In the field of pharmaceuticals, Americans have been told that price doesn't matter. Generic drugs are supposed to be identical to their brand name counterparts. For nearly 30 years, we believed this argument. We encouraged people to save money by insisting that their physicians prescribe generics whenever they were available.

All that changed several years ago when some pharmacists started telling us they had doubts about the quality of certain generic products. We also began getting letters from readers who had trouble with their generic prescriptions. Readers have shared their disappointment with generic pain relievers, antidepressants, blood pressure medicines and diabetes drugs. The generic drug manufacturers discount these reports.

Kathleen Jaeger, president and ceo of the Generic Pharmaceutical Association, has written: "To set the record straight, there are no differences between FDA-approved brand and generic medicines. A generic must meet the same high standards as the brand-name drug, with the same safety and effectiveness, same active ingredients, same strength and dosage, same labeling and use and same high quality manufacturing standards."

While we agree with Ms. Jaeger that FDA approval is rigorous, we worry that once drugs are approved and marketed, monitoring is spotty at best. For the most part, the pharmaceutical industry runs on the honor system. The FDA is not capable of analyzing more than a handful of pill bottles from pharmacy shelves each year. As a result, unscrupulous manufacturers or counterfeiters may be slipping substandard generics into the marketplace.

Joe and Terry Graedon

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  1. BetsyR

    How do we report problems with “physically defective” generic pills? One of my medications recently had a generic version released, and the tablets are literally Falling Apart in the bottle!! I’ve filled the prescription 2 times so far, and there have been a Lot of broken pills in both bottles. They come pre-packaged in sealed 30-day supply bottles (packaged & sealed by the manufacturer), so I know the problem isn’t caused by my pharmacy mishandling the tablets.

    My only options for now are to either discard the broken pills and hope there are enough left for me to be allowed to refill the Rx without it being “too early to refill”. Or I can try to match up the pieces like a bunch of little puzzles to assemble a “full” tablet. I’ve done this successfully with a few tablets, but seriously, it’s getting ridiculous! I was told by the pharmacy tech that I can’t return the medication for a refund, but I think I’m going to call again and speak with the head pharmacist, store manager, regional office, etc.

    What’s even more troubling, though: if the generic pharmaceutical company can’t even manufacturer a pill that doesn’t Fall Apart (a pretty basic requirement!), how can I trust Anything about manufacturing of this pill? How do I even know the active ingredient was synthesized properly & safely?

    The company is Orchid Pharmaceuticals, headquartered in India. They have a location listed in Princeton NJ as well, but the manufacturing is done in India. I have the phone numbers for both locations, and I considered calling one or both of them. But at this point I’d rather report them to a US federal agency like the FDA, or any other relevant agency. Especially since these agencies keep records (I assume) of the number and types of problems reported with specific drugs and the drug manufacturing companies.

    Any suggestions on who to contact to report this? I’ve also alerted my pharmacy about it (both the local pharmacy and their toll-free customer support). Pharmacies have the option to order their generics from a different company if needed, and I would seriously hope they’d change suppliers, but I suspect it’s not an easy thing to “demand” that from a pharmacy.

  2. Louise

    Has anyone noticed problems with generic cymbalta manufactured by Lupin? I am having symptoms of withdrawal after taking it two days – light headedness, some nausea, insomnia.

  3. Jenny

    I’ve been prescribed both Ambien Generic by Teva and Generic Klonopin by Activas! After over a decade with no problems with Watson being the generic company my medication came to a halt and no longer works! At first my DR increased my Klonopin to a whopping 8mg daily and Ambien to 20mg switching every other month with Ambien CR! I’m at the point I need to have to pay more money to get the brand! The FDA has approved all these generic pharmaceutical companies that are overseas and are NOT effective! 8 mg of generic Klonopin doesn’t even make me drowsy! It’s not a tolerance issue because it literally happened when my pharmacy switched brands back in February! If I take a brand it works in its full capacity! I also had issues when prescribed generic Percocet 10/325 by Activis!

    The Watson version worked wonders after major oral surgery yet Activas brand barely dulled the pain and gave me sever diarrhea! I felt sick and jittery while Watson eliminated pain and pressure, no stomach issues and did not cause jitters or racing heart beat! I actually slept! My mental health with my Ambien and Klonopin is far more worth paying more that to put drugs that contain unknown fillers from foreign companies!

    • BetsyR

      @ JENNY from NY. Have you mentioned this to your pharmacy? Sometimes pharmacies will order a particular version of the generic for you. If your current pharmacy won’t special order, are there other pharmacies in your area that do? Better yet, have you tried calling around to see if other pharmacies carry your meds from by the previous manufacturer (Watson)? Since pharmacies periodically change vendors (as you know too well), there may be a pharmacy out there that carries and/or may be willing to order the Watson version. Good luck, and sorry to hear you’re having to deal with all that.

  4. Katie

    I have been taking 20 mg. of lisinipril for several years. I haven’t noticed a change in my blood pressure until I got a refill and the manufacturer was accord healthcare. Most days I have to take 2 tablets to keep my blood pressure controlled with this new refill. I plan on seeing my doc soon to discuss this and will be calling the pharmacy.

  5. Rodney

    After two months of taking the Teva diazepam generic, I was having heart palpitations, sweating, insomnia, to a *much* greater degree than normal. I just got my Rx refilled with the same Teva brand. If I continue to have trouble I am going to have to have my doctor ask for a switch because I do NOT feel comfortable talking to my pharmacist about matters such as these because they always think, as is said a thousand times here, they think it’s “all in your head” if you claim your meds are weak… and I know that it is not in my head. The only way I stayed out of the ER this month was the fact that I had one day of the Watson brand saved… How to piss off a Ppharm? Ask for Watson brand

    • Francis

      I was switched to a different manufacturer and I am having a very hard time this month. I feel like screaming!

  6. ruth

    The doctor prescribed this medicine for rapid heartbeat. The pharmacy filled it about 3 times, then substituted the medicine. My heart was erratic and pounding after about a week or two. It got so bad, I called the pharmacist, who said it is exactly the same just different manufacturers.
    Then it got worse, I called the doctor’s office, the receptionist was not sympathetic, but said to come on in. The doctor met me at the door, said it was not my meds, even tho it started when i started taking the substitution.
    After a very unpleasant time of it, he reluctantly prescribed the first meds, if I would go to a different pharmacy. The way I could tell it was the first, was it was a larger pill that you could half.
    I take one half in the morning and one half at night. The other pill was a smaller pill, with no half marking on it, My heart still hasn’t settled down but is much better.

  7. stacie

    I’ve been taking Levothyroxine for several years. Manufacturer Sandoz 25mcg pills dissolve on my tongue the second I start to swallow water.
    This can’t be good for efficacy – I can’t find one bit of information while researching for several months now.

    • Ryan

      I have been researching this myself and can’t find anything either… I was taking them for about 3 months, and in that time I had blood work done and my numbers went from 1 to 5.5. So I called around to other pharmacies asking about manufacturers and found one that uses Mylan which is the Manufacturer that I previously used… I noticed that they aren’t accredited by the BBB where Mylan is.. Maybe there is something to that, I have know idea..

  8. Bd

    In 2013, while traveling, ran out of Effexor XR 75 mg. Received generic refill by Teva at a Walgreens. Within 2 days went into what I think was Effexor withdrawal — many side effects, including fuzzy vision. Switched back to Effexor XR in another city, which worked, but it took weeks before I was back to normal. When a generic releases most of the active ingredient at once instead of slowly over the 24- hour period, it is dangerous. FDA should decide these generics are NOT equivalent to extended release brand name meds. Thank goodness I was not driving when my body got messed up.

  9. Marcus

    Almost every month one of my prescriptions has changed formula or manufacturer. I take 3 psychiatric medications, and the change ranges from having a bad week of adjustment to my current period where I feel like I am in all-out withdrawal. These generics companies are not consumer-focused but investor-focused. When I see news reports of recalls, the CEOs talk about how it won’t hurt their stock this quarter and that things are full speed ahead.
    If you don’t know what benzodiazepine withdrawal is, it has been described as worse than heroin withdrawal. And that’s what I have been going through while trying to stay in college for the last 4 weeks. I know it started to the day when my brand of medication was changed. I know that long-term use of benzodiazepines is not good. I was 14 years old when I was put on them, and I can’t get off now—although in essence it feels like I am since the brand switch.
    I don’t trust any of these companies. Why is it that we know where our food is made but we accept generics made in India in factories that are now regularly shut down by the FDA? The FDA needs to be completely reformed and actually start regulating and TESTING these drugs!

  10. robert

    I am prescribed diazepam, had several brands over the 40 years I’m using it. Apotex and PCM =TEVA 5mg are (for me) by far the worst. This week I got Apotex thought I was going to die. Heart rate more than 140, impossible to sleep. I phoned and convinced the pharmacist to switch back to Actavis, those are what my m.d. prescribed Feel reborn. But it makes me sad for people who cannot do anything about it. Believe me staying friendly and polite to someone who is almost killing me was not easy. I live in the Netherlands

  11. F.P.

    FYI. A similar story as told by others here. I have been taking generic Zoloft or sertraline, 50gm for a few years. My pharmacy, a large chain, will sometimes switch the generic manufacturer from time to time, I suppose based on cost or availability or both. I noticed my symptoms reappeared when taking the Aurobindo Phama generic. Of course, you are never certain if its the meds or something else going on. But I was bothered by the perceived lack of effect when taking the generic so much, that I asked the pharmacy, and paid out of pocket almost $200 / 30 day supply, for the name brand Zoloft. I noticed an IMMEDIATE difference taking the brand name. Since the name brand is so expensive and not covered by insurance, I hope to at least find a generic manufacturer product that will perform as well as the name brand.

  12. Virginia P.

    I took a name brand thyroid medication from childhood (I am now almost forty) and was given a generic without warning while living in California. My life started falling apart. I lost moments of memory. I had trouble doing basic things. I was writing a dissertation at a top university and my ability to organize my work and thoughts fell apart in less than six months. As I had no warning I also had no suspicion of why or what was happening. I had brain fog, exhaustion, depression, and ultimately three different kings of anemia–leaving me with a feeling of electric shocks running through my body.
    Is there something I can do to make sure this doesn’t happen to others? It had a terrible effect on me personally and professionally–and several months of my life just feel like a blur. I want some answers … I am more or less fine now — I’m still taking supplements to try to fix the anemias. I think it is understandable that I am upset. I will write to the FDA and to Wallgreen’s (where I was unwittingly filling the prescription). This happened in California and North Carolina–and I don’t understand why the latter since they are not supposed to be able to change medications without telling you. My feeling is this is malpractice in fact if not in law …

  13. Patti

    Wow this website is incredible! I honestly thought I was losing my mind as did my Dr. I have been on toprol for 5 years with no problems …until the pharmacy I use (no names needed) and when switched to the generic I have felt like walking dead.
    My Dr. has notified pharmacy that I can’t take generics in my Dilantin and synthroid… but the metoprolol is generic and every month seems to be a different story… one month I can feel fine and than the next feel shaky, foggy, depressed and trembling legs.Anyone else experience this issue… I’m off to see the doctor next week and I’m sure she will think I am over the edge because she weaned me off generic Zoloft because I was not feeling any effect from it. Please someone tell me I’m not over-reacting.

    • Crystal

      I also live in NC and can’t comprehend why docs here don’t understand that the Synyhroid is so dosage specific that once it’s right, it shouldn’t be tampered with! Same thing happened to me after moving here so I feel your pain. It was a nightmare, first they had me on antidepressants and Librium. Didn’t want to listen and accept that generics are different. Now I’m disabled with arthritis from a car wreck many years later. Same battle trying to get neurologist and pharmacist to accept pain med generics, the cheaper they get, less effective and shorter shelf life. Not years but weeks! Glad I got my Synthroid back, but this pain is getting to me. Neck and spine. Ouch. And I will not take extra or put anything up my nose except my pinky! Small nostrils. Good luck to you all. Pharma can buy low and sell high. Docs don’t listen much anymore as we are on a stop watch. Ouch. Goodnight and God bless.

  14. AB

    I’ve been on Loestrin 1/20 made by Duramed for awhile now and I’ve done quite well on it. My menopausal symptoms abated and I felt well with no side effects. For several months I took a generic version called microgestin made by Watson. I felt no difference from the brand name and did well. When we had a pay cut at work, I began to order my medicine from Caremark. We’ve had many problems there, including wrong drugs, wrong dosages, incorrect information given over the phone, conflicting information on the phone vs. online secure messaging, but the pertinent problem here is with the generic version of Loestrin they sent me: Junel manufactured by Teva. It took me a long time to figure out what was wrong.
    Gradually I began to have hot flashes, night sweats, mood swings, many of the troubles that had me begin the medicine in the first place. I did not attribute it to the medicine until very recently when I said “you know, it feels as though I’m not taking any hormone at all! Just placebo day after day!” I looked at the manufacturer and sure enough, Teva. Previously I had a doctor ask our pharmacist not to use Teva with another medicine so I guess this isn’t so shocking.
    I wrote to Caremark and asked if I could switch to another generic or brand name. I’m going to call my doc on Monday and tell her about it. I still have some of this batch left. I wish I could have it tested somehow.

  15. LR

    I found the same issue with my generic script that I just had filled at a local pharmacy. When I checked package, it wasn’t made by the same manufacturer that had made my previous generic imitrex. It is made in India. The other generic worked fine. This same pharmacy filled another script with product made in Israel, where previously the meds were made in NJ. This particular script is a topical chemotherapy. Not the same in texture and when you open the tube it oozes and you can’t stop it. The tube is $381 so to end up wasting 10 to 15 applications every tine you open the tube is unacceptable.
    These two scripts came from a local pharmacy not a chain, so I would have thought they would be better about issues like that but I guess they go for the cheapest possible suppliers.

  16. SL

    Is there somewhere you can have medication analyzed if you have suspicions that a generic is not complying with guidelines? I would be willing to pay if there is a legitimate way to do have a medication analyzed. I reported my concerns to my pharmacist, but only got the standard company line of generics are by law biologically equal to their brand name counterparts. Thank you.
    PEOPLE’S PHARMACY RESPONSE: Such an analysis is sadly far too pricey for an individual or even a small company like ours to undertake. Do report your concern to MedWatch.

  17. Teresa

    I was taking a 5 mg generic for flexeril (cyclobenzaprine) for fibromyalgia pain. I found that 1/2 of the tablet (round pink TL 211) was sufficient to block pain and allow me a decent nights sleep. I had to switch to another pharmacy and they filled the prescription with a different generic (round blue M 771). My usual dose of 1/2 pill for the blue pill did not work at all. I upped the dose (yes this was OK, the prescription states 1/2 to 1 pill 3x daily) and took a whole pill nightly for two weeks with no noticeable effect. I had 5 of the pink pills tucked in my travel bag so that I would be sure to have some medication in case of emergencies. I gave up and took 1/2 of one of the pink pills and slept all night.
    I took the prescription back to the pharmacy to talk to the pharmacist. He stated he had never heard of any such thing and that it must have been my body that changed. Obviously not true. After I asked specifically, he stated that he had received no other complaints. I asked specifically, and he stated that there was no way to report that the drug didn’t seem to work, no way to test the drug, and no way to file a complaint. All he would suggest is that I up the dosage to 10 mg.
    I’ve been searching the FDA website, etc. for some guidance on who to report to or complain to and this is the only place I’ve found so far. Why isn’t there an official place to which one can report less than effective generic drugs?

    • Francis M.

      Hey I know the feeling. Going through the same problem.

  18. robert

    I was switched from Avtavis witch was fine to me to TEVA diazepam I’ve got ill an hour after taking it, heart irregularity is the scariest and the spastic like uncontrollable movements. Now I’m trying to get the old Actavis again. Lucky I have some til Monday when I have to phone pd, pharmacy, and TEVA what in the name of hell is in the tablets. It is no diazepam.

  19. DTM

    I wanted to report that Teva’s generic drug Zolipidem 10MG (Ambien) is ineffective in treating insomnia . Just tried this brand which my pharmacist substituted for Mylan Mfg. which I use to get RX from. There is no comparison between the two brands in the way the medication gives expected results. FDA should look into this since Teva is selling a lot of Zolipidem to a lot of unsuspecting people and making a lot of money for a poorly manufactured drug.

  20. AW

    I find that I have to take twice as much of the generic Imitrex to get about two-thirds of the effectiveness of the name-brand, but I’m unable to get the name-brand anymore because of the cost.

  21. usdoc

    Generic Zonegran, manufactured as Zonisamide, 100mg by Mylan are causing the skin on the palms and fingers on my hands and feet to peel and sluff. This is only with this one manufacturer, and it is nearly continuous year round.
    I need Zonisamide to fight a broken sciatic nerve’s pounding pain, and now radiation nerve damage.

  22. B. Coleman

    Thank you for providing this forum.
    As a 63 year old male, I take a variety of generic drugs. I have, many of us have, grown to depend on them for our health.
    We are seeing now many of the problems involving purity and bio equivalence that were predicted, coming to light. I had been taking the generic bupropion, Wellbutrin XL since it became available several years ago and have had my suspicions. This recent inquiry into this product explains some things. Many doctors, nurses and pharmacists considered my concerns as “all in my head”. Many symptoms, unless severe, are often not evaluated properly.
    I expect this is only the tip of the iceberg as there are hundreds of different drugs in many strengths and forms. I take several pain medications they seem to vary in performance, at times. Thanks again for providing a forum to address these issues. I will continue to be vigilant for myself, my family and loved ones.

  23. LK

    Generic form of Clarinex (desloratadine) by Virtus Pharmaceuticals did NOT work for me because it caused increasingly severe gastrointestinal symptoms over several weeks. Finally I stopped taking it in hopes that I’d get some relief, and almost immediately things improved. I suspected this medication after a few weeks because nothing else had changed. Also, the pills have a bad odor and taste (musty odor, almost like penicillin). The G.I. symptoms became pretty bad (diarrhea 5-6x/day, to the point where I almost couldn’t leave the house). I’m wondering if one of the “fillers” is the culprit.

  24. tamcush

    HI It doesn’t matter what spelling they use. There are articles on the internet. its the manufacturer that is important. In the effected Wellbutrin, it’s TEVA Manufacturers. Their version of generic Wellbutrin is the one at issue and they “voluntarily” recalled it. Check with you pharmacist on who’s drug they sold you. My daughter is better after switching her meds and 18 days inpatient, she is stable again.

  25. w d p

    I’m confused, I take BUPRONION HCL XL TABS and have developed the same symptoms as others claim in earlier comments. I had been taking Welbutrin in the past and got along fine. I ask my druggist yesterday as I’m getting concern and she said that is was Budeprion that was recalled not Bupropion that was recalled. ( notice the spelling ) so what is the real story ?? please someone answer because in need support to get my Doctor to get me off of this… How does one ween from a drug ?
    What is the difference between the spelling ???
    Thanks wdp

  26. John

    My insurance, Tricare, demands generics. I take Fosinopril for my blood pressure. They switch to a different generic manufacture of it, every third or fourth prescription refill. Every time they do that, my BP goes up. It usually takes months to get it stabilized again. I have gone from 10mg a day (TEVA manufacture-to now 40 mg a day (Eon/Sandoz). I would happily pay a premium or surcharge for a quality manufacture of Fosinopril, just to keep from having to go through that. I’m 60 years old and don’t need the grief. All generics are not the same. All manufactures of the same generic drug are not the same. I complained to Tricare about it. They said it was not their problem because I had already paid for it.

  27. Linda

    Has Anyone concentrated on the inert ingredients in generic formulations?
    Recently, I took a generic of Keppra, a brand-name drug that worked well for 7 years but which costs 1000’s of Dollars a year. The generic, which costs 320 a year, meant unbearable itching and burning. I finally had numb feet–Peripheral neuropathy… from which I hope I am recovering. No generic formulation has the same formulation as Keppra. Yet, these other ingredients are misnamed inert. They all have functions. They are chosen for their precise role. They are not inert. I had a reaction to one of them.

  28. Tammy C

    My daughter has recently been diagnosed with Bipolar Disease in January of this year. We thought after 2 inpatient admissions, we thought that we had her stabilized with her meds. THEN, the insurance company that I work for, forced us to use generic Seroquel and Wellbutrin. Now after 6 months of dealing with her sliding back into depression, we have the suggestion that the generic Seroquel does not work as well and now there is a voluntary recall or withdrawal of the Wellbutrin.
    I am at a loss for what to do. Is anyone else having this problem with the Seroquel? Her doctor’s office seemed to be all to familiar with the problem and put her on a 3rd drug, Celexa. They have now doubled the dose of the Celexa but she is barely able to function.

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