Q. My husband has been taking Prozac successfully for years. He was recently switched to generic fluoxetine. In the last several months he has become much the same person he was before Prozac–angry, depressed and easily irritated.
The pharmacist says the generic is the exact same ingredient. Would it help for him to go back to Prozac?

A. It might be worth going back to Prozac for a trial run. Another reader had a similar experience with fluoxetine: “My husband has taken Prozac faithfully for about three years. We get our prescriptions through a mail order pharmacy.
“He sent in a new prescription for Prozac because all his refills had run out. Four to five days after the new bottle arrived I noticed a lot of his old symptoms reappearing. He said he was taking the medicine but the capsules looked different.
“The bottle was labeled fluoxetine. The mail order pharmacy told him that unless the doctor wrote ‘Dispense as Written’ they would send this generic.
“The doctor wrote him another prescription for Prozac with a note not to substitute. Within a few days of starting back on Prozac, we both could tell that the drug was working again. While he was taking the generic, it was as if he wasn’t taking any medication!”
If anyone else has a bad experience with any generic medicine, please share your story with the FDA. The agency maintains that it really does want to hear about your experience. The best way to do this is via their MedWatch reporting system. You may also want to share your story on our PeoplesPharmacy website.

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  1. TR
    Reply

    I have been taking generic Prozac for years upon years with no problems until about two years ago (?) I picked up my refill and right away noticed that the capsules were different in color, but the strength had not been changed and the pharmacist explained that it was a different manufacturer but same product. Also, my public medical assistance would not cover that manufacturer and I had to pay a higher amount, although it was a discount price from WalMart, so it wasn’t that much more. Anyhow…several days later it was as if I were not taking the drug at all! I was a “basket case.” Then I remembered the change in manufacturer and came looking on the internet and found people with similar problems. I got the pharmacy to re-refill my script when they got more of the one I had been getting….and I was back to “normal” pretty quickly. At that time, I had been taking Pliva and was switched to Northstar.
    Everyone here seems to react differently to the generics…many saying that Pliva doesn’t work as well for them. Not for me; it is what I need, and is now TEVA. Just this past April, my dosage was changed from 60 mg. to 80 mg. At first, I took four of my 20 mg. capsules instead of three until I got my new script filled. The new 40 mg. capsules were different color and I thought it was due to different strength…until I crashed and had a very bad, very dark experience several days later…and remembered the previous change in manufacturer – checked the bottle and these were BARR. Spoke to the doctor and got her to write “fill with TEVA/Pliva only” on the script.
    I had trouble getting this filled correctly and consistently – was filled with other brands even though it was written for TEVA… I finally called around and found that the new drug store in town – Walgreen’s – could order it for me and would order it for me, even though it cost more for them to get it.
    I got a refill last week and for a couple of days I have been feeling like it is not working…agh! I called TEVA and they were very nice about checking for any changes to the “inactive” ingredients. The only change was a different brand of imprinting ink in April. It is doubtful that would be the cause of my symptoms, but the representative is forwarding my information as a product “problem” to be checked into. Meanwhile, I will have to wait and see and try to think of any other cause for the way I am feeling.
    Best wishes to all of you…depression and anxiety are hard enough to cope with, but we will be okay despite these challenges!

  2. Susan
    Reply

    Try the generic made by Sandoz. It’s available at Walgreens. I have found it works very well, and I cannot tell the difference between it and brand. I can’t afford brand name anymore.
    Btw, Pliva was the absolute worst generic I used. It did nothing.

  3. Allwright1
    Reply

    I too have had a difficult time with generic Prozac. Fluoxetine does not provide the same relief for me. Single payer, healthcare for all, would be a civilized solution for all of us.

  4. PP50
    Reply

    Does anyone have any experience with MYLAN brand fluoxetine (red capsules). I was on prozac for about 20 years for major depression episodes lasting several months each, several brands of generics worked fine, sometimes there was a little adjustment period when my pharmacy switched manufacturers but they all worked fine until they switched to PLIVA brand I had dramatic mood swings, a couple of short hypomanic episodes (NEVER HAD THESE IN MY LIFE BEFORe), stomach problems and an overall bad feeling, not major depression but chronic low level depression.
    Kaiser would not offer another brand so my doc switched me to generic celexa, depression is back under control but I’ve gained about 15 pounds in the last year. Kaiser switched to MYLAN fluoxetine so I’m going to give it a try. Anyone have any experience with this brand?? Thanks for this site and the info confirming that it’s just me having problems with PLIVA.

  5. LS
    Reply

    I have been on prozac many years. when I was on brand I felt great. I go to kaiser and pay for a drug plan and they can not give me anything made in America. I took northstar but they said they couldn’t order it. You can not even get the generic you want. Pilva is the worst. Waiting for that one to be pulled by FDA. I used to get Eli lily but now it’s like 1000 dollars a month.
    So you really think India and China are as good. It all about money. Shame on kaiser you should sell better anti depressants. Like made in USA

  6. EG
    Reply

    Haven’t read through these comments yet. Just briefly scanned through looking for Pliva 648 because I’m having an adverse reaction to it for the second time in the last two years. When I take this medication I experience anxiety, increased sadness with sudden waves of extreme unhappiness accompanied by a loss of hope.
    That’s the best way I can describe it. I’ve been taking prozac since 1990 or so, and over the years I have gone off of it for long periods (3 pregnancies, nursing babies, forgetting to take if for several days, etc). Going off of prozac entirely does not create the symptoms that Pliva 648 is creating.
    In other words, no anti-depressant at all is preferable to Pliva 648. It is INCREASING anxiety and depression, not alleviating it. This is a bad drug.
    I would very much like to be part of the solution here, so tell me who to contact and I will be writing letters and making phone calls before the day is over. I have a happy life, but this drug is taking me back to my days of suicidal ideation. Very bad.

  7. ML
    Reply

    I’ve experienced a similar phenomenon: when taking the generic Fluoxetine by the manufacturer Northstar, I did GREAT. My pharmacy changed suppliers twice (to Pliva & Aurobindo) and both times my depressive symptoms re-emerged almost immediately.
    My point here though is that one specific generic brand has actually worked incredibly well, so it’s not just the difference between brand name & generic. My pharmacist said it’s common to have a reaction since each manufacturer has their own process and sources. They special order the kind I need now.
    Don’t be afraid to ask for what you need! I was initially afraid to speak up because of the stigma attached to depression. I was convinced they would tell me it was “all in my head” but my pharmacist surprised me & has been very supportive.
    You can usually get the Northstar brand of Fluoxetine at Target for $4/bottle versus the ridiculous price of Prozac.

  8. P
    Reply

    I had the same experience, there is a huge difference between brand and generic and I now realize this more clearly when I look back. I got back depression when getting my supply from US, and got well each time I supplied from abroad during my visits home, where only brand is available. This time I tried each in consequent days and there is an unbelievable difference between taking each. Pliva 648 has been worst for me. I may report this to FDA and other websites. This is deceiving and harms people.

  9. mh
    Reply

    Please re-read what you wrote; your comments evidence a clear disregard for others. What is your motive for responding to this forum? As an outlet to disparage others? There is no need to be cruel. We all know that everyone is different. We are attempting to help one another here. I also ask that you please look into the subject of pharmacokinetics and to reiterate, please re-direct/manage your anger (unsolicited advice: exercise, martial arts and the like). Thank you.

  10. Noah T.
    Reply

    Dear, Karen. I do not need to take anything. However, I know lots that take this med about 1 in 10 go back to the brand name because this generics doesn’t work for them. Joe and Terry have indicate practically the same and that the brand name is better absorbed. I believe your decision will be the best by what I know. Good luck.

  11. Karen O.
    Reply

    Fluoxetine is horrible. going back to brand Prozac. infuriates me that we have generics shoved down our throats by ins companies. I don’t believe for one minute that brand & generics are the same. If so why such a big price difference.

  12. mistyrose2
    Reply

    The doctor is right. It is my understanding the FDA requires that all generic medicines must contain the same amount of of the drug as the brand name.
    What FDA does not control is the fillers that go into the wrapping of the generic drug. In other words, who really knows what is put in the filler.
    I have tried several different types of generic prozac hoping to they would work for me due to the exorbitant price of the brand. I can tell you that I had the same side effects as your husband on the generics. I had to go back to the generic brand and had absolutely no negative side effects except being a little bit more sensisitve to heat especially the sun which is not a big deal for me.

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