Generic Concerta in Canada
By*This article has been updated on May 30, 2010.
Concerta is a long acting preparation of Methylphenidate. It was launched in the US in 2000, and in Canada in 2003.
When a new medication is released, the company which produces it has a patent for a certain number of years. This allows them to market the medication exclusively until the patent runs out. This is important for the company to recoup the money invested in research and development of the new medicine, as well as to earn a profit.
I understand that it is reasonably regular that the generic pharmaceutical companies petition the courts to create a generic version of the medication BEFORE the patent runs out. Companies that create generic medicines are able to take the formula of the medication, and produce it. They then sell it at a lower price than the original medication. Often times, the generic is at a price point that is only 20-30% better than the original medication.
For background on generic medication, I want to point you to these resources:
- An Article on generic medications in ADHD – Are They The Same?
- An Article on Adderall XR going generic in the US. Take note of the comments that people share – many of them explaining the side effects and difficulties with the generic version, as well as frustrations with their pharmacies and insurance – Generic Adderall XR in the US; and Generic Adderall XR – New Formulations
Concerta Going Generic In Canada:
Concerta was brought to market in Canada by Janssen Ortho. In mid January 2010, Novopharm won a lawsuit in Canada, to be able to start to produce a ‘concerta like’ medication in Canada. The courts essentially overthrew Janssen’s patent on Concerta. Novopharm is planning to market Novo-Methylphenidate ER C, as a replacement for patients taking Concerta.
N.B. In early summer 2010, the name of the generic medicine will change from: Novo-Methylphenidate ER-C to Teva-Methylphenidate ER-C. This article will be updated when the product’s name is fully changed over.
Let’s Review the Pros and Cons of Novo-Methylphenidate ER-C:
Cons of Generic Concerta:
1) Does this medication work equally to Concerta?
Unfortunately, no one knows the answer to that. For a generic company to get approval for a new medication, they simply have to prove that their medication is absorbed within the range of 80% – 125% of the original compound. That is a huge variance.
The problem with that range? This means that the original Ritalin SR could likely meet criteria to be a generic for Concerta.
If you’ve been around long enough to remember Ritalin SR (or if you have not had insurance so it was the most cost effective medication option), you’ll know that Ritalin SR was widely found to be a very ineffective long acting medication. It often did not last longer than short acting methylphenidate in most of my patients. Most of the doctors in the field considered adding Concerta to the medications available in Canada to be a huge improvement, because we could get away from Ritalin SR and its poor efficacy.
I have been unable to get any scientific data (and neither have any of my colleagues) to demonstrate how Novo-Methylphenidate ER-C works. For all we know, it could work like Ritalin SR – which essentially means that it won’t work very well at all.
Concerta has a lot of technology in each little pill. Each pill has a laser drilled hole in it. There is short acting Methylphenidate on the outside of the pill, and then there is an osmotic capsule (meaning that water can come into the capsule from the gut). The water from the gut comes into the capsule, and expands a polymer, which then pushes the medication out of the pre-drilled laser hole – in a researched process which delivers the medication in a fashion which has been shown to work best for people.
Has Novopharm invested what is needed to develop this complex a medication delivery system?
No – they haven’t.
2) Will you be able to control which medication you get?
Let’s say a member of your family is doing very well with Concerta as a treatment for their ADHD. Now that there is a generic product – can you guarantee that you can keep this product as your monthly medication?
Not necessarily.
As of late April 2010, the Ontario government has deemed Novomethylphenidate ER-C interchangeable with Concerta.
When a medicine is deemed interchangeable, then pharmacists have an obligation to automatically substitute the generic form of the medicine for the brand name version. in other words, your pharmacist will have to substitute your Concerta with Novo-methylphenidate ER -C.
There are a couple of factors which can impact whether you get Concerta or the Generic:
- Your insurance: your third party medication insurance may decide that to save cost, they insist that you take the generic Concerta, and they may not cover the real Concerta. If the generic doesn’t work for you, you may have to either pay for it out of pocket, or just stick with the generic.
- If you are on a government provincial drug plan – they may insist on the generic version, and not cover the name brand Concerta any more (Ontario has just forced automatic substitution on their plan).
- What your pharmacy carries: some pharmacies may order in ONLY the generic version, and stop carrying the name brand Concerta. In this case, you may have to go to another pharmacy to get the medication you need.
- How your doctor writes the prescription: If your doctor just writes the prescription for ‘Concerta’, the pharmacy can substitute it automatically for the generic. If your doctor writes the words: NO SUBSTITUTION on the prescription, then the pharmacy will have to give you the name brand Concerta.
Pros of Generic Concerta:
- If this generic works well, then this means there will be a lower cost long acting medication option for people who can’t afford the more costly brand name Concerta. It seems that the price reduction is in the range of 50%.
Overall, as you might have gathered, I feel very uncomfortable with the Generic Concerta at this time (Novo-Methylphenidate ER-C). Most people that I see in my office have had a long and/or challenging road to get to the diagnosis and treatment of ADHD. Often taking a medication for ADHD is a huge decision, and arriving at a medication which works well with few side effects is beneficial and often a relief for concerned parents and family. To have that medication changed and become less effective would be very detrimental to my patients – and create a huge disruption to their lives.
Will Novo-Methylphenidate ER-C work well?
I don’t think anyone knows right now. Where is the scientific data?
I don’t know anyone who has seen it yet. And despite this, pharmacies across Canada can start stocking this and replacing it for regular Concerta (and they don’t even have to get your permission).
What do I recommend you do if you or a family member take Concerta?
- Ask your doctor to write a prescription for Concerta NO SUBSTITUTION (it doesn’t have to be capitalized – I am adding that for emphasis). Your doctor can even write: No Sub (which is faster!). It has to be in handwriting. If it is a stamp, or some other form of automated process, then the pharmacist can ignore it.
- Talk to your pharmacist about this – to check if you can still get the name brand medication
- Look closely at your prescription bottle – to see if the medication is: Concerta, or ‘Novo-Methylphenidate ER-C’
- If needed, check with your third party insurance for medication – to see if you are still able to get the name brand Concerta covered
- If you start to notice that Concerta isn’t working as well as it used to – look closely at the bottle, and realize that your prescription may have been substituted for the generic.
As this is a significant change to medication for ADHD in Canada, and one which came as a surprise – I wanted to provide you with some background. I’ll be happy to update this blog as more information comes out, and I know more about this.
One of the things that has been very helpful to many people on this blog – is that readers like you share their stories in the comments below (as you saw with the link about Adderall XR going generic in the US). So, I ask you to share your thoughts, experiences and comments below. Let’s help one another figure out how this new medication works, as well as what is going on in pharmacies, and with insurance coverage, etc. Thanks in advance for your contribution to this post.
New Updates:
Janssen Ortho Releases A Program To Help To Keep You on Brand Name Concerta:
Janssen Ortho is the company making Concerta. They have invested a lot of resources into developing Concerta, as well as educating doctors, educators, and patients and their families about ADHD and its potential impact on people’s lives.
The acceptance of the generic medicine as ‘interchangeable’ is leading to people being taken off of Concerta and being put on the generic very quickly.
Janssen has created a program which can help you to stay on the brand name product. It is called the: “Concerta Co-Pay Assist Program”.
What happens is this:
- You get a prescription from your doctor that says: Concerta No Substitution
- You go to the pharmacy, and give in the prescription – and insist that you get the brand name product.
- If the pharmacy says that your insurance will only cover the generic product, and you have to pay the difference – then you give the pharmacy a ‘Concerta Co-Pay Assist Card, and then Janssen Ortho will pay the difference between the generic medicine and the brand name medicine.
In other words, when you give one of these cards to the pharmacist – you won’t have to pay any extra above the costs of the generic medicine. This applies whether you are on the Ontario Drug Benefit Card, or whether you are on private insurance (i.e. from your work), or even if you are a cash payer.
Here is an image of the card:
You’ll notice that the card says: ‘Multi Use Patient Co-Pay Assist Program’.
This means that you can use the card over and over again, as long as you are taking Concerta (and as long as Janssen continues to run the program – which seems to be for the duration at this time). Logistically, you can either leave the card at your pharmacy, or take it with you – just make sure you still have it when you need to refill your prescription.
Now the big question you may have is: where do you get these cards?
These cards are being give out to doctors, as well as to pharmacies. So, ask your doctor if he or she has a card for you. If he or she doesn’t, you can either ask at your pharmacy, or ask your doctor to contact his or her representative from Janssen Ortho to get a card for you.
Hopefully, it will be easy for you to get a card to continue on the brand name Concerta.
***Please note – that at this time – these cards are only available in the following provinces: Ontario, British Columbia and New Brunswick.
Another Update: Potential For Abuse:
One of the risks with Methylphenidate medicines is that the medicines can be abused. Kids in school yards can sell ritalin (or short acting methylphenidate medicines) for $5 per pill. Many people will take the tablet – and crush it, so that they may snort it. When they change the route of delivery to the brain (i.e. when the medicine is absorbed via the nose vs. via the stomach), it can increase the speed of the medicine getting to the brain and it can then increase the abuse potential – i.e. people can get a ‘high’ from it when they snort it.
Concerta has a polymer inside, and a hard outer capsule. When it is crushed, there is no powder which can be snorted.
However, the Novo-methylphenidate ER-C can be crushed easily.
Look at the picture below which shows two 54 mg capsules – Novo-Methylphenidate ER C on the left, and Concerta on the right.
Generic Concerta versus NovoMethylphenidate ER C
You can clearly see that the Generic medicine is easily crushed into a powder which could increase the chances of the medicine being abused.
There are studies done which show that with Concerta, there is less risk of abuse. There aren’t any studies done on Novomethylphenidate ER C yet, but, as they say – a picture is worth a thousand words. This picture shows that it can be crushed into a fine powder – thus increasing the risk of abuse.
Best,
Dr. Kenny
p.s. regarding dosing – Novo-Methylphenidate ER-C will be available in the same doses as Concerta:
- Novo-Methylphenidate ER-C 18 mg
- Novo-Methylphenidate ER-C 27 mg
- Novo-Methylphenidate ER-C 36 mg
- Novo-Methylphenidate ER-C 54 mg
p.p.s. A comment from me about this blog post: I am not being reimbursed by Janssen Ortho for this blog post. I do not own any of their stocks. I use this blog to post my opinions and to share updates to science, research and general ‘goings on’ in the field of ADHD. That is what is happening here. I happen to feel very strongly about the generic Concerta not working as well as the brand name product – and that is why I am working hard in my office to support people staying on the product, and using this blog to get the information out to a broader audience as well.
Dr. Kenny,
I wonder if this means that the U.S. will also start offering the generic for Concerta. I will share this with our psychiatrist. Of course, it would be nice if an equivalent quality generic existed, but if it does not work the same way or is absorbed differently (I’m not a doctor, forgive me) I would hope insurance companies would cover the brand. Some generic antidepressants (e.g., prozac (fluxotine)) work just as well and are much less expensive. Thanks for sharing…this is the first I’ve heard of a generic version of Concerta. -Amy
Amy,
The patent challenge in Canada would only apply in Canada. So I don’t think this would apply to the US at all.
Nonetheless, the world is a small place and it’s worth being up to date on what is going on in different places.
Best,
Dr. Kenny
My son takes generic Ritalin SR and it works wonderfully! He does metabolize it faster but not by an exceptionally long time. I’d say it lasts 8 hours, which is twice what Ritalin does. To broadly claim that generic medications don’t work, and name a brand, is a little off. Like all medications some work for people and some don’t. For my son, generic Ritalin SR has worked wonders!
This article is of interest to me, though, because I was taking Concerta (until we planned a pregnancy). I’ve been looking forward to taking it again (after I’m finished breastfeeding). This will lower my cost considerably if it works (it will bring my monthly prescription cost under $100). Thank you for letting us know about this development!
Hi Candice,
Thanks for your comments.
In response to your comments – I’m glad to hear that Ritalin SR is working well for your son. As I mentioned above – “(ritalin SR) often did not last longer than short acting methylphenidate in most of my patients.”
There were some patients for whom it worked well, and some that it even lasted too long! However, the most common response was not very good.
In response to your statement: “To broadly claim that generic medications don’t work, and name a brand, is a little off.”
Having just re-read my article, I don’t say that generics don’t work broadly, and I don’t say that novo-methlyphenidate er c doesn’t work. I say that some people have trouble with generics (and I reference the comments on some other blog posts), and we don’t know the data on the new generic concerta. As I mention at the end of the post – if it works well, then people can save on prescription costs – which may be the case for you.
Best,
Dr. Kenny
Dr. I believe too that the generic is not the same. I think it will be proved to be less effective.
Your site has been so informative. I have 3 children, the oldest now 32, diagnosed w/ADHD or ADD. I “go back” so far that when the oldest was diagnosed, no one had heard of ADD or ritalin. He was put on ritalin 5 mg. twice a day in kindergarten (his 3rd school!) the day he turned 6! The teacher called me that afternoon and said, “It works.” His 7th grade year, in a new school, was a disaster because ritalin SR DID NOT WORK. I HAVE HEARD FROM A FRIEND THAT GENERIC CONCERTA IS NOT AS EFFECTIVE AS BRAND NAME. SHE ASKS FOR BRAND FOR HER SON (and she tends to be frugal otherwise!). HELP!!—- I HAVE A QUESTION FOR YOU: DO THE TIME RELEASE MEDS LIKE CONCERTA, VIVANCE & STRATTERA TAKE AWHILE TO WORK? I saw under Vivance that results were seen as quickly as 3 wks and was surprised (I thought instant.) My daugher, 25, has concerned me for 3 years. Her ADD has gotten worse, her hyperactivity (which didn’t cause problems when a kid–just made her outgoing!)disappeared with puberty which she hit at age 11, and a LOT of anxiety appeared instead. Her BA final presentation, her MA student teaching and thesis have been total phobias/ordeals for her. She was tested, but she will not advocate for herself or even be honest with professionals:( Her apt. is filthy. I hope to help her find a new doctor who can see her regularly until she is on a medicine that works. She is currently on 32 mg. Concerta. She weighs at least 160 lbs. It seems not to be doing anything much and totally wears off in 8 hrs. When I saw your conversion chart to ritalin, I said, “NO WONDER–she’s just taking 8 mg. ritalin! And in “descending” phase, there is nothing! More concerta might work (twice as much). Strattera did nothing for my boys, but would be worth a try if it worked and didn’t cause nervousness. Let me know what you think–I’ll pass on the response to her. Becky
Generic Concerta is not the same. I would never give it to my child. NEVER.
I am 55 years old, was on the original Concerta , and doing quite fine,
now since the 7th of April, my pharmacist switched me to the generic
and right now i would like to rip some ones head of and do something nasty down there throat, you have no idea of the thoughts that have been going through my mind since this new drug has been applied. I can no longer sleep at night, i can not concentrate on anything, in short, i would like to jump off of a bridge, because i no longer feel normal or in total control. What gives these people the right to screw around with my life, with out telling me about it..
Now you know the other side of the story, this new generic sucks, and does not work as well as the original concerta .
I have 2 dtrs. on Concerta 27 mg here in the US. I am desperately tryng to find a way to get their meds cheaper. Any suggestions. We have health insurance but no drug benefits. We are self employed and have a high deductable policy so essentially we pay $700.00 monthly premiums and the girls prescription cost $140.00 each a month. Do the math. It’s almost $1000.00 a month. We are looking into a different policy but it’s not looking favorable. The girls Dr’s do not want to switch their meds. There is 1 online pharmacy I may call
that requires a prescription that a friend used for other meds, (non prescription.) Don’t like that idea but I may try it once. Everyones
informatin has been very helpful. Thank You
I’m sorry – I don’t know of any programs in the US which can help.
Maybe some of the blog readers can help you.
Hi!
I live in Canada, my daughter is on Strattera. Her doctor told us about a “compassion” program for those children that couldn’t affort the expensive ADD meds. She has been taking this med for about 8 months and has had it given to her through the doctors office each month! We are very thankful for that!
I also mentioned in passing that I too was taking ADD meds,(Concerta) which is also expensive, she gave me 3 cards for a one month supply of meds at no cost! Programs are out their, mention it to your doctors or your local mental health services. Good luck!
How can the Canadian govt overrule patent protection by giving Novopharm the ability to market this drug?
Do they not understand that bill C-91 also protects R and D spends for new compounds? I think this is terrible and this is unacceptable. This government has hubris to the detriment of the law.
If you think pharma companies are profit driven, think again when you ponder the generic companies. Their CEOs are amongst the richest people in Canada.
Shame on them and shame on this government.
I’m 16 and I have ADHD and my grandma and grandpa brought home this lovely new generic Concerta today. I nearly cried because I absolutely can’t stand routine change and when I looked into it online it didn’t help. I talked to my grandparents and they said our pharmacy no longer has Concerta, only Novo-Methylphenidate which is the generic. Another pharmacist told me to get my psychiatrist to write “NO SUBSTITUTIONS” on my prescriptions. I simply don’t trust the generic especially after the psychotic symptoms I experienced on Strattera… Messing with medicine that already works and switching it for one that isn’t even really tested to my knowledge is never okay.
Since Most of these comments are neg i though id through in my experience..
about me, 30 year old male, fit, i have been dealing with ADHD my whole life, since my level of exercise has dropped in the last couple years, been finding that i can’t sit down and work with out the meds.
while on Concerta i found the initial hit was to high giving me a buzzed state for about an hour then not enough through he day, if i went to the higher dose the day was fine but the initial peak was to much for me..
on the generic i find that it starts much slower but give a higher amount through the day, it does however run out sooner maybe 8 hours instead of 10-12
both drugs left me with lack of feeling hungry (no issues with appetite, just have to remember to stop and eat from time to time)
both left me short on sleep, however i get more sleep on the generic as it runs out sooner..
so as it stands i actually prefer the generic.
I have been taking concerta for a few years now & it has worked really well for me,my doctor even cried a little when we found out how well it worked.Unfortunately the pharamacy just switched to the generic novo-methylphenidate of which I have now been taking for 5 days.Big-bad-hairy reaction.I was fine for most of the morning,got really tired by lunch time then suddenly I just did not ‘feel’ right & went to lay down.I experienced severe hallucinations,aggressive mood swings,depression,massive headaches and unforntunately whilst I was downtown yesterday I passed out.Not good!For those who are on certain plans that cover your medication,most will switch you to the generic -> but you can get your doctor to write you a new prescription that states ‘no substitute’ and the company brand will cover the cost.The company wants to keep your business.I find that concerta does keep me optimistic & ‘perky’,but I am willing to give the generic a shot only because I find myself being a little more realistic & that is more like my personality,I find that concerta makes me a little ‘too nice’,it’s kinda nice to feel a little more like myself.Today,so far,has not been bad at all.I feel fine,alert,focused & awake.We’ll see how it goes!
Thanks for this very informative and helpful post!
My 7 yr old son has been on Concerta for a couple of years now and it has worked great!! He tried Ritalin before that which was a disaster.
Just a few months ago my 10 yr old daughter was diagnosed with ADD and was prescribed generic Concerta. I was so excited to find out there was a generic version and consequently had my son’s refill change to the generic version. We found out the hard way that it IS NOT THE SAME as Concerta.
My daughter has had headaches constantly and has become very emotional since she’s been on the generic Concerta. My son’s behaviour is similar to what it was when he was on Ritalin (sporadic and extreme). We have an appt with our pediatrician tomorrow and hope to get the prescriptions changed back to Concerta – NO GENERIC.
Thanks for all your info – both Dr. and others who’ve commented.
I was recently switched from Concerta 54mg to the generic and I am telling you, I feel so unstable, can’t remember anything and I am feeling so depressed off and on all day. I also have depression, i’m not sure if it’s the switch in the Concerta or if I need a change in my antidepressant. This all came on quite suddenly and I’m starting to suspect that it may have to do with the generic. I can’t function this way!!!
[...] generic form of concerta which is newly being pushed in Canada. Generic Concerta | Ask MetaFilter Novo-Methylphenidate ER C | Generic Concerta | Canada | ADD ADHD Blog.com __________________ Tanya-Mae Johnston tanyamj@rogers.com single mommy to Taylor (May 6/98) and [...]
Went to my doctor today in desparate need of help since being switched to generic Concerta. He does not believe that the switch has anything to do with my symptoms….feeling okay for a couple of hrs in the am, increasingly tierd and confused by noon and depressed, grouchy and unable to function by the end of the day. This has all come on suddenly since that one change. The pharmacist still thinks it’s the Concerta however. Now I have a ‘goodie bag’ full of Cymbalta 90mg for 3 days, then up to 120mg, Risperadol 1mg in the am and 3mg in the pm and Ritalin 15mg twice a day. I’ve only ever been diagnosed with depression and suspected ADHD. Ever since I was prescribed Concerta my symptoms were tremendously better, now however I feel like I’m losing it! Any feed back would help.
There are some programs that can help you get Concerta, even other brands. You need to fill out a form and if you qualify they will send you a card to get them for less or even for free at your pharmacy. You may try Johnson & Johnson Patient Assistance Foundation, Inc. or others, depending on the one you qualify for. Just go to Johnson & Johnson’s web site and search for Prescription Programs. Good luck.
We had concerta, unfortunately, I don’t remember if it was the generic brand or not. I worked for a short while much earlier on in his treatment and he was younger then. I think it’s good that you informed us that there are some of these meds that are generic. We cannow keep a close watch on future perscriptions. Thank Dr. Handelman. Keep up the good work and let us know if any new info. comes your way.
To Dr. Handelman and patients who have noticed a difference after being switched to the generic: your suspicions are correct. Bioavailability testing of Novo-Methylphenidate ER-C vs Concerta from Teva’s PM shows the following differences in a fasting state:
Cmax Novo-MPH ER 54mg: 15.3 ng/mL (110% vs Concerta)
Cmax Concerta 54mg: 13.9 ng/mL
Tmax Novo-MPH ER 54mg: 3.8 h (3.4 h earlier than Concerta)
Tmax Concerta 54mg: 7.2 h
T1/2 Novo-MPH ER 54mg: 5.1 h (1 h longer than Concerta)
T1/2 Concerta 54mg: 4.0 h
What this means is that the peak level of MPH in your bloodstream with the generic is not only 10% higher than with Concerta, you reach this peak level 3.4 hours earlier (basically, in HALF the time)!
MPH needs to have an ascending PK profile in order to maintain clinical efficacy due to rapid intra-day tolerance, and that’s why Concerta’s OROS formulation has a low initial dosage level from 1-4 hours and ramps up to a higher dosage level from 5-8 hours (notice the Tmax of 7.2 h) and gradually drops from there (T1/2 occurs around 11-12 h, but really Concerta starts being less effective after maybe 9 h because your ascending profile is gone.
But look at the Tmax of the generic: 3.8 hours. You go straight to the max dose from 1-4 hours and it gradually drops off from there (T1/2 occurs around 9 hours), but the generic starts being less effective after maybe 6 h because your ascending profile stops way earlier.
That’s why you guys notice a buzz up front and then a crash afterwards: not only do you get loaded up with more methylphenidate in half the time, but it also “runs out” a lot quicker.
And that’s the fasting state. Testing from a fed state reveals quite a difference in Cmax and Tmax with Novo-MPH vs fasting state:
Cmax Novo-MPH ER 54mg fed: 18.7 ng/mL (+22%)
Cmax Novo-MPH ER 54mg fasting: 15.3 ng/mL
If you take the generic with a meal, you get 22% higher levels of MPH in your system. Contrast this with Concerta, with which there is only a 5% increase. What this means to me is that you have to be more careful about when you take the generic and when you eat, because it can affect the levels of MPH in your system a lot more than it does with Concerta.
Anwar – thank you for taking the time to provide such great data for us!
No problem… Thank you for warning people right from the start about the uncertainty surrounding Novo-MPH’s PK profile, and for providing useful information about auto-substitution and how patients can still receive “real” Concerta. I don’t think people realize how important the PK profile for MPH is with respect to how effective and well-tolerated the medication is for patients — including the experts at Health Canada’s TPD and ODB. You are providing a very important service here.
[...] Generic Concerta was introduced into Canada around February 2010. As I’ve written in my full article about Generic Concerta – I’m quite concerned about the fact that the new generic medicine does not have the same properties as brand name Concerta – and this may lead to problems for patients who are automatically switched from brand name Concerta to Novo-Methylphenidate ER C. [...]
We have recently received the generic Concerta. It is an utter disaster. It wears off within 6 hours or less and is not as effective. As a result, our children are unable to cope at school, their hyper behaviour is very disruptive and homelife is completely disrupted. Unfortunately, we have a 60 day supply and we cannot convince the pharmacy to reissue us the non-generic Concerta. It’s extremely disturbing that this particular generic medication is permitted on the market.
I have read all of your comments and I am searching for a new drug to answer my 11yr old son’s problem. He is onFocalin XR 25 and although it is giving him a good level of concentration he has developed aconstant head turning tick. He cracks every joint in his body constantly anywAy but this is so distracting people haveoffered him a seat on the bus. Girls look and make fun of him. He doesn’t see it thank goodness but he needs a change. What is the best choice. He has only been on this drug and vyvance which put him to sleep. I am on it and it has no shakey effect what so ever in fact my son wound up sleeping in the nurses office could not easily be woken up. I find if I don’t get 8hrs sleep I will have to sleep during the day. My body just crashes. It is important to know when taking these drugs what can interfere w absorption and reaction. Orange juice, sleep, allergy medicines. The last one will not be as effective while on the ADHD drugs. Last,my doctor has
my son on melatonin and intunit for sleep aids Intunit or intuit(?) alone caused depression suicidal thoughts. But throuh all this my son started havingseizures so now he is on an anti seizure med. Such a shame,so young so much for an amazingly creative smart funny caring boy to have to endure and yet I see my own life minus allthe drugs struggling to conquer life’s add difficulties and wonder how come we d ont have more real solutions and resources for kids, parents and schools?
I have actually had a positive over all experience with the generic so far. I am 35 yo woman starting perimenopause with severe ADHD, I was undermedicated with name brand at 54 mg, and after the initial getting used to the generic, my experiences have been VERY positive. I have a slow metabolism, so I find it lasts LONGER for me than the name brand.
You can read about it on my blog, along with my concerns/cautions for people switching from equal amounts of mg of name brand to generic.
For me, I have no choice being on a government disability program, I have to take the generic, because it is all my drug plan will cover now that it is available, so I’m very thankful the switch for me has been positive. i am less groggy in the morning, it seems to have a residual effect on me, i have not taken ANY caffeine pills since I started taking it over 3 weeks ago, and I used to top my name brand concerta with 200 mg of caffeine pills 2 or 3 times a day to try to attain awakeness and clarity.it waxdes and weans giving me a healthier ability to eat properly through the day whereas the name brand made me sick to my stomach to even consider eating in the day.
Everyone is different, so don’t be afraid to try the generic because others have had negative experiences. It might be good for you too, who knows. Just try it with caution and chart your side effects and it’s effectiveness for your doctor, as you should with any new medication.
I understand that there is a higher “abuse” factor with the generic, but in all honesty if a person is going to abuse their meds, the kind is not going to stop them. In my searches for info on how the name brand concerta was put together, I found web forums of people who are concerta users giving info on how to split the pill open with razor blades in order to get past the wax compartment that holds the meds, and were abusing it that way. Like they say, if there is a will, there is a way. People who NEED the medication to work correctly how it is intended to work for ADHD symptom relief, will be less likely to abuse it. Addicts abuse cough syrup and gravol, so I don’t see the “ease of crushing” the med as a con for people who NEED the med, and are prescribed it for using it the way it was built to be used.
Good luck.
SuperADDmom
writer of “The ADDventures of Motherhood” Blog
* i am not paid by any company to say the things I say about er-c generic. I am ADHD and a Herbalist with a personal opinion who has used ritalin, ritalin sr, concerta name brand, and now er-c. that is what I base my opinion on…personal experience.
Dr. Kenny,
I was on your side, until you lied through your teeth. You crush a Novo pill, and you crush a Concerts pill. I guarantee you will get more from Concerta every time.
TThumper – Thank you for your comment.
Regarding the crushed pill – this was done in a lab. The point of the crushed pill was to show that if someone wanted to abuse the medicine -it is much more easily done with the generic medicine than with the brand name Concerta.
(by the way – your repetitive and attacking comments were deleted).
Dr. Kenny
[...] My experience in Canada is that the new generic Concerta which has surfaced in Canada is quite an inferior drug, and falls short of Concerta in many ways. That didn’t stop Health Canada from approving the medicine, and deeming it interchangeable – which allows pharmacists to automatically substitute the medicine to people, even if they come in with a prescription requesting Concerta. To read more about this, please refer to my article on Generic Concerta in Canada. [...]
I noticed a HUGE difference in my son’s behaviour after starting on the generic. It was almost like he had not taken his medication at all. Took me about 3 weeks to clue in that this new generic Concerta was was the culprit. Even the doc said he’s had dozens of calls about it and feels that the development the generic version was a very big mistake.
My son had once been on Ritalin, Ritalin SR….none of them worked and Concerta was such a gift! We now have ‘no subs’ on file at the pharmacy.
Hi there,
I have three kids with Adhd and a drug plan that will only cover the cost of the generic drug. So, because the cost is so prohibitive, we tried the generic. Unfortunately, it was not the same. The medication appeared to be released all at once. When the medication was taken at 7am, my son appeared basically unmedicated by 1-2 pm. The beauty of Concerta was the 12 hour coverage, to see us through homework and other evening challenges. My son has consequently been in some trouble at school. (trouble we have not seen in years.) So we now have the Concerta card, but our drug store is making us jump through hoops to use it. (We cannot use it on a repeat prescription, we need a new one etc…) Our family situation is challenging enough as it is, without these new challenges. I applaud your efforts, to make people aware.
Anne – thanks for sharing your story. As this issue evolves – it is seeming that the 2 major Canadian pharmacy chains are giving people trouble – i.e. making it hard to work with. If the problems persist, I suggest you find a nice independent pharmacy, which will be very happy to work with you and make things much easier.
First off TThumper – your comments are irrelevant to this topic, and you should be ashamed talking to a physician in such a way.
Dr, Kenny, I am a third year Bio Psychology Major in ontario, and i went to pick up my prescription for concerta and was given some generic brand.
So i went back, demanded the actual concerta with the OROS pump and raised hell with the pharmacist who did not even bother to tell me they were switching my medication without even telling me.
How can they do this, even though the patent did not expire.
this new generic concerta is pure garbage , it is RITALIN SR, except the government says its a substitute.
This medication should not be played around and controlled by the government in this way, why do they care what medication i take? and why are they so desperate to get a generic concerta?
there will never be a generic concerta, and please know to all your patients, that this new generic is not a substitute. this is pure dictatorship intervention from the government, they should be jailed for interfering with our lives and wasting 3 days of my time trying to sort out the medication i have been taking for years
Hello thanks you so much this was really helpful and i have asked my pharmacy to give me a few to try because I am self employed and do not have the extra money but I believe that Concerta saved my life and it is worth the money but anything would help. I will let you know how i like the generic but it sounds like the Concerta is made in a specific way and that is what I believe has been helping me…
Hey! I just went to the pharmacy today and got my prescription for CONCERTA filled. I was shocked when I went to pay for the ‘concerta’ because it was a lot cheaper than I expected. I told my friend about how cheap my meds came to and that’s when she enlightened me to the fact that there are now concerta replicas in Canada. I am rather ticked off because I have done so well with concerta and I began taking it after hours of research, now I was given a replica with out being informed by the pharmacist them self? I’m not happy about this at all. I want to go back to the pharmacy and express how I feel about this. I did not ask for the replica! Will they reimburse the money that i paid since this is not the right medication?
Rachel – if you take the prescription back right away (without having taken any pills) the pharmacy MAY take the prescription back. But they may not. You’ll have to advocate for yourself (i.e. you may have to make some noise, depending on the pharmacist).
Dr. Kenny
Yeah I hate this.
Shame on the government.
I was taking Ritalin-SR for 10 years from 16 until Concerta was finally allowed in Canada.
unfortunately, the government does not cover it under the drug plan. So my Doctor put me back on Ritalin SR
I am currently at the maximum dose of 4x20mg per day.
The concerta I know is much better for the consistency of plasma levels throughout the day etc … but it is way too expensive to buy out of my own pocket.
My girlfriend has finally got the treatment she needs and was immediately put on Concerta. She has gotten comfortable on 54mg.
now lately, the pharmacy is trying to push this Generic Ritalin SR on me. and usually I ask for the name brand, because I am use to it. but when I am really running low on cash and since the Generic is the only one covered now, I have no choice. But I tell you. it is NOT the same thing.
now I just saw my girlfriend come home with the Generic Concerta ? I was really upset.
open both pills up. they are NOT the same mechanism.
Generic Concerta is just a bigger Generic Ritalin APO SR
there is no patented Concerta release mechanism ( the green part ) like the name brand
THAT is what makes it work so well .
so now people need to pay out of their pockets for the real drug.
I think its ridiculous.
I too have noticed a huge difference with this so-called equivelant medication. My son was doing great on the concerta and since he started this generic brand it’s been nothing but grief. he can’t sleep at night and I feel like he is suffering because of it. They worry about saving money but it’s the children that pay the price. I too will be calling my doctor and telling him to put the NO SUB on his prescription. thank you for your valuable info.
What a very interesting and very useful article! Thank you so much for shedding some light on this subject for me! I was diagnosed in April of this year with ADHD, and was prescribed Concerta ER, 36 mgs. A couple of weeks ago, when I went to refill my script, the price was about 30 dollars cheaper! I was so happy, as I have to pay out-of-pocket for all prescriptions, and the Concerta ER per month runs me about $120. (and now my doctor has me taking one in the morning and one in late afternoon, which doubles that price to $240) The pharmacist at Shoppers Drug Mart told me it was because it was the generic version. I just figured it would be exactly the same except for the way it looks. Well, I found out it is not exactly the same, and the Concerta ER helped me so very much, and I am beginning to experience the same depressed, overwhelming feelings I had when I was diagnosed. I just told myself that maybe it wasn’t working anymore, or maybe I needed more of it. My thoughts went back to being all over the place and chaotic, my agitaton and impatience with my family and myself came back full circle. I am unable to relax, and feel like that old familiar “motor” that just runs and runs until it collapses. Unfortunately, I still have a half a bottle left in my cupboard, and because I paid a small fortune, I feel like I should finish them. I take one in the morning, and one in the afternoon, and for the first couple of weeks I was unable to sleep. Now I am sleeping better but still very tired. I will most definitely be asking for the brand-name stuff from here on out. Thank you again for the information!!
Dr Kenny and to all that have replied to this post.
I started taking Concerta in January after finally being diagnosed with ADHD after 15 years of “Bi polar” depression. I knew I was not bi polar but no one would listen to me.
I first started taking the “real Concerta” and started to feel so much better and all bi polar meds stopped. I was in the hospital when they increased the dosage and after 20 years started feeling so much better again with the brand name. It gave me hope that life was worth living.
My Dr. always wrote no subs on my prescriptions so I improved rapidly. Two weeks ago I had a script filled and not having to pay for it did not notice it was generic. I started feeling very good in the morning but crashed in the afternoon. I knew the pills were made differently so I cut the generic in half and noticed no inner core whatsoever. I then started cutting them in half, taking one in the morning and one in the early afternoon all the time knowing that was NOT advisable.. but not caring. I felt better the next day.
I filled another script yesterday and my pharmacist gave me a Concerta card and the brand name as well. Now I know all will be right. My pharmacist also went to a convention and they said that the generic brand is basically not properly time released causing the big hit dose in the morning. This is a fact and in time it will be proven to our gov that it is not the same…but it will take time. TThumper you are simply wrong and should not offer on opinion if you are not sure. I myself crushed each one of the pills and the results were the same as in the photos above. Concerta will always have the patent on the design with its special core and it cannot be copied…that is why the generic does not work the same.
Thank you Dr. Kenny for all your information.
Thanks for the warning Dr. Kenny. However, I’ve found that even if the doctor writes “NO SUB” on the prescription, the pharmacists still try to sneak in the generic. My doctor wrote “NO SUB” on the prescription, but warned me to keep an eye on what they gave me. (His exact words were, “Watch those buggers – they’ll try to sneak the generic. Don’t let them.“) Sure enough, they gave me the generic. I refused it, and insisted on the brand name Concerta. They didn’t even have any in stock, and had to order it in for me. Makes me wonder how many other unsuspecting patients have been duped.
You are so right Alistiar but maybe with the new Concerta card they will finally take us seriously. I always go to my pharm where my doc is so they know now always stock it for me. I am a very good customer! The place where I received the card from was Walmart and they gave me the heads up.
I have a question though…what advantage is there for the pharmacies to give you the generic? If you are willing to pay the difference or your insurance company will cover the real thing it does not make sense. It seems to always come down to money so I am guessing that may be it
Dania, Dr. Kenny answers that question when he says this:
As of late April 2010, the Ontario government has deemed Novomethylphenidate ER-C interchangeable with Concerta.
When a medicine is deemed interchangeable, then pharmacists have an obligation to automatically substitute the generic form of the medicine for the brand name version. in other words, your pharmacist will have to substitute your Concerta with Novo-methylphenidate ER -C.
Pharmacists are obligated to do so by provincial regulation. The Ontario government (and other provinces) deem this to be in the consumer’s best interest. Usually it is, as substituting a generic gives you the same drug for less money. However, in this case, as we know, the drug is not the issue, it’s the release mechanism that makes Concerta so special (and so expensive). The pharmacist seemed annoyed with me when I pointed this out, but he didn’t argue, other than to say that if I didn’t mind paying 3 times as much, he’d order the brand name stuff for me.
The makers of Concerta went to court to block this pathetic imitation and lost. Which just goes to show you that judges aren’t always the best ‘judges’ when it comes to medical matters. Part of the problem is perception, and the way these issues are portrayed in the media. The media tends to paint the generic drug-makers as heroic Davids slaying the price-gouging pharmaceutical Goliaths. They also tend to characterize patent protection of new drugs as evidence that the government is pandering to “Big Pharma”. While they carry the flag for their naive and simplistic idealism, people like us get short-changed.
Thanks Allister,
I always get in trouble at work for not reading the “whole email” I have ADHD you know: lol… I told them to start with the bad news first then.
What can we do to make a change in this stupid ruling. I have now thoroughly red the blog with my mouth agape and am understanding the big picture. Those who do not know this are not being properly medicated and doctors seem to be thinking that it cant be the medication therefore putting them on more meds that are not necessary. The people who are so naive thinking our government could never do this as they always do what is best for us. From what I understand (and I reiterate) is it is not the medication as much as release method.
I am using the examples of poor Lisa and Anne that had one had a solution for the problems their children were facing and that of Karen who is on meds she does not want. Karen and Cheryl who were feeling great and now are feeling lousy again. Myself for the amazing pharmacist at Walmart that gave me the heads up about the difference and gave me the brand name and the Concerta card. That also peaked my interest thus bringing me to this website where once again I find that I am not alone.
Do I sound angry and frustrated… I hope so as this information needs to be made available to all that are prescribed Concerta and have been switched to the generic without knowingly do so.
To Ril Giles… anyone who was taking caffeine pills along with Concerta really needs to talk to her doctor about taking a higher dose of Concerta instead. Those who have not felt the difference probably should not be on Concerta anyway.
There is no positive or negative here…we are all just telling our stories and find we have a lot in common.
they cant force you to take the generic, they just automatically give it to you now unless you request the name brand,.
after you request it once, they should have it on file to always give you name, but I always make sure each time I refill.
we must come together and find a way to make this better now, because this is only going to get worse.
I heard a lady screaming the other day because her lipitor was generic and the name brand wasnt covered for her anymore. sweet old lady .
this is absurd. what can we do ? seriously ?
atLEAST make the pharmacists aware that this medication is NOT the same, or atleast give the patients accurate data on how the generic meds were made, with not enough testing, etc …
the companies or government is trying to force pharmcies to claim they are the same as name brand, and sell those since they are cheaper, yet they are not, so they are lying to us. period.
so, again … what now ? … make a new website ?
come on Dr. Kenny, we have something good in the making here. advocates against generic meds ;_)
with good cause.
we have battled for years to get help for ADD or ADHD or Adult ADD and then to get the proper treatment, and now they want to take THAT away from us by giving us sub-par medication at cheaper prices.
we can NOT let this happen now, what can we do people. lets seriously think about this and get together !
- DJ
My 7 year old son was switched to the generic as well. What a disaster. He started having hallucinations every day sometimes even twice a day for a full 1/2 hour. He also developed phobias. I felt so sorry for him that I had not figured it out sooner that it was the switch to the generic. He would literally start screaming bloody murder during daylight hours that someone with a knife was trying to kill him, and yet there was nothing there. He was very traumatized by this, constantly looking over his shoulder and acting very jumpy even when he was not in the hallucination. I started receiving complaints from his teacher about his distruptive behavior, which on Concerta he was very normal in the classroom. He became very agitated and irritable, not sleeping through the night, and very anxious about situations.
I am disgusted that the government or the courts do not make more testing mandatory. I would love to see a lawsuit come against someone so that responsibility would be taken for this. I would be the first to sign up for that.
I would like to say My 16 yr old daughter was given on July 26 2010 Novo-Methylphenidate ER-C 18 mg and she started taking it on july 27 2010. The first day she was fine then on jult 28 2010 I have to call 911. She was taken to a near by hospital to fine out this fake med cause her heart to be irregular and she had dizzy spells and lost version in her eyes and she was numb in her hands and lips and she had a fever and serve headache. The gave my daugter a ECG and it showed up her heart was irregular so they had to contact her heart doctor @ Sick Childrens Hospital who claims my daughter should have never been put on this as she was on Concerta 10 mg and made her depressed n like walking somby. This Novo-Methylphenidate ER-C 18mg made her really sick and more voilent. Is there sumthin sumone can help me with as the doctors lastnight told me to take my daughter on this fake pill as I already said she will not be taking this again. R these side effects normal for this drug?????
[...] For excellent and comprehensive coverage of the Concerta/Teva-Methylphendiate fiasco, I urge you to visit Dr. Handelman’s blog post, Generic Concerta in Canada. [...]
I just started the generic last month. i didn’t know about any of the controversy aside from a quick chat with the pharmacist. I am one of those people who did not find Ritalin SR helpful, and I am finding this new generic to be almost identical to SR. I find it agitating, with a very heavy “kick” when it first gets into my system. My wife says I’m much more irritable in the morning as it kicks in. I notice it wears off 6 to 7 hours later with a noticeable crash (I actually get a bit sleepy in the middle of the afternoon, which I DON’T with concerta.
I gave it a try for more than a month, but have now filed an adverse report to Health Canada (the agitation and irritability) and will be asking my doctor for an early refill specifying real concerta. I’m not a fan of drug companies normally, or of patented medications but Concerta works, and that is not my experience for myself with SR or this new generic.
THIS is BAD now. end the MADNESS.
Dr. What the heck ?
what do we do ?
this is no joke eh …
so …
?????????????????????????
I would like to know the courts reasoning for overturning the patent before it was up.
If it’s all about money I think the people who suffered the consequences should get a share in the money as well.
I also wondered about the ability of a ‘generic’ drug’s delivery system to match that of the ‘original’ since the innovative delayed delivery method of Concerta was one of its marketed superior benefits. I didn’t have to wonder very long if there would be a difference.
A few months ago my Wal-Mart pharmacy refilled my Concerta prescription with the ‘generic’ because that is the ‘law’ in Ontario. They said they could change it if I insisted and that Concerta would pay the difference between the two. I was in a hurry and didn’t have time to wait so I said if the pharmacy was sure that the ‘generic’ worked the same I would take it.
They said that there had been no reports of any ‘differences’ between the two and that they had a few patients on the ‘generic’ who had not mentioned anything. (Well in hind sight, I’m thinking those folks may not really have ADD and need the meds or else my brain is really wired way different than them!)
For me, THERE WAS A HUGE (NEG) DIFFERENCE!
I noticed the difference immediately but thought I might be experiencing a type of ‘reverse placebo’ affect meaning that I was consciously looking for differences and was imagining the following differences:
1.Extreme foggy thinking ( even worse than before diagnosis of ADD) and spaciness.
2. Increased lethargy and tiredness.
3. Stuttering (which I have never experienced in my life!) and difficulty in forming my thoughts into sentences and inability to find the right ‘words’.
I gave the ‘generic’ a fair 4 week trial and the above-noted side effects never relented.
I went back to the pharmacy and explained my situation and offered to draft up a feedback document to give to them but they didn’t need (or seem to want) the feedback.
They switched the remainder of the ‘generic’ for ‘Concerta’ and I noticed the difference immediately +postiively.
It is outrageous that our Government is allowed to mess with our minds like this (no pun intended). I thought maybe I was a ‘rarity’ and perhaps imagining the differences and hadn’t reported anything to the drug regulators.
After reading this blog, I realize I was not imagining my side affects so I will report my stuttering and excessive tiredness due to the extreme level of distress they caused me during the month I was a ‘team player’ and agreed to be guinea pig for an ‘INFERIOR GENERIC”. Never again.
We all need to say NO to generic’s if the orignal, brand name is working for us. Especially if the ‘generic’ has been approved in contradiction to supposed patent protection.
It probably wouldn’t take long to find the ‘paper trail’ ($50′s and $100′s would be my guess as a start) that allowed the generic to be deemed ‘interchangeable’.
Karen
My pharmacist recently gave my daughter the generic instead of her regular Concerta and assured us that it would be the same. I’m finding that it isn’t. It’s not a horrible debilitating difference, but it’s there. The generic doesn’t last as long, and there is a more noticeable rebound when it wears off. For about a half an hour in the evening she is running/rolling around, faking laughter and flapping her arms. She’s having a hell of a good time, but it’s a little annoying for those around her! Thanks for this blog post, I appreciate seeing all the information so clearly presented. I think I’m going to talk to the pharmacist/doctor and ask that she go back on Concerta. We’ve given this generic a fair shot for nearly a month and I just want to be back to what we were originally comfortable with. As you say, we’ve gone through many meds to find one that is just right, and a dosage that works, and I really don’t feel like playing around with it when it isn’t necessary.