Are you a Health Professional? Jump over to the doctors only platform. Click Here

Generic medicines: Questions to ask your pharmacist (Part 3)

In what ways are generic and original medicines different?When a pharmacist offers you a generic version of the medicine prescribed by your doctor, you probably expect to be given the same medicine, only cheaper. In many cases the generic version is not cheaper, so check that there is a price benefit for you. In addition, there are some other differences between an original medicine and a generic copy which are important to understand.


Sometimes the generic version is not cheaper, so check that there is a price benefit for you.

Name and appearance

There may be several different generic versions of a particular medicine available. They will all have the same active ingredient, but may be different in colour, shape and size, come in different packaging, and be called by different names.1,2

This can be confusing. In fact, patient confusion is the most common concern that GPs and pharmacists have about using generics, especially among the elderly and people who have difficulty reading or speaking English, or who are taking several different medicines.3-5

Getting confused can have serious consequences. For example, a double dose of the same medicine could easily be taken by accident if you have two versions with different names that look different.3,5

Be sure to always read the pack. Your medicine may be clearly labelled by the pharmacist if the brand has been changed. It will say something like, "This medicine replaces brand X, do not use both." The active ingredients should also be obvious on the label. Your pharmacist should always explain any differences in the appearance (e.g. colour) or form (e.g. tablet or capsule) of the medicine. Don’t be afraid to ask questions if you’re confused.5


Other ingredients or ‘excipients’

There may also be differences in the other ‘inactive’ ingredients used in the product. These might be used to make the medicine hold together, or to make it easier to swallow.1 Even though they’re called ‘inactive’, these ingredients can sometimes affect the way you tolerate treatment.3

While rare, there is a risk of allergy or intolerance to some ingredients like lactose or gluten, or to the colours used in the medicine.1,3 It may not be possible to know which ingredients in generic or original products cause reactions, since their formulations will probably be similar.3

Inactive ingredients may also be an issue if you observe particular religious or cultural practices.1,5

You can find out which inactive ingredients are in your medicine by referring to the consumer medicine leaflet (CMI) inside the pack or available from your pharmacist.5


Dose variation

All generic versions of a particular medicine have to be ‘bioequivalent’ to the original brand. This means that the same amount of active medicine enters the blood and you can expect their effects to be identical.2,3 However, when 785 Australian GPs were surveyed:

  • 27% believed that generic medicines were not always as effective as original brands;5 and
  • 30% were undecided about their bioequivalence.5

Products that are not bioequivalent should not be substituted for each other.3 A few medicines are so sensitive to even tiny changes in dose, it’s recommended that you avoid changing brand.3 Also, the inactive ingredients may be different even in bioequivalent products, although it’s rare for these ingredients to cause side effects.5


The National Prescribing Service does NOT recommend brand substitution if:

  • You have a significant intolerance/allergy, or if there are religious/cultural issues, related to any inactive ingredients in the generic medicine.5
  • You are more likely to become confused (e.g. from a non-English speaking background, or have vision or cognitive impairment).5
  • A relatively small change in the concentration of your medicine in the blood can make it less effective or cause significant side effects (e.g. treatments like cyclosporin, digoxin or warfarin).5
  • You have a condition where negative perceptions/attitudes to substitution can affect how often you take your treatment or your response to it (e.g. mental illness).5

Always check with your doctor before accepting a generic alternative if you are unsure.

 


 Glossary: What is …?


 … an original branded medicine?

A branded medicine is the original version of that medicine, which has been through rigorous clinical testing over a number of years to prove its effectiveness and safety for a particular medical condition. A new medicine can have a ‘patent’ taken out on it.6


 … a patent?

If a company that develops a particular medicine takes out a patent on it, only they have the right to produce and distribute that medicine for a period of time. In Australia, a patent usually lasts for 10+ years from when a medicine is first marketed.2


 … a generic?

Once the patent on a medicine expires, other manufacturers can make and sell copies of that medicine. The active ingredient in these generic copies is the same as in the original branded version, but the medicine may look different and have a different name. To add to the complication, there may be many different generic versions of a particular medicine available.2 

Always speak to your doctor about which medicines are suitable for you.
 

References

  1. NPS Fact Sheet: Know the active ingredient [online]. October 2008 [cited 10 March 2010]. Available from URL: http://www.nps.org.au/ consumers/ publications/ factsheets/ factsheets/ get_to_know_your_medicines/ know_the_active_ingredient2
  2. NPS News 44: Generic medicines: same difference? [online]. February 2006 [cited 4 January 2010]. Available from URL: http://www.nps.org.au/ __data/ assets/ pdf_file/ 0020/ 15842/ news44.pdf
  3. McLachlan AJ, Ramzan I, Milne RW. Frequently asked questions about generic medicines. Aust Prescr. 2007; 30: 41-3.
  4. Phelps K. Australian Medical Association accepts generic prescribing. BMJ. 2003; 326(7396): 985.
  5. NPS News 55: Generic medicines: Dealing with multiple brands [online]. 1 December 2007 [cited 4 January 2010]. Available from URL: http://www.nps.org.au/ health_professionals/ publications/ nps_news/ current/ generic_medicines_dealing_with_multiple_brands
  6. Virtual Medical Centre. Generic Drugs and Brand Drugs (Generic Medicine and Branded Medicine) [online]. 28 April 2009 [cited 4 January 2010]. Available from URL: / treatments.asp?sid=147

Dates

Posted On: 2 July, 2010
Modified On: 13 March, 2014

Tags



Created by: myVMC