bottles of medications with warning stickers and information

The FDA maintains that all generic drugs are “identical” to their brand name counterparts. Of course, the word identical does not mean the same thing to everyone. Most of us assume that identical means exactly the same. For example, identical twins have the same exact DNA. If you drop your iPhone down the toilet and want to replace it with an “identical” iPhone, you can be confident that your new iPhone is exactly the same as the old one.

“Identical” Is Different for Drugs

The FDA, however, has a different definition for identical, especially when it refers to generic drugs: “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.”

What the FDA does not tell you in this sentence is that generic drugs can have different “inert” ingredients or fillers. In other words, all the other stuff except the active ingredient could be completely different. What’s more, the formulation can be be quite different. Take Wellbutrin XL 300, for example. This brand name antidepressant gradually releases the active ingredient bupropion over the course of a day. It uses a “membrane” technology for this slow release.

Budeprion XL 300

One generic equivalent, Budeprion XL 300, uses a “matrix” technology for its slow release. The same amount of bupropion (300 mg) is released, but the timing is quite different. Budeprion XL dissolves and releases its ingredient more quickly. The FDA confirms this in a report it has released on its Web site.

We have received hundreds of complaints about Budeprion XL 300 not behaving like the brand name Wellbutrin XL 300. In an unprecedented response to these concerns, the FDA and the manufacturer and distributor of Budeprion are planning a study. Perhaps we will learn if the two formulations are indeed “identical” or not. It will take time, however, to collect and analyze the data.

Update: When the FDA completed its study, it found that in fact Budeprion XL 300 was not identical to Wellbutrin XL 300. Read our story about it here.

Questions about Other Generic Drugs

Budeprion XL 300 is not the only generic drug raising questions. Over the last several years we have received hundreds and hundreds of complaints about a variety of generic drugs. They range from the generic form of the anti-seizure drug Keppra (levetiracetam) to the heart drug Toprol XL (metoprolol succinate), the heartburn medicine Prilosec (omeprazole) and the pain reliever OxyContin (oxycodone).

If you would like to report a problem with a generic drug, either side effects or lack of effectiveness, please add your comment below. Put the brand or generic drug name at the top of your comment. We will forward your story to the FDA.

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  1. Bella

    Topamax by Zydus Pharmaceuticals
    Something is wrong with this medication!!! My 2nd refill was with this brand, and within 10 days I couldn’t sleep, had tingling in face, feet, nausea all day, heart racing. I thought it was side effects but on my 3rd refill the insurance company made me change pharmacies(thank God). My script was filled by Glenmark pharmaceuticals. Within 2 days I was beginning to feel better, and within 10 days back to normal!!!! So I did search on Zydus/Topamax ….. quite a few people have the same complaint/problem.

  2. Marcia

    Omeprazole by Zydus. In the last month I have experienced heartburn at night and during the day. I take 20 milligrams AM and PM.

  3. Deborah

    Medication Topiramate
    Zydus Pharmaceuticals

    There is definitely a difference! I was on name brand Topamax and switched to generic due to insurance change and they would not cover name brand. Within a few days I was having terrible headaches and nausea. After calling my doctor, he said to discontinue the meds and go back to name brand for a few days. The symptoms stopped within 12 hours. The following week, I started back on the generic prescription and had the same reaction. I have taken generic Topiramate from other pharmaceutical companies and have not had this reaction. Just Zydus. My neurologist tried sending to appeal to Express Scripts to get coverage for Brand name but to no avail.

  4. Elizabeth
    AL, FL

    Actavis oxycodone 10 325

    Actavis oxycodone 10 325 are from India distribution is from PHILADELPHIA. No they are not the same strength. They are shipped from India. They sit in hot shipping containers for days, possibly weeks. How hot? 110 to 123 degrees according to a report done by U.S. Army Transportation Engineering. A more recent study suggests that temperatures under our recent extreme climate can reach up to 135 degrees. I do know that medications have specific requirements for temperature and longevity in heat. Just figured it out. The inert ingredients differ as well. I’m getting migraines. Literally sick and tired of doctors and pharmacists telling me they are the same. If they look different, they are different. Spread the word, write the FDA.

    • Jennifer

      I have been on Topamax since 2004 for migraines. My dose has been as high as 400mg/d (after viral meningitis), but normally stable at 200mg/d. I’ve been on name brand and generic and have been well maintained. I got a 90-d supply in July through Express Scripts and had the worst summer since starting Topamax.

      I’ve had daily headaches, 3-4 breakthrough migraines/week. It felt like I just stopped my topamax. I did some research and realized I was given generic by Zydus (first time). In the past I’ve had Teva or brand. There is something wrong with Zydus generic!

      My insurance wanted $1600 co-pay for 90d medically necessary name brand Topamax. My neurologist just switched me to Trokendi ER 200mg. Keeping my fingers crossed.

  5. CutTheWood

    I have noticed that over the course of developing a relationship with real estate owners, you’ll be able to come to understand that, in most real estate contract, a percentage is paid. Finally, FSBO sellers do not “save” the percentage. Rather, they fight to win the commission simply by doing a strong agent’s work.

    In this, they devote their money as well as time to carry out, as best they can, the obligations of an real estate agent. Those assignments include exposing the home by means of marketing, showing the home to prospective buyers, creating a sense of buyer desperation in order to induce an offer, arranging home inspections, dealing with qualification inspections with the bank, supervising maintenance tasks, and aiding the closing of the deal.

  6. Jessica

    Brand: Adderall XR 20 mg
    Generic: dextroamp-amphet er 20 mg cap
    Manufacturer: impax generics

    Have taken generic adderall from other manufacturers in 10 mg doses (2 pills for 20 mg). The above generic I’m currently taking has no effects for me at all, it is as if I’m taking a placebo.

  7. Sheri Barrett

    Generic Drug Controversy Won’t Quit!

    The problems in this thread regarding generic pain medication sounds just like the problems I have been experiencing with my pain medication, Percocet 10/325.

    More Doctors need to be aware of this problem and insist on the original manufacturer. It’s hard enough to get the proper dosage of pain meds that really work. And don’t even get me started on all the other problems associated with filling your RX when the doctor does give it to you. I have documented medical records showing all the problems I have that require me to take this medication but that still comes with many problems.

    It is very obvious the overseas drug companies and maybe even our own here in the states are cutting corners to make a buck and it needs to STOP. WE ARE SUFFERING!

    I hope everyone writes, tweets, emails, and snail mails to the FDA members about this problem and what they are doing about it.

    Below is the next meeting.
    March 15, 2017: Pharmaceutical Science and Clinical Pharmacology Advisory Committee Meeting

    • Dianne

      There is absolutely a difference. I have been on KVK-TECH oxycodone for a while now and they didn’t have them fully in stock so they switched me to Zydus brand and I felt like death. Hot sweats, chills, headache, nausea, and very little pain relief. It was awful and it took all day to get it switched out. I still feel the affects of it.

  8. Jessica

    The generic for Tramadol manufactured by Zydus Pharmaceuticals is completely useless. I have used the generic from their competitor Teva Pharmaceuticals USA Inc in the past and it was highly effective.

  9. Stephanie

    I also am prescribed 15 mg oxycodone and am receiving Actavis brand. I have always taken my medicine as directed and thought maybe it was a tolerance thing for the past couple of years. I have severe chronic pain issues, and until the Actavis name came about, I could feel some relief from my pain.

    As for the fatigue and forgetfulness, my god!! I am barely functioning anymore. I feel like I have a severe form of dementia. I fall asleep everytime I stop moving! I literally have no quality of life anymore. Something really needs to be done about this. It’s a crime. God only knows what we are taking anymore. I am unfunctionable with the pills due to effects, and also without due to chronic exasperating pain. HELP!!!

  10. Bliss
    New York, ny

    I’ve switched from Prevacid, to nexium, to finally Prilosec after spending a summer bent over the toilet because my GERD was so bad. I finally did really well with the generic of Prilosec. One day I went to a different pharmacy and the capsules were purple and white as opposed to the usual yellow color. I’m extremely sensitive to medication changes and was hesitant. I took the capsule anyway and went about my day. Suddenly I was overwhelmed with intense anxiety to the point of sweating and tears. I had no reason to be anxious but couldn’t shake it. I took Xanax (which I’m prescribed for panic attacks) and it did nothing.
    The next week of taking this genetic this continued. I couldn’t sleep, and if I took it before bed I would
    Wake up (why I’m awake now) with anxiety. And the most hilarious part is it’s not even treating my GERD. I’ve been throwing up all week. However for some reason Medicaid can’t seem to understand the concept that a certain manufacturer produces a different drug.
    The pharmaceutical industry in this country is a joke.

    • Bliss
      New York, NY

      I forgot to mention, the capsules are produced by Zydus.

    • Ryan
      Waco, TX

      Having the same problem with Generic Esomeprazole Magnesium 20mg made by Mylan. I find myself having to double-up the dosage for acid reflux. Bad LOT/Batch or bad manufacturing.

  11. Jane

    Wellbutrin XL300-for a fortunate reason the first time I picked up my prescription I received Wellbutrin XL300. After the first 90 days I felt emotionally and physically great. On my second refill I received the generic version manufactured by Zydus. After three weeks I was getting ready to order my next month. It felt as if I was taking a placebo so I told my pharmacist that I don’t want the generic because somehow it wasn’t working for me. He explained to me how they were ‘chemically identical’. But they aren’t. This month I hashed a different pharmacist the same questions so she has me on Anchen. After 7 days I don’t feel better I actually feel more depressed. I don’t know what I can do. Wellbutrin is now over $1500/mo. Prozac did nothing either. That’s why I switched. If anyone has any advise please let me know. Can you get a discount from the manufacturer?

  12. Laura
    Dayton, OH

    Hi. I’ve been taking Citalopram for many years. It has kept me even through retirement, serving as a juror on a pretty awful criminal trial, and my husband’s stroke and successive hospitalizations during the past summer.

    In late autumn, Walgreens refilled my prescription with a different pill made by a different company. Almost immediately I felt like I’d just stopped my anti-depressant cold turkey. I’ve basically cried and yelled my way into the new year and was still crying yesterday on Valentine’s Day. When I complained to the pharmacist, he said it might be taking me awhile to adjust to the new formula. I have to tell you, a sugar pill would work better than this.

    The pill is a round pink tablet. Side 1: MX32. Citalopram 20 mg. Manufactured by Mylan.

  13. KATHI

    I became so ill after Express Scripts switched to Zydus Pharmaceuticals generic omeprazole that my MD ordered an endoscopy to make sure I did not have esophagus cancer. I was sick for almost 3 months, and am still having issues almost a year later.

  14. Linda
    Los Angeles, CA

    I have been taking Prilosec by AstraZenca for 20 years and have had no GERD problems at all. As of November 1, 2015, I was advised by my CVS pharmacy that AstraZenca had stopped making the drug and I would now have to take a generic. I have taken a generic Omeprazole 20mg by Zydus Labs for 40 days now, and it is NOT the same. I am burping all the time and have reflux and choking, something I never had with the brand name Prilosec. I am fortunate that my insurance has paid 80% of the cost (over $200 month).

    I have had bad luck in the past with the generic form of Mobic, which did not relieve the pain from my arthritis in my knee, quite the opposite. The Lab had stopped producing brand name Mobic for about 4 months last year because ‘they couldn’t get one of the ingredients’. I found it odd that if they couldn’t get an important ingredient, how was a generic made.

    What do I do now? I researched Prilosec and found that the brand name is made with Omeprazole MAGNESIUM but the generics are not. Where can I find Omeprazole MAGNESIUM?

    • Janice F.
      Bntfl, Utah

      I have had the same problem as you. I researched and found Walgreens and Walmart have an over the counter omeprazole magnesium. I am going to try one of them. Good luck to you!

  15. Henry

    My first generic flomax was made by one company which was barely tolerable. In the second prescription the pharmacy changed manufacturer and this generic was far worse and not as effective. If the FDA is not directly monitoring these drugs then there are unlikely to have the necessary ingredients to be effective.

    Since when is the “honor system” effective for prescription drugs. Besides, the binders may also play a role in the dispersal of a drug in the body. All in all Congress fails again in allowing potentially unsafe or ineffective drugs. What a mess because I am trying to search for the drug store chain that carries the first generic I used. This is no way to run health care.

  16. Lisa
    San Diego, CA

    Everything Teva makes is garbage.
    Sun Pharmaceutical Bupropion is very weak.

  17. Bev

    I recently change pharmacies, due to an insurance change and they request Walgreens is their preference for the best value. I have been taking Omeprazole for many years, it was a yellow and white capsule. I started Walgreen’s generic of this which is a tan capsule. I right away felt very exhausted. I started dizziness, migraines and feeling jittery. Sunlight bothered my eyes. I felt congested and also had gas pains in stomach. I was so tired, so after about 2 weeks on Walgreen’s Omeprazole, I realized that this was the only different medicine or brand that I had changed. I was just considering what had caused my symptoms, when I realized this. I have stopped the medicine and have heartburn, so I will have to pay for another medicine over the counter to help treat this. My conclusion as each of us is different and reactions to medicines can be different, is that whatever they are using in the fillers, I may be allergic to, I am waiting to call pharmacy for 2 more days just to see if any symptoms come back, but truly think it is Walgreens generic Omeprazole. When I read the side effects, and the rare side effects, there it was in the prescription leaflet attached to the generic medicine, I have the worst side effects, maybe worse due to filler.

  18. Julie

    I am a compounding chemist by trade. I chose not to write a dissertation as to why I am forced to use a narcotic pain reliever but I am medically administered the medication after failed surgeries. I hate taking it. I don’t get high. I’ve never taken it ‘not as prescribed’.

    I think I am ‘sensitive’ to drugs more than other people. I can tell when the waitress gives me pepsi and not coke. I can tell my burger was cooked in a pan where onions were previously cooked. I have a sensitive palette.. and I can smell things before they happen. Its not a gift, its a curse.

    That being said,. my pharmacist was special ordering my Endo 10/325’s and then due to February ‘not having as many days’ (this is the excuse given to me) my Rx didn’t show up. No problem I have a bottle put away so I gave them a few days.. and then a week. After 10 days it was not arriving. I asked my friend the pharmacist, . What brand do you have? HE said Watson. I said Ugh, but ok just fill it. I am so tired of coming here. I never looked at the pill. I saw white and ‘assumed’ (insert that saying here,. about assuming)..

    After a day or so….. Headaches,. drowsy,. I left candles burning overnight. I forgot formulations. I was forgetting simple names, . mid sentence,. I thought I was having a stroke. I fell asleep on the TOILET…. woke up and my legs were asleep. It didn’t dawn on me to LOOK at the pill. And there it was A333. I spent all night googling Actavis. The merger. The fact that Actavis doesn’t manufacture pain pills. I read warning letters and recall warnings on products in quality control. The tablet centers were caught taping hoses that had active ingredients blowing out,. I mean. ,letter, after letter after letter. You can read them too just google things like Actavis warnings, complaints, RECALL, etc. And then read and use keywords to dig more.

    This is a financial windfall for several pharmaceutical companies to merge like this. When Watson handed the keys to Actavis they didn’t hand them ‘grannies secret codeine recipe’. They got the accounts and then Actavis called their suppliers in INDIA and GUAM and said “we need some pain pills el-rapido”

    FDA doesn’t regulate these medications. The biggest issues pharma companies have is import/export. Nobody tests the product. Nobody regulates the product. And here is where MY experience differs. 2013-2014 everyone flooded FDA and ACTAVIS with complaints about ineffective pain meds.

    The new word for generic isn’t bio identicals. ITS BIO SIMILARS. ” Make us a pain pill that looks like a pill,. tablets-up (presses well) Can be imprinted and offers an Analgesic reaction “FOR THE LOWEST PRICE POSSIBLE”. Well the pharma companies said “no problem boss”.. And BIO SIMILARS WERE created and are now flooding the pharmaceutical world.

    In my case I believe that those complaints caused them to tweak their formulation,. What is the most ironic thing is that I can take one pill and feel very little. The second one makes me forget my name. Head pain following gut rumbling. Take one at bedtime and I sleep like I’ve been given a roofie. I wake up in agonizing pain so the pills do not have the codeine that sends signals to the brain receptors. This is a tranquilizer of some type,. enough to shut the patient up who needs pain relief.

    The side effects? I am not sure yet what the long term residual effects are. We are talking about INDIA here,. so imagine a pharmaceutical version of lab created pain killer. You know how you watch TV and almost every day you see a Law Office of DoWeCheatumAndHow citing a class action suit against XXX maker of XXX medication,. permanent injury like renal failure, heart valve swelling etc etc. This is how that starts.

    One thing you CAN do,.is learn about WHO distributes your medication and whether or not they manufacture it or they buy from one of the hundreds of international pharmaceutical companies all over the world. Get smart. And don’t just do it with your pain pills. Do it with everything you take.

    I also use LIDODERM for neuropathic numbing. I got my box of numbing sheets and it said LIDOCAINE 5 ON IT,. I was puzzled, looked nothing like Lidoderm. I opened one up, pulled it off the backing and it rolled up and stuck to itself. I fought with it trying to roll it flat, trying to affix it to my skin,. I put it on my arm,. and waited.. and waited. No numbing. Nothing. And because I’m a crazy chemist I touched it to my tongue. NO NUMBING,. couldn’ t taste the lidocaine. IT WAS NOT PRESENT IN THIS PRODUCT.

    I got my magnifier out.. and almost fainted when I read “manufactured by Actavis” . Another BIO SIMILAR. LOOKS LIKE LIDODERM. Same size. Same feel,. Similar enough to pass off to a customer who would not really notice. I checked my insurance and they charged $150 for a box of 10. The next thing I am doing is meeting with my broker and making sure my annuities are well invested in pharmaceutical R&D and merger acquisitions. If I’m going to suffer in pain, I might as well earn some residuals.
    Love and Light,. Julie

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