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Are Generic Drugs Really Identical?

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In answering the question What are Generic Drugs? on its Web site, the Food and Drug Administration states unequivocally: “A generic drug is identical, or bioequivalent to a brand name drug in dosage form, safety, strength, route of administration, quality, performance characteristics and intended use.”
If you check the Oxford Dictionary, you will find this definition for the word “identical:”
adj. 1 agreeing in every detail. 2 one and the same. The Merriam-Webster Dictionary defines identical as 1: being the same 2: having such close resemblance as to be essentially the same.

Given such definitions, it’s only logical that patients, physicians and pharmacists would assume that all generic drugs are exactly the same as their brand name counterparts. The reality, however, is not so clear.
For one thing, the FDA does not require generic drugs to contain the same inactive ingredients as the brand name product. That means colors, binders and fillers (that often make up the majority of the pills) can be quite different. In some cases this may mean someone is allergic to one formulation of a generic drug even though he tolerates the brand name.

Many pills are designed to release the active ingredient over a sustained period of time. Generic products may use a different formulation. This could alter the way in which the medicine gets into the blood stream.

A few years ago we started hearing from readers of this column that the generic drug Budeprion XL 300 was affecting them quite differently from the brand name Wellbutrin XL 300. When we investigated, we learned that the generic used a different technology to control the release of the active ingredient bupropion. This resulted in the drug getting into the blood stream faster.

Here is just one of the hundreds of stories we have received about this: “Wellbutrin XL has worked wonders for me. Recently, however, my insurance provider substituted Budeprion for the Wellbutrin and my experience has been awful. Soon after starting it I began having feelings of despair, hopelessness, disorganized thinking, anxiety and depression.

“I’ve had physical problems as well: migraines of greater duration and intensity, sleep disturbances and night sweats. All of these changes coincide with my taking Budeprion. I have resumed taking Wellbutrin and I am feeling better and thinking more clearly.”

Readers have also reported problems with other generic formulations. The generic form of the heart and blood pressure pill, Toprol XL, has produced dozens of complaints: “I've taken Toprol XL for 11 years. When my insurance company dropped the name brand for generic metoprolol, the pharmacy re-filled without advising me. I noticed the change once my blood pressure went through the roof along with pounding heart rate, flushing and very swollen ankles. I was weak and dizzy. I demanded the pharmacy give me the correct prescription; after two months I was back to normal.”

You can read more stories at www.peoplespharmacy.com. Anyone who has a problem with a generic drug can report it to us or directly to the FDA at www.fda.gov/medwatch.

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What about the following generics: verapamil, lisinopuil, atenolol for blood pressure; vytorin for cholestol; synthroid and alendronate sodium (Fosomax).
Have folks commented on the activity of these or are there any studies about these?

Every time I read that generics are "identical" I get really, really upset.
My sister's psychiatrist in Shreveport, LA refused to let any of his patients get generic "anything". Reason: He knew that generics were not absorbed the same, not the same quality and other things! My sister, may she rest in peace, had to get generic Klonopin (financial reasons); She slowly began to go into withdrawal WHILE taking the generic and ended up in hospital with convulsions that lasted for hours; it was an awful experience.
I have been using atenolol and last year I had an awful experience; as I began using a new month's supply I began to feel as if I had not even TAKEN the med. Each day my heart beat a little faster until it was pounding. IT went on for a few days; I went to my doctor and had an EKG, etc. NOTHING was wrong. I read peoples pharmacy religiously. I suspected that maybe my new batch of atenolol was not good. I got out a few from my purse (emergency supply) and for the next day or so, (on and off two different times) I took some older ones. I felt better, like I used to before the refill.

When my emergency stash ran way low, I had to go back on the new refill and the pounding returned...as if I had not taken anything. (I told the drugstore counter person about my experience with the batch;) I told that person that it was as if I was not taking ANY thing.
I WAS TOLD that it was the "binders" that give people problems. NO GUARANTEE that the binders will allow the "identical" med to be absorbed properly, etc. I was told, also, that there was probably going to be lawsuits over the cheap $4 Rx out there being advertised on t.v., etc.; some even crumble in the pill bottles."

Dozens of complaints divided into the number of user of generics that you cite is a very small percentage of the satisfied users of generic drugs. Your article tends to obscure this. It reads like the standard blurb from the big pharmaceutical companies. There may be differences in such matters as titration rates or other differences...but, on the whole, these generic drugs are effective and safe. I should point out that the side effects you identify are equally present in the brand names: Lipitor/simvastatin for example.
I believe you have done your readers a disservice with this unbalanced article.

PEOPLE'S PHARMACY RESPONSE: YOU ARE QUITE RIGHT THAT WE CANNOT JUDGE THE FREQUENCY OF GENERIC PROBLEMS FROM THE COMPLAINTS WE GET. IT'S PROBABLY TRUE THAT MOST PEOPLE HAVE NO PROBLEMS WITH THE GENERIC DRUGS THEY TAKE. WE STILL THINK THERE SHOULD BE MORE RIGOROUS MONITORING FOR QUALITY OF ALL PRESCRIPTION DRUGS, GENERIC AND NAME-BRAND ALIKE.

I find this "report" truly outrageous. What will your next report reveal, that the world is flat? Generic drugs ARE the same. I urge anyone to go to the FDA website and read the full explanation. And they cost so much less that to suggest they are somehow less effective or even dangerous is to do a huge disservice to the millions who without safe, effective, affordable generics could not otherwise afford their meds. "The People's Pharmacy" indeed. What a misnomer. Good to see that the dictionary is your source for this empty analysis. I look forward to your next editorial on the superiority of leeches to surgery.

PEOPLE'S PHARMACY RESPONSE:

Dear CMS;

For more than 25 years we absolutely agreed with you and always insisted that patients demand a generic alternative whenever one existed. We assumed that all generic drugs were identical to their brand name counterparts.

Over the last several years, however, we began to hear from readers and listeners that they were having problems with generic drugs. We talked to most of the key players at the FDA and learned that there is no organization (not the FDA nor any other federal or state agency) that actually monitors products on drugstore shelves for quality. Basically, the drug pipeline depends on the honor system.

Perhaps you have heard of the heparin disaster. Before that there was melamine contamination of pet food. Over 100 generic drugs have been withdrawn from the market in the last year. Many were made in India, where the FDA has little oversight over manufacturing.

We are glad you are so trusting and only wish we could believe that all generic manufacturers are producing perfect products. We have lost confidence in the FDA's ability to monitor the quality of pharmaceuticals, especially now that so many products are imported from China, India and many other countries where oversight may not be the same as in the U.S.

And if you are willing to do some homework, you will discover that the way in which the generic antidepressant Budeprion XL 300 releases its active ingredient (bupropion) varies considerably from the brand name Wellbutrin XL 300. That doesn't seem "identical" to us.

I have to agree to the wellbutrin XL 300. The generic sent me into a slow downward spiral. It was the only prescription drug I changed so I knew what it was. I talked to my pharmacist after about 8 months on the generic and he admitted that he had a lot of complaints about the generic. I am back on the wellbutrin and feel great!

A generic of Cardizem sent me to the dr.'s office after One. Statin drug generic had me so crippled, I could almost not get out of the car. Tramadol from Medco had my feet sizzling in pain from neuropathy; I'm finally back on the CVS generic Tramadol so even the generics aren't the same. Phew!

My husband was on the generic for ativan (lorazapam) for many years, but when we switched pharmacies (to the medicare mail order) we noticed that he was much more anxious and had to increase the dosage several times, without good results. His psychiatrist also agreed that generics are not always the same as the original. Apparently several companies make lorazapam, and only 1 works like the original for my husband. We switched back to our old pharmacy and that solved the problem.

You should start out with the brand name drug then switch to the generic and judge for yourself. Switch back to the brand name if necessary. Always use the brand name if you can afford it. Always ask your doctor for samples when you see him. Also check out patient assistance programs on the web. You may get the brand name for free.

Four years ago my pcp and I had a terrible time finding 2 blood pressure meds for my htn. We finally found that Norvasc and Benicar were working well, along with diet changes and exercise. I had many trips to the er and a lot of tests and scares, until these 2 drugs were put together. Now! along came Amlodipine, and our insurance carrier told me that you will take the generic it is the same.

Two weeks into taking the generic my blood pressure started to climb again, and I'm not talking about small increases they went to 190 or 200 over 80 or 90. Called my Dr. and had script filled for Norvasc. I have to pay full retail, but my pressure is under control.

I take pravachol for high cholesterol and have autoimmune hepatitis. I've taken the branded for years, but was automatically changed to the generic when it came out. Within a week or so I was feeling sick to my stomach constantly and at first blamed it on a recent trip to Egypt. When I mentioned it to my rheumatologist on a regular visit, he told me to check my liver enzymes.

I did and they were through the roof-more than 100 times the normal! After stopping the drug for a month, all returned to normal. Thanks to my doctor I was granted a generic exception so I only have to pay whatever the highest co-pay is. The doctors agreed there was an allergy to the fillers, so all generics are not alike!

Thank you for letting the public know that some generic drugs are not the same as brand name . I have elevated cholesterol and I kept trying to take the generic simvastin , also pravachol for 4 months, and it gave me a headache and stomach ache , I also felt horrible, so decided I wasn't going to take it anymore and just suffer the consequences , but decided to try the brand name Zocor , with special permission from my insurance ,at a much higher cost .....but low and behold, I CAN TAKE IT, and my levels have dropped to a safe level ...also always take a large glass of water with your meds always .

Years ago my wife and I were both taking Tegretol (carbamazepine) made by Novartis. I was taking it for peripheral neuropathy and my wife was taking it as part of her regimen to treat bipolar disorder. I think that when we were using the brand name product there was no generic version and that it was when the generic version was released that our pharmacy switched us to the generic version. Both of us found that the generic version did not work as well as the brand name product. The results were more serious for my wife than for myself. Both of our doctors wrote new prescriptions specifying the Novartis product.

Both of us now take gabapentin instead of carbamazepine and find that the generic version of gabapentin works as well as the original brand name version, Neurontin.

As I have no insurance, I switched from Wellbutrin XL to Buproprion for a cost savings. I quickly went back into the pit of depression. After going back to the brand name Wellbutrin I was feeling much better. Why was I forced to pay for a medication that did not work? I want a refund! The FDA said they did not find any difference between the two. I beg to differ with them vigorously. Patients deserve better from the FDA and the drug companies. This situation can cause a life threatening crisis and should never happen.

In my experience the following Generic SSRIs are NOT the same as name brand!!!!!!!!! I have to fight to get name brand Zoloft and Wellbutrin SR. I learned this while trying to find the right combination to stop my severe OCD/BDD/Depression. Luvox was the first and when they changed it to Fluvoxamine I thought it had just stopped working not realizing generics at the time.

Then I was put on Prozacs Generic and it didn't help me and now I know why. Then finally I found the right meds I needed Wellbutrin SR and Zoloft. After a short time Wellbutrin SR purple pill changed to Wellbutrin XL white pill due to the different color pill and some research I figured out all this generics crap and the fact that they would rather save money then help people survive in life.

It was hell enough to find the combination and now I have to have anxiety fearing that prescription pre approval may not be approved. Who the hell decides what works for me???!!! Without Wellbutrin SR and Zoloft life is not worth living for me and that's a fact. These medications keep my brain in check and make life easier to tolerate.

I am lucky to have a good doctor and insurance company so I can get the medication I need, but I worry for others who are not so lucky and confused about generic and brand names as I once was. As far as I am concerned generic meds especially psychiatric meds are NOT the same as name brand and this problem is hurting a lot of people and it’s dangerous to mess with. People just find something that takes their misery away and they want to take it away?

That’s really disgraceful and it needs to stop. People need to spread the word that when a med goes generic it doesn’t mean it stopped working for them they just need to demand the name brand that they have been taking before it was deviently snatched from them. My husband takes Protonix to help stomach pain caused by a different med and when they switched him on the generic it stopped working and he was put back on the name brand.

The FDA needs to stop saying the generics and name brands are the same when they are not the ones who know from personal experience that they are NOT.

I have taken Wellbutrin SR for almost 10 years. 3 years ago I got changed to a generic and did ok, until I was switched to the Teva version. It felt like it was dissolving too quick or something, and I would get a jolt of anxiety/headache/sweating/thirst/etc. I switched back to the other generic brand and it went away. 4 days ago I was put back on the Teva version again with the promise from the pharmacy 'it wouldn't be like last time'.

I spent 8 hours in the ER last night with a heart rate over 200 and a host of other symptoms. The only thing that has changed is the other generic of Wellbutrin SR to the Teva Wellbutrin SR, and it's happened more than once. It's too much of a coincidence for me to not think something in the Teva version does not get along with me. I will never, ever take it again.

Due to my prescription insurance changing, my pharmacist sold me a generic of my headache/migraine medicine, Imitrex. It took several episodes for me to realize that I was getting no relief from this generic. I contacted my doctor, who told me that generics ARE the same drug, but that dosages may be 20% off..either more or less in strength. Mine was definitely less potent, and although it was cheaper, I now must take more of it to get any relief from my headaches.

I started on wellbutrin xl for 2 months and it changed my life. After that the doctor went to bupropion 300 and it has not helped me at all except headaches, no motivation, and weight gain that I did not get on the real wellbutrin where I lost weight. Should i go back to original?

It is well-known in the medical profession that anti-convulsant generics are often not the same. Due to severe, disabling symptoms of a brain injury, I was put on a high dose of Neurontin and it changed my life, allowing me to get out of the house and do normal things. After eight years, the generic became available and I was switched to it. I thought this was great because it would save me money.

I slowly started slipping downhill to the point where I had so many severe symptoms that I wound up in the hospital. No one could figure out what was wrong.

Then it occurred to me that my decline had started shortly after I switched to generic gabapentin. I found some of the original Neurontin in my emergency pills in my purse and when I began taking it, I immediately started feeling a lot better. After a big fight with my insurance company, they agreed to cover the cost (it is a very expensive drug) with me paying a $50 deductible each month.

That is better than being in a living hell on the generic. I since have experimented with four other generic versions of gabapentin and have found one that works a little better than the others, but none that work like Neurontin.

I mentioned this to a friend of mine who had also been declining on generic gabapentin. After she successfully went back on Neurontin, she decided to get rid of her generics by pouring water over them to dissolve them before disposing of them. They wouldn't melt! She poured very hot water on them and they still would not dissolve. She then tried this on a Neurontin capsule as an experiment and it dissolved immediately. How many people have been unsuccessfully placed on a generic version of this drug when the brand would have helped them?

GENERICS ARE NOT THE SAME. Please, FDA, stop brainwashing the public. And if someone is placed on a generic drug for the initial prescription and has no or limited results, I would recommend that they give the brand version a try before concluding that the drug doesn't work for them.

A question for Joe and Terry:

I understand why generics are so much cheaper than brands - no burden of research and development, advertising costs or testing on live patients for safety and effectiveness. But why, when the brand is off patent, does the company that produces the brand not lower the price of it to compete with the generics? My pharmacy has to order Neurontin for me every month because doctors and insurance plans only put patients on the (in my experience) inferior but cheaper generic gabapentin. If Neurontin sales are now this low, why doesn't Pfizer lower its high price to better compete?

I have been on Wellbutrin XL for about 2 years now and it was GREAT! Last month, I decided that because of the cost difference, I would try the generic and then thought nothing more of it. One month later, I have been trying to figure out why the depression is back - and it hit me! The generic bupropion is not working anywhere near as well as the Wellbutrin. I am calling my dr. tomorrow and asking him to redo the prescription back to the brand - even though the cost difference is about $2000 per year! I don't understand why the FDA is getting away with this when there are so many complaints! How can we force our insurance companies to cover what we really need not what they feel is best?

Just wanted to add my story to the list of people who have had trouble with the generic form of Wellbutrin. I've tried the generic twice now, and have had the same negative reactions. The generic seems to aggravate the symptoms that the brand version alleviates, similar to the downward spiral comment another person posted. GENERICS ARE NOT THE SAME!!

I too switched to the generic form of Welbutrin XL, and in the two years since the change, my health and life have been miserable: weight gain,extreme depression that comes and goes (these bouts include thoughts of suicide), difficulty concentrating, debilitating fatigue. while taking Wellbutrin, I was NOT ill like this.

I also take three other meds in the generic form: Fosomax, Pravachol, and Klonopin. I have no way of knowing how these generic forms are affecting me, damaging my health, or even what they are doing vis-a-vis the conditions for which they were described. Is there anyone reading this who can comment? I'm talking about the ruination of my life, and NO M.D. knows why.

I believe that FDA is aware of the difference between generic formulation and branded formulation. However, the data or proof they have so far is not strong enough to stop the use of generic drugs. From their perspective, the positive impacts or advantages outweigh the disadvantages far more than anyone of us can imagine. The only way to stop the use of "problematic" generics is to justify that the use of generics is not better than the use of original. But, how to do that? One effective way is to report formally all issues like serious adverse drug reaction, unexpected adverse drug reaction and lack of efficacy. I would like to suggest a generic drug adverse drug reaction database to be set up to monitor the performance of generics as compared to branded drugs.

I had been taking Tegretol XR for several years very well. Suddenly in 3/10, my insurance co. called my doctor to get permission to change to the generic. I became extremely constipated for three months. I had no idea it was the new generic causing the constipation problem. When I found a partial old bottle of Tegretol XR, I decided to use it.

My constipation was unbelievably corrected. I asked my doctor to write a new prescription for Tegretol XR specifically. When I had it filled, I found out the generic and the patent name drug now cost me the same. My insurance company pushed the generic for profit.

Also, I have been taking the generic Neurotin (ie. gabapentin) made by Greenstone. It worked well, but now I receive a generic made by Teva which does not work as well. FDA does not show Greenstone making it anymore. Greenstone is a subsidy of Pfizer who owns the patent for the drug, so it explains why the Greenstone generic probably worked better. What should I do to find a generic gabapentin?

NOT all generics are the same as brand name. To the person above that states how wrong this article is. I've been in the medical field for 20 years... I've seen reactions to generics meds, I've also seen them not work when we really needed them too. Insist on the brand name, if the insurance company wont cover them, have your doctor contact them, the insurance company is not the last say so on the med and either is the pharmacist. It's your med, your body... demand what you feel is safe.

Just wanted to comment to CF re: Greenstone generic gabapentin. It is still be manufactured. Finding a pharmacy that actually sells greenstone generics took me many phone calls but I found CVS Pharmacy sells Greenstone. If you don't have a local CVS, I believe CVS has a mail order. Or you could can google Greenstone pharmaceuticals and call them and ask who carries their generics in your area.

I have been using a generic gabapentin by Amneal and one thing I have found they are consistently inconsistent. I finally opened quite a few capsules and found that none were full, many were 2/3rds full, others 1/2 full, I told my pharmacist I will not take Amneal gabapentin because the capsules never have the same amount in them. I asked for a different generic and when they would order another generic (I assume they will only buy the cheapest) that is when I went on a search and switched to CVS. Greenstone generics have won an award for best generic medications (can be googled too). Best of luck!

My daughter has bi-polar. She works for an ins. co. who paid for her meds. for a time, but now have refused to pay anymore. She has to take wellbutrin xl for her condition. She is alone and cannot afford to pay for this med. It would cost her $198.00 a month. Being her Mom, I have tried to get this med. for her somewhere that it would be cheaper for her to pay for.

It took her Drs. 8 yrs. to find the med. that really helped her and now she can't afford it. She has tried many kinds of other generic brands, but they do not work for her. She works at home for this co. but has been unable to do her work, like it should be done. She is so afraid that she will get fired. She is 50 yrs of age, to young to draw s.s.

Is there any way or anywhere, that she can get this med. for a reasonable price? Please ans. this e-mail as soon as possible. Thank you Paula H.

Generics are definitely not the same (not only to the brand drug but to each other). Even the most subtle of differences in drugs (especially psychoactive ones!) can have drastic effects on how we physically respond to it.

For example, a lot of people do not tolerate the methylin generic for Ritalin because they feel the side effects to a greater degree (especially the shaky, jittery, energized feeling). I take Malinckrodt's methylin for narcolepsy and that is the ONLY form of methylphenidate that I feel an effect from. The Ritalin brand drug produces no effect at ALL for me. And the Watson generic methylphenidate not only makes me dizzy, it actually makes me slightly drowsy! The first time I took it I thought something was seriously wrong with me. I was infuriated that I had been switched to that generic without notice. Now I can't even use it.

My goodness! After reading all these posts, I definitely know "it is not all just in my head". Thank you. I've had the same experiences over the years with generic meds. Many years ago, we always got just plain medications for whatever. We paid our insurance premiums, etc. Then they "sold" everyone on these generics. I say "everyone", but I really mean is those of us who cannot afford the "brand names". If this isn't discriminatory against the middle and under class, I don't know what is. It's a disgrace.

I lost my mother a couple months ago. She complained all the time about dizzy spells, etc. We always blamed everything on "aging", but the reality is, perhaps if the "people who cannot afford brand name medications", were "truly" given the equivalent of a generic form, they would definitely have a much better quality of life. Goes to show you how greed works. Funny how during hospital stays everyone gets the "brand name" meds. Interesting.

I am suffering the effects of a tramadol generic. I normally take generics, however, I have found that with 2 of my medications one manufacturer works well for me while another will put my body into withdrawal as if none were taken. It's very disappointing as you have to suffer until your next refill. Fortunately my pharmacy honors my request for certain manufacturers on the drugs I develop a problem with.

I find this article to be helpful. I had been on Wellbutrin XL for years, with great success. Some side effects that I found unpleasant though. Mainly sweating. I decided to try other medications for depression to avoid the side effect from Wellbutrin. I tried many. They all made me feel like a walking zombie. So I decided I would deal with the sweating and go back to Wellbutrin.

My insurance out me on Bupropion (generic). There is such a remarkable difference in the effects between the two. I am having completely different results on the Bupropion than the Wellbutrin.

This is just my opinion on the observations of my own body and the medications. Everyone reacts to medications differently. Some may love the Bupropion, others may feel the same way I do.

But in my opinion from experience.....there is a DIFFERENCE!!!!

One supplier in NY of a gabapentin generic did not work for me.
It might have been a polymorph of the correct molecule.
It may have worked for other people, but not me.
Twice CVS switched me to that supplier without telling me
and twice I had to go back to them and complain.
Eventually I had to go to Riteaid to get the gabapentin from
a different supplier since CVS would only sell the one that didn't work.
Now CVS has taken over the local Riteaid customers and
I have to find a different pharmacy again.

No way, I have had both and the name brand is for sure stronger.

I have severe neuropathy. I take percocet 10/325 up to 5 times a day, depending on pain level; 2 60mg morphine sulfate ER twice a day, and 2 600mg neurontin (gabapentin) 3 times a day. The gabapentin was added last, about a year ago and has really been helping. The color of the pills I've been taking was blue. Recently, my drug company has forced me into getting gabapentin through the mail, 90 days worth at a time, evidently to save them money.

I just got the first batch of mail order pills and the color is white. I've been taking them for a week now, and my neuropathic pain has gotten much, much worse. Can you tell me if there's a chemical difference between the blue and the white gabapentin pills? Is there any way I can request the drug company to get me back on the blue pills? Thank you so much for your help.

I want to add my experience with the generic drug Propranolol ER. I have been taking this medication once per day for over 10 years now for my anxiety. I take the 80 mg dosage. I have had no issues with the name brand Wyeth/Pfizer version and the generic version made by Upsher-Smith. However, I have had 2 instances where the pharmacy dispensed the generic version made by another company that I will not mention here and after taking the capsules for about 4-7 days, I experience severe side effects. Those side effects include severe anxiety, hot flushing and obsessive thoughts and noticeable shaking in my hands.

Each time I call my Psych Dr and he puts in a call to the pharmacy to prescribe and dispense the aforementioned brand. After a few days of being back on that my issues go away and I am good to go. I have thought about calling the manufacturer about my issues with their product but I feel like my concerns will probably be ignored. I can attest from my own experiences there can be side effects from different generic versions of the same medication.

Hope you try buying Greenstone gabapentin at Costco. You do NOT have to be a member but you will have to persistently insist on that generic only. They normally have to special order it. Double check when you pick it up!! On another problem... with cervical dystonia for 16 years taking gab. for 14 yrs. I seem to be having muscle spasms and cramping this past year. My specialist at Ohio State Medical retired and I cannot trust any others here where I moved. And I have tried. My internist that is out of state re ups my 2 Rxs after I see him once a year and he knows more (he made it a point to read up on it too) than the 'specialists' here in SW FL.

I always had that fear one day it would stop working for me....that day seems to be here. I may try the Pfizer capsules (God help me with paying for it) next time in a small amt. and see what, if anything, happens.
Again...Costco for the best price on Greenstone gabapentin.

I have been taking Topamax for years for pain management due to nerve damage. My company changed to United Health Care, they (United) are insisting that I use the generic form of the drug. I tried it in Feb., I could not tolerate the drug because I had a migraine every single day. I took it for 3 weeks, finally my doctor and I said Enough of this, so she put me back on Topamax. At the end of April United pulled the plug w/o telling me or my doctor why.

My doctor's office thought it would be up for review at the end of July. This company has 3 levels of drugs, any drug in the 3rd level has to be justified ever so many months. 2 of mine are in the 3rd level. I have yet been able to get back on Topamax, my doctor said Friday she does not want
me to be on generic because a migraine everyday is not acceptable. I have talked to the company several times a week about this, sometimes 4 or 5 times a day. I have had 4 back surgeries (fusions), both total knees replaced, 2 foot surgeries. I also have Arthritis in my spine.

I can't understand Why the company would fight this battle, they said Friday that my Dr. can send an appeal for my and say that I am allergic to the drug. By the way, the CEO of United made 24 million last year with I believe an addition 7 million in stock options. Guess he sleeps well at night!

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