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. Karen
    Pennsylvania
    Reply

    My pharmacy just switched to an aurobindo generic for venlafaxine. Ever since my symptoms have been getting worse. Today I had a major episode of tremors, confusion, sweats, and speech problems. So bad that my doctor wanted me to go to the emergency room. Now she told me to stop taking the medicine abruptly and I’m scared to see what is about to happen.

  2. Tim S
    Reply

    Refilled my prescription for sertraline at Walgreens,( the MFG for my drugs went from Greenstone to Aurobindo), I noticed the pill looked different and the MFG seemed different but, I figured it wouldn’t be that big of a deal, the pill description matched the pills inside.
    Then after 2 weeks of the drug, I would go home after and I wanted to kill everyone. I was so emotional and all over the place. I literally started to feel schizophrenic and not myself. I hated anyone that crossed my path at home, and I would lock myself in my room for hours, wondering wtf is wrong with me. I just knew I was feeling weird.
    Finally at work, someone mentioned a very similar issue they had where they had a bad reaction to a new generic version of a pill they’ve been taking forever. Going home, I was set to figure everything out, but as soon as I closed the door, I had the worst panic attack of my life. I have had anxiety issues for many years and I have overcome this a million times, but this one sent me to the hospital. I called my mom because I felt strange and I was slurring my words and could only answer yes/no questions. My mom came to check up on my and found me face down on the floor having a seizure (ended up being a pseudo-seizure). I was hospitalized for 24 hours. Can I sue someone or contact anybody for this? I feel like this is sickening that you can be on the same drug for years and then they’re allowed to switch generic brands (A TOTALLY DIFFERENT DRUG) without really telling you.

  3. Karen
    Mpls, Minnesota
    Reply

    I was taking a generic zonisamide made by Caraco Pharmaceutical Laboratories then my pharmacy switched to the generic zonisamide made by Ranbaxy Phamaceuticals, took for a couple of months and started having seizures. I had my pharmacy order the original ones, then felt like I did when I first started taking the zonisamide, tired, somewhat drugged. I’ll give it more time before I declare myself seizure free.

    • Sharon
      North Carolina
      Reply

      I just had a similar experience with Walgreen’s switching from Greenstone’s generic sertraline to one manufactured by Aurobindo. I had done very well for years on the Greenstone generic, but within two days of starting the Aurobindo tablets, I began feeling manic and couldn’t sleep at all. I felt like my brain had gone into overdrive. I also experienced constipation and had headache. I looked the two generics up on Drugs.com and found that the inactive ingredients were almost identical, with the exception of some type of potato starch in the Aurobindo tablets (which would make it pretty bad if you had celiac disease). I did, however, notice a difference in the ORDER of inactive ingredients listed, so that may have an effect on the absorption of the active ingredient. What I do know for certain is that switching generics like this is DANGEROUS and seems to be made solely on the basis of cost, with no examination of the difference in ingredients and the possible effect on the patient (as in the aforementioned potato starch and celiac disease). I have contacted my representative in Washington and asked that this be looked into. It’s time to STOP this practice!

  4. Mel
    Wisconsin
    Reply

    I have been on Sertraline 25mg manufactured by Greenstone for many years until Walgreens switched to selling the drug manufactured by Aurobindo, in July 2015. I have had the most horrific panic attacks and pervasive anxious feelings since the switch. I have never before experienced such mental anguish, which is chemical and due to the change of manufacturer. (I am fortunate not to have any major stressors to blame.)

    Apparently Walgreens stopped selling Greenstone since it was more expensive than Aurobindo. Walgreens informed me today that they will “try” to get me a refill from Greenstone. I was also able to find a small independent pharmacy which carries the Greenstone drug.

    • David
      Denver, Co
      Reply

      I have had this same problem. I tried calling Walgreens Pharmacy and they refused to help in any way. I really don’t know what to do. I can’t find any nearby pharmacies that carry the Greenstone brand sertraline.

      • Melissa
        Denver
        Reply

        I’m having the same problem with the auro bindo generic. Been on it for two weeks and feel horrible. I just had my pharmacist fill my prescription with the brand and not the generic. I’ve taken the brand before and it’s so much more expensive but I’m not taking this junk generic anymore

  5. Sue
    Michigan
    Reply

    I have been on Zoloft since 1991. I switched to Sertraline HCl as soon as it was available. I have been stable on 200 mg for several years. Since my last refill I have noticed a gradual decline in my mood. I am ‘down in the hole’ again and can’t seem to find a way out. I have even been obsessing with suicidal ideation again. It’s a scary place to be in. Situationally nothing has changed in my life. I am in a therapy, so I feel safe. I am starting to wonder about the effectiveness of my Sertraline 100 mg. It is an oval, yellow tablet with the imprint G 4910/100. My next refill is from a different manufacturer. It is an oval, yellow tablet with the imprint A/1 8. This change causes me further concern. I was curious if anyone else has had a return of symptoms while taking Sertraline vs Zoloft.

  6. Cliff
    Portland OR
    Reply

    I had the exact same issue as Jennifer from Boston. Sertraline was switched from Greenstone to Aurobindo at Wallgreeens. I started feeling anxious, lightheaded, and I had a Vesovagal reaction and passed out at work. After 2 weeks of this I have called Walgreens and they have ordered the Greenstone for me. I have been on this drug for over 10 years and I have never had a reaction like this.

  7. Rachel
    Clarksville, Tn
    Reply

    I have started taking lisinopril and spironolactone manufactured by qualitest and my last blood pressure reading was high. I haven’t gained weight, actually have lost. And my sodium intake is less. I have noticed I haven’t been visiting the restroom as often as I did taking a different brand. Last night I took one of my old spironolactone and I’ve been urinating every two to three hours and my feet aren’t as puffy. I’m thinking the quality of Qualitest is not there. It’s not working. How do we get checked out?

  8. Cheryl
    MA
    Reply

    I never realized there were different manufacturers for generic medications. I recently refilled a prescription for escitalopram, which I’ve been taking with great success for a long time. But shortly after I got the refill, I started having really pronounced symptoms. I’ve been joking, “who switched my Lexapro for placebos?”

    I called the pharmacy today just to make sure there hadn’t been a mixup. The pharmacist told me they’d switched manufacturers for escitalopram. I asked more questions and found that the generic made by Lupin was working just fine, but on the recent refill I got the generic made by Accord. I might as well be taking tic tacs.

    My doctor called every pharmacy in town, and no one has the Lupin escitalopram. So now she’s calling in a script for Lexapro name brand only, no generic. It absolutely infuriates me, because the generic has been working so well for such a long time. Now I’m going to have to pay more for brand name. It doesn’t feel fair.

  9. Jennifer
    Boston, MA
    Reply

    Recently filled my Rx for generic sertraline and was informed the manufacturer changed (went from Greenstone to Aurobindo). I know from past experience this can be an issue but I was trying to go with the flow. Fast forward after taking the Aurobindo for 2 weeks and it was scary how dark my mood/thoughts were getting. Walgreen’s actually handled it great when I went in to tell them I was not responding well at all to the Aurobindo sertraline and needed to switch back. They were able to get me the Greenstone manufacturer again within a couple of days but it took another 2 weeks to get it back into my system and start to feel like I was in control of my thoughts again…pretty terrifying really. Overall bad experience with sertraline manufactured by Aurobindo.

  10. D
    VA
    Reply

    I take the Zolpidem generic Ambiem.The oval shape with E and the #79 works great but the generic round shape with TEVA/74 doesn’t. I must say it is a difference in the mfg.

  11. Carol
    Pennsylvania
    Reply

    I find the generic brand Qualitest is of little help with my anxiety while Tva & Mylan both work

  12. jean
    maryland
    Reply

    Been taking Sandoz valsartan and pharmacy switched to Aurobindo. Not working and must have a lot of fillers as it also upsets my stomach.

  13. Jason
    Birmingham, Al
    Reply

    I started using Apotex Metformin 2 months ago (March/15) sourced from Publix due to being a “FREE” drug. In the past 2 months my blood sugar has spiked by 40-50 points on average in comparison to the version I received from Walgreens. I guess free is a substitute for CRAPPY MEDICINES!!

    • jay
      FL
      Reply

      I had the same experience Publix free metformin my numbers were 150-160 switched back to Walmart’s $15 for 90 days supply and my numbers are back to normal 120-125. Spend the money get REAL Drugs. This must be horrible for the elderly who move south and think their diabetes is getting worse, when in fact it really isn’t.

  14. Alice
    Easton PA
    Reply

    I just restarted pravastatin sodium 10 mg. I was given a prescription manufactured By Apotex. I have never had such bad side effects. I don’t think this was “up to snuff”. I have requested my pharmacy to only give this drug manufactured by Teva.

  15. CDH
    HI
    Reply

    Ever since the switch from the Oxycodone 5mg / 325mg round white tablet w/ #512 on one side & scored on the other – the switch was to Aurobindo Pharm (supposed equivalent) U15 oblong tablet – These Aurobindo tabs DON’T WORK AT ALL !!! My pain levels are thru the roof with little relief of parastesia pains – I talked to the Pharmacy/Pharmacist but to no avail – they claim I’m the only one complaining !? Huh? – After seeing the web results, I don’t believe I’m the “the only complainer” & they must be full of shizaam. I don’t know what to do – almost 1 yr. w/ so much pain – Oh yeah, BTW -I still have just a few of the “old round 512’s” & still they work way better than a “Fresh Aurobindo Pharm U15″. I must say – these Aurobindo U15’s suck because they simply don’t work. :(

  16. Tanya
    Durham NC
    Reply

    I have been on generic lexapro for a while but on occasion, the pharmacist will switch the manufacturer and I get the escitalopram oxalate that has a letter M on it. The last time I took this, it made me so incredibly tired and light headed that I could barely function ( I am on a 10mg dose). It has been a while since this has happened but last week I was given the drug with M on it again and same symptoms are happening. The pharmacist insists it’s the same as other generic (that has an I/G on it), but I just can’t believe this based on symptoms. Has anyone else had a problem with the generic with the M on it? Who is the manufacturer of the one with M on it and how can I report it?

    • Molly
      Maine
      Reply

      Sorry this is a bit late, but any pills of any type of medication that have a boxed M on them are made by Mallinckrodt Pharmaceuticals. Sometimes people mistakenly think this brand mark means Mylan (another company) but they are not.

  17. KoricleWA
    Reply

    I have stories and anecdotes about this subject for days, but as we all know, that won’t make a difference when it comes to enacting real regulatory reform for generics. In an ideal (or even obvious) world, the fact that *thousands* of people have noticed differences in their medication from brand to brand would be enough to, at least, warrant some further investigation into the matter. This post alone is a microcosm of that point – it’s over seven years old, and it is *still* gaining comment-traction, attention, and search-engine-generated results from people who want to know why they’re experiencing differences in their medication from brand to brand.

    As far as statistics go, the number of people who take X-medication and the number of people who have noticed discrepancies in X-medication after switching from name-brand to generic (or after switching from one generic to another) is large enough to make a convincing pie chart. It’s a bit curious that the issue is still present and unchanged after wide speculation and concern. If an average business found a large percentage of its consumers expressing quality-inconsistency, it wouldn’t be long before the business was forced to change… or fold (word-of-mouth, competition, governmental regulation and/or quality control, failure to comply with standards of safety, etc etc etc). So why hasn’t anything changed when this many people have recognized inconsistencies in their prescription medications? The ‘business’ in question is not your ‘average business’. It’s extremely difficult for average folks (even if they are also the business’s primary consumers) to enact large-scale scrutiny/reform/transparency when the business or industry 1. generates significant money (and is therefore responsible for large economic growth), 2. finances scientific research or other studies (which happen to often cross-benefit mutual industries and/or interested parties), or 3. actively participates in a symbiotic relationship with political affiliations. Yet if anyone tries to point this out (that is, “what separates the “average business” from a pharmaceutical company) they’ll be accused of sounding like a conspiracy-fueled, tinfoil-hat-wearing loon.

  18. Brenda
    Georgia
    Reply

    As of Jan 2 2015, I am now paying almost $300.00 ea month for2 brand name drugs – Maxide and Glucophage. The generics used to work but haven’t for a long time. I have previously had to pay
    more, but the difference is almost $300 compared to $100 ea month. They told me a letter from Dr will not even be considered.
    Thank you for any help.

    • Lena
      Ohio
      Reply

      The Metformin pills from India are so cheap, Walmart, Target and Supermarkets are giving monthly supplies for free. We all need to write to the FDA. Sun Pharma, AscendLabs are falsifying quality records. And the pills don’t work. No one cares!

  19. susan
    iowa
    Reply

    You should know that synthroid has never been approved by the FDA because it is a very old drug. I took it for a few years. Then broke out in a rash over all of my body. Culprit after many many tests was Synthroid. Switched to levothyroxine and no problems. Check out the color of the pills that cause issues. I cannot take pills with green dye in them.

  20. Gretchen Saaduddin
    Los Angeles
    Reply

    Have you heard anything about Metformin by Major Pharmaceuticals not working? For some reason the VA sent my brother many more bottles than he could use of the 1000 mg strength, which he was supposed to break in half and take 1 bid. My mom ran out of hers and was given some of my brothers. His blood sugar never changed at all with this Major Metformin, which I found odd. Before my mom took the VA Major brand, her blood sugar which was quite well controlled with her own prescribed Metformin. It promptly went up to almost 200, and has never gone below 125 previously. Why is this? Is some weird research being done on vets that we know nothing about? With all the recent VA problems I am wondering if I inadvertently uncovered something. They have really been pushing insulin on him, because his blood sugar is so high. Something really stinks here, and I would like to know what is going on.

    • Mrs. M
      OH
      Reply

      Interesting! I got pushed into mail-order pharmacy via insurance (thanks, Obama!) and my metformin is a different manufacturer. Have taken it for about 30 days and my morning b.s. readings are too high; I’ve even slightly increased the Levemir I take daily and it still isn’t working. Tomorrow, back to my local pharmacy to get meds from previous manufacturer. I pray it makes a difference! Btw: old meds from Ascend, new from Aurobindo. Also — why are the majority of our meds made in India?

    • Dennis
      Washington
      Reply

      Major Pharmaceuticals also supplies a generic of Tylenol that hasn’t worked for me so I went back to the Costco brand (Kirkland).

      I don’t know about the VA owning Major Brand (which is out of Livonia, MI).
      Another med that I get from the VA is Baclofen. I get that pill in 3 different
      shapes, Each is verified based on shape/color/imprint but it shows how difficult it can be to keep up with even one med. The VA always shops for a better price.
      If I bring an issue to their attention they “explain” that the side effects aren’t always terrible so don’t worry when the printout they ship with the prescription says to NOT take this if you’re taking that.

  21. Juanita
    akron ohio
    Reply

    seems strange that the price of synthroid and levithroxide have gotten very expensive, I recall when the drug stores were envolved in a class action and in my casse returned me for 100.00 for their tactics when I first had synthroid it was around 6.00 for a 90 day script. If the item is cheap they discontinue the product, not fair tactics

  22. Bettie
    San Antonio TX
    Reply

    I had been taking Synthroid for about 15 years when I went on Medicare and Tricare for Life and started getting prescriptions from Tricare’s Express scripts. They substituted a generic, and very soon I started gaining weight (I have never had a problem with weight), I couldn’t get enough sleep, and my hair and nails became brittle. I went to my MD who checked my thyroid levels and said they were OK.

    I went online to search for thyroid problems and found lots of reports of the same problem with the generic. I asked my MD for a prescription for the Synthroid brand and my symptoms disappeared within days! Tricare won’t pay for the brand, so I have to pay for it myself. It is quite expensive, almost a dollar a pill.

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