release and was fine [Barr]). Moved to 15mg IR QID (split 30mg tabs) and noticed reduced efficacy (more “rollercoaster,” jittery, reduced duration of action (given same mg amt) with Barr 30 mg tabs. Clearly suboptimal but welcome considering the med’s profound positive impact. Then came CorePharma. MAJOR PROBLEM. I experienced a nearly 50% or more reduction in efficacy (focus, concentration), had drastically increased side-effects (fatigue 1h post dosing (?!), intolerable jitters). I refused to be ripped off/suffer the next month and found a CVS with one last month of Barrs stashed. RPh warned that next month would probably be CorePharma which I will not consume. Period. I’ll find an alternative somehow. Just my experience, phenotype disclaimers apply. Thanks again.
December 6th, 2009 at 3:52 am
Jimi – Thanks for the compliment. I appreciate it
I’m sorry to hear of your problems in getting the medicine.
Can you please explain to me what CorePharma is? Is that a different generic manufacturer of the immediate release Adderall? Is Barr no longer producing the generic?
And to help you out – are there any programs which may be able to help to pay for your medication? Either sponsored/subsidized by pharma or by government?
Dr. Kenny
December 6th, 2009 at 5:19 pm
You’re welcome, this really is an excellent resource.
Sorry, although I initiated therapy with XR (DAR) I cant afford either the generic or Shire (which actually sold the XR to Barr), I have gone off-topic in mentioning the Core/Pharma IR failure. Either way this topic is about (Big)Pharma and is/will affect large numbers of patients negatively. I’ll try to put in an up to date nutshell… hold on…
December 6th, 2009 at 6:05 pm
CorePharma/Ranbaxy manufactures the pink 30mg IR that has caused an uproar on many ADHD support boards for quality issues.
Shire (orig patentholder of XR+IR) sold to Barr which was engulfed by Teva. Teva reformulated the IR also to poor consumer reviews and will be/is producing a reformulated/abbynormal original Shire brand. .
Sandoz=Eon Makes IR form that may be the generic of choice based on several anecdotes.
The death of the miraculous Shire brand Adderall XR has been pronounced by the financial talking heads and stock message board manipulators/shills alike. Apparently we have Shire to thank for bailing on “the Colonel’s recipe” XR product (off patent) in favor of the more lucrative Vyvanse.
I’m starting to get the gist of this… correct me if I’ve misstated the details. Bottom line, the Barr XR generics I was dispensed weren’t that bad, but that was pre-Teva.
The proper formulation of this medication is crucial to providing the gold standard for the stimulant treatment of ADHD. Thousands of anecdotes suggest that these reformulations may not only be inferior for therapeutic success, they also suggest that years of clinical trials and safety data may have been rendered noninformative. Unsettling to the consumer and prescriber, I’m sure.
Again, chime in if you see errors.
December 6th, 2009 at 7:30 pm
Is it just me or are many of your side effects non medicine related? I have many of these symptoms quite often in a week including rib, chest, back pains sleep problems and depressed behaviors. But I think it could be due to mood swings, diet, not enough exercise or even an old mattress.
I don’t know much about these medicines much, but I’m a 22 year old adult who haven’t taking any kind of medication or treatment since I was in elementary school (9 years old) Ritalin. I was diagnosed with ADD/ADHD (inactive version) and I think I was taken off of Ritalin after the first year because of head lice or something. Ever since then I have been living with it and school was a problem but I was a diligent and pushed my self alot to get things done. The problem with me is really the processing aspect where I couldn’t concentrate with the work and tests took me forever to finish but the teachers gave me extra time in tests. Reading and math was quite bad because i have to reread,remember and understand the steps to get it in my head, though my memorization was quit good for me. Another big problem i have is self-esteem issues so depressed feelings set in quite early for me. Shyness and inability to tell and reminisce stories gave me social issues when in group situations.
Well enough about me.
I guess now is really the time why I’m thinking of starting medication again since I’m in the working world and being fast at your feet and multitask is really important.
I’m hearing more favorable accounts with Adderall XR then the other ones any objections?
Thnks.
Sid
December 8th, 2009 at 11:14 pm
Hi Jimi,
While I can’t say for certain – I can share my opinion.
When it comes to the assertion that Shire ‘bailed’ on the Adderall XR patent – here’s my understanding.
When a research and development Pharma company brings a drug to market – they invest heavily in the research and development. Estimates are that it costs upwards of $1 Billion USD to bring a medicine to market. The pharma companies are given a patent to market and sell their medicine for a set price (I know this is regulated in Canada – don’t know about how it is done in the US), for a set period of time. Then they lose their patent and generic pharma companies can start producing it.
While people love to vilify the pharma companies – the reality is that they invest heavily in the development of medicines, and they (and their shareholders) need to see a return on investment – or – there won’t be any new medicines developed!
So – that is all reasonably clear.
Where it gets tricky – is that the generic companies start suing to break the patent well before it is supposed to finish. And, they can be successful in their lawsuits.
Normally, big pharma fights these battles hard to protect their patent and their medicines.
My understanding with Shire was that their patent for Adderall XR in the US was getting close to being near its end, and they were facing legal challenges from generic companies. My reading of the business reports online was that they decided to create a deal with the first generic company (Barr, I believe), so that there was essentially a settlement, rather than fighting a long drawn out battle.
Of course, Shire had Vyvanse coming in advance of losing the Adderall XR patent, so their business model was certainly to promote Vyvanse before Adderall XR went generic.
The unfortunate thing – as this blog post and all of the comments show – is the huge cost for PEOPLE who now can’t afford their brand name Adderall XR because their insurance won’t cover it, and the generic doesn’t work as well for them.
Anyhow – thanks for a great and lively discussion.
Dr. Kenny
December 9th, 2009 at 9:41 pm
Hi everyone,
So it has been a while since I have used Adderall XR, probably 4-5 years, and I am trying it again. I am trying it again, since I am diagnosed with ADHD without Hyper-activity, to see whether it will help me stay focus on my schoolwork while in college. From what I have heard about the side-effects of the generic Adderall XR, I really do hope it will not affect me. Are these claims really true or do each individual react differently to it? Though, like I said before, it has been quite sometime since I have used it. Hope it goes well.
December 29th, 2009 at 2:20 am
hi!
I’ve been taking 30 mg Adderall XR for about 2 years now and will sometimes get the generic and sometimes get the brand name, usually depending on whats available at my pharmacy. I personally can’t tell a single difference between the way i feel or act when taking the generic compared to brand. The generic is by BARR. I think it works just as well as when i take actual Adderall. I usually try to get the brand name only because I pay 50$ a month for the brand, and still pay 50$ for the generic. Does anyone know why i pay the same amount for the generic? Isn’t the whole point of generic medications to lower the cost???
January 3rd, 2010 at 12:49 pm
Does Shire even make/sell Adderall XR anymore? Or is “Barr” the primary company now?
January 4th, 2010 at 3:18 pm
Sarah,
Shire still makes Adderall XR. To get it though, your doctor would have to write a prescription that says: Adderall XR NO SUBSTITUTION. That way, they have to give you the Shire version. That said, your insurance may or may not cover that.
Best,
Dr. Kenny
http://www.SafeADHDMedication.com
January 5th, 2010 at 7:17 pm
Hi,
How can I tell the difference as to whether I am getting the real (Shire) or some other version of Adderall XR? I take a 30 mg pill, and I have noticed that some months it just doesn’t seem to work as well – but I haven’t noticed a difference in the colour of the pills, or anything…I thought maybe I was just tired or stressed or it was a ‘bad’ batch or something.
Thanks
January 14th, 2010 at 6:49 pm
I’ve been taking Adderall XR for over five years with great results. Without my noticing, my pharamicist filled my prescription with the generic version. I started feeling terrible. I was constantly nauseous. I took a pregnancy test and it was negative. I went to my GP to see if I had an inner ear infection and didn’t. I lost weight and didn’t have any appetite. My GP couldn’t find any reason for my nausea. The next month I had my Adderall presciption filled at a different pharmacy and they gave me the name-brand and within a couple of days I felt like my old self. The next time I had my script filled I had to go to four different pharmacies to find the name brand.
January 17th, 2010 at 12:26 am
I too have been taking Adderall XR for years with great results. I don’t currently have health insurance and now have to take the generic form although it is expensive as well. After my last refill, I started experiencing terrible headaches and nausea everyday. I thought it could be from my medication but disregarded that because I hadn’t had the same side effects when I had previously taken it. I am now going to check into it more. Thank you for your comments and insight.
January 31st, 2010 at 4:01 am
Today I tried to get my prescription for Aderall XR and the pharmacist told me that the prescription saying “prescribe as written” was not the same as “no substitution.” I had pointed this out to my dr’s office and they insisted that it was same thing because the name brand was written at the top. In my state, the pharmacy is required, by law, to substitute the generic if it is available. However, my insurance does not cover the generic. The pharmacy would only fill my prescription with the generic version.
When I called my insurance company, they told me that the generic version had not been approved by the FDA. A second pharmacy told me that the generic version had been approved. Searching the FDA database, I cannot find an approval for a generic version of Adderall XR for 20mg. Is there an approved version of generic Adderall XR for 20mg?
January 31st, 2010 at 7:36 pm
Hello,
I am a Psychiatric Nurse Practitioner licensed since 2003. I started Adderall XR 20 mg in 2002 (at age 31 for ADHD, inattentive type) which was a significant factor in my ability to complete my training program. I love psychopharmacology and have a great appreciation for its complexity. I am not sure I will ever master it as I seem to learn something new constantly.
When I prescribe meds, I explain to patients that they should get a similar response with the generic that they do with the brand name but may very by the individual AND (possibly more importantly) their perception may have a significant impact on the response. I encourage patients not to decide on med choices based on what they hear from others and explain how important it is that they communicate and journal their own response. So… I tried to practice what I preach when switched to the generic Adderall XR. However, after changing from Adderall XR 30 mg brand name to gereric for the past several months, I started looking for feedback from others due to my poor response and decline in functioning. -With the brand name, within an hour of dosing, I am ready to go – focused, organized, with good energy. Taking my meds at 6:30 am, I seemed to do quite well until about 4:30. To combat the rebound, I would take a dextrostat 5mg about this time most days that got through making dinner, etc.. Since, taking the generic has been a whole different ball game. My sleep cycle is totally screwed up. I also take Wellbutrin XL 300mg and have for years but seemed to be getting more and more depressed. Within and hour of dosing, I have to go back to sleep and currently sleeping 12 + daily. It’s miserable. Usually about 4pm, I finally start waking up and have some energy but at 10pm, I am ready for bed.
I never expected such a drastic difference with the generic and thought surely something else was wrong. In November I went to see my PCP and found that my vitamin D was a little low but now normal, otherwise medically cleared. Last week, I started an extensive work up for rib pain that has been increasingly bothersome and ongoing since August. I explained that it starts during the night and terrible by the am but once I get up and move around, it’s not noticeable. Of course, he immediately started asking about my mattress. I felt like such an idiot going to him with this weird somatic complaint so I had been going through all kinds of scenarios and symptoms with my husband (a radiologist) knowing that the PCP would likely think I was a complete fruitcake. —I was floored to see the above complaints of chest, rib, and back pain. Now I am hoping to put off the KUB and chest CT I am scheduled for.
It is my understanding that manufactures of generics are only required to have 80% of the active compound (in the US). I also think that the “fillers” can effect the release of meds in the XR form. I have an appointment with my psychiatrist next week to discuss options. It doesn’t sound like increasing the generic will improve the response. I am wondering if I am getting significantly more of the active compound in the morning and being overmedicated then tapers to what I am used to in the afternoon. Also, I am wondering if the rib pain may be a rebound symptom since it starts at night and improves when I get up in the morning and move around (the same time I take my morning dose).
Sorry so lengthy but I would greatly appreciate your feedback.
February 1st, 2010 at 11:28 pm
Amy,
Thanks for sharing your story. I have to say that i was a little surprised to see several reports of musculo-skeletal pain as a side effect of the generic, but there are a few people who have reported this on the blog.
You also raise a very important fact – when a generic is made – it has to have an ‘area under the curve’ of 80%. This means that the amount of medicine in the blood over time has to be the same. It does not mean that the generic has to have the same absorption profile. So, it is possible that the generic releases its medicine more slowly, or more quickly – and could still be approved.
I hope you feel better – and please do come back and update us. Having your medical background provides great insight for us.
Thanks,
Dr. Kenny