The People's Perspective on Medicine

Can You Trust Foreign-Made Generic Medicines?

If you've ever wondered where your shirt was made all you have to do is look at the label. Too bad you can't tell where your generic medicines came from.

We continue to receive complaints about generic medicines. Many are made in countries where the FDA does not have an adequate number of inspectors. Often the FDA staffers do not speak the native language and require interpreters. Even more worrisome, the FDA often has to alert the company weeks or even months in advance that it is coming to inspect. That is not the way inspections are done in the U.S. Here, inspectors show up unannounced so the company has no time to clean up its act. Some readers, like this one, wonder how they can tell where their generic medicines came from.

Q. How does a person know if a drug they are taking is produced in a foreign country, diluted or even filled with harmful chemicals?

A. Your questions are challenging. Although food and clothing are labeled with country of origin, medications are not. We find this bizarre. If you can tell at a glance where your shoes or sweater were made, why not your medicine?

Your Pharmacist Has Vital Information:

You will need to ask the pharmacist which company made your pills. Sometimes it can be found on the label of the prescription bottle, but it is often in very small print. Before you take your bag of medicine out of the store, ask the pharmacist:

  1. What company made my pills?
  2. What country did they come from?

In the event that your pharmacist does not know where the company is located or where the pills were actually manufactured you may need to look the company up online.

Do not rely on the name to provide clues as to country of origin. For example, some people might think Wockhardt is a German company. In reality it is an Indian pharmaceutical manufacturer. The FDA has on occasion accused Wockhardt of deleting data and hiding results from tests. Some of Wockhardt’s manufacturing plants have been banned from exporting medications to the U.S. market.

Testing is Challenging:

As for contamination, you have to trust your pharmacy to supply quality medicines. If you suspect a problem, report it to the prescriber, pharmacist and to FDA’s MedWatch.

Unfortunately, the FDA does not seem enthusiastic about receiving pills from consumers so they can be tested. Even when people send the FDA medications that they think posed a problem, it is unlikely that the agency will test them or report back to the patient (or health professional) what they find.

Many Links in the Chain:

The manufacturing of generic medicines has a surprising number of links in the chain. Each link poses a potential problem.

  • The API (active pharmaceutical ingredient) is the actual medicine. It might be made in China or Thailand.
  • The “inactive” ingredients (binders, fillers and coloring agents) might be made in Bangladesh or Slovakia.
  • The final dosage form of the pills could be formulated in India.
  • The shipping of medicines from abroad to the U.S. is a mystery to us. We’ll bet your pharmacist doesn’t know either. Can some foreign generic pharmaceutical companies afford to ship by air or do they rely on container ships? Are the pills stored under careful temperature and humidity-controlled conditions? Does the FDA monitor transportation of medicines from foreign manufacturers to U.S. distributors?
  • How are pills shipped from ports of entry to wholesalers and mail order pharmacies? Do mail order pharmacies ship under temperature and humidity-controlled conditions?

It seems to us as if there are a great many opportunities for problems all along the chain of manufacture and distribution of generic medicines.

Stories from Readers:

Naomi in Maryland is in a bad bind:

“I was in a car accident that caused a brain bleed. That resulted in a hemorrhagic stroke. I had to relearn how to walk and talk again.

“As a result of brain damage from my stroke I have seizures. It is very important that I take medicine that works. I’ve gone through several generics and NONE worked for me. I took generic Keppra, I broke out in a rash, then my neurologist played around with the dosage of oxcarbazepine generic (Trileptal).

“While on oxcarbazepine I broke out in sores on my forehead that won’t heal. I had two break-through seizures while I was taking generic oxcarbazepine.

“Now my neurologist writes on the prescription (DAW) dispense as written. It now costs me $188 for brand Trileptal and $261 for brand Topamax. That is the price for the American way if you want to stay alive.”

M.J. also had problems:

“I have been on the name brand of Cymbalta for 5 years now. Suddenly, my insurance company has decided that because there is a generic for Cymbalta (duloxetine) that I now have to take it instead.

“I have tried 4 different kinds from different manufacturing companies, and NONE have worked. Only the BRAND name Cymbalta works on me!

“I have spent months fighting with my insurance company. My wonderful doctor constantly wrote on the Rx: “Brand Name Medically Necessary.” My insurance company still will not pay for my Cymbalta! I have even had blood work done while on each generic, proving that it wasn’t working or even showing in my system!”

Sheila in PA shared this report. We have found that chronic pain patients can tell quite quickly if their medication is not working:

“I recently got my first refill of 10 mg Percocet manufactured by an Indian drug company and am so angry. These are the worst pills I have ever taken and they do not work!

“I have had my Percocet from several different manufacturers and none of those have ever come close to being as bad as the ones from this company. Not only do the new ones not work, but they make me feel absolutely awful. That is in addition to all the pain you are already in.

“What in the world is the FDA doing? Certainly not their job!

“Now, I ask the pharmacist what company they are using before I fill my meds and go elsewhere if necessary. FDA, you are doing the consumer more harm than good!”

What has your experience been with foreign-made generic medicines? Share your story in the comment section below.

Rate this article
4.8- 19 ratings
About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
Saving Money on Medicines

This online guide offers 20 pages of information on how to safely buy prescription drugs from Canada, assess generic drugs, qualify for free medicine from drug companies, and more. Updated 10/2016.

Saving Money on Medicines
Join over 150,000 Subscribers at The People's Pharmacy

We're empowering you to make wise decisions about your own health, by providing you with essential health information about both medical and alternative treatment options.

Showing 21 comments
Add your comment

Both my husband and I take valacyclovir and have been taking it for years. Our pharmacy switched to the Mylan brand this year, and it does not seem to work at all. I wrote the FDA and in response received a letter from Mylan asking me a bunch of personal questions about my identity and my medical conditions. A letter from the FDA accompanied the Mylan letter. The FDA letter said “You don’t have to give them your name.” Of course, there is no phone number on the FDA letter, so that I can call up and find out why it would be disadvantageous to give my name, my height, my weight, medical conditions, how long I’ve been taking valacyclovir, etc.–essentially a bunch of information that is none of their business.

I don’t believe the Mylan executives are in a good position to diagnose what’s wrong with me. I want someone to put these pills in a mass spectrometer and see how much actual active ingredient is in them. (At least I think that’s the name of the machine that can analyze what’s in a pill. Could anyone weigh in on this?)

BTW, I researched and found some appalling non-compliance reports on Mylan quality control in 2017. However, the “big stick” in the FDA letter warning them was the following:”…the FDA may withhold approval of any new applications or supplements listing your firm as a drug manufacturer…” New? What about these “placebo” pills they’re now distributing?

I have been taking Sertraline (generic Zoloft) for 2 years for mood issues related to PMDD. My December refill marked a change in shape and a slight change in color due to different manufacturer. I thought nothing of it since I have never had a noticeable issue with generics. After a couple of days I realized I was not feeling very well. I realized I was actually feeling seriously blue and relentlessly depressed. I lived with this for about 3 weeks. It occurred to me that Sertraline may no longer be effective for me. It’s hard to believe that I can feel that badly so fast. I know it’s possible, but that has never been the case for me.

The manufacturer, in this case, is Lupin Pharamaceuticals. From my MD, I politely requested a name brand prescription for Zoloft. I tried the name brand with great improvement! I was so relieved. I quickly looked at the other med I take and those of family members. My other medication, generic Lisinopril/HCTZ (20/12.5mg), was also made by Lupin. I filed this away in my mind in case I found this med to be ineffective as well. Since then I have had to transfer my prescriptions to another pharmacy who provides these medsfrom other companies. My Lisinopril/HCTZ was wildly ineffective as well. Not sure if it’s my genetics or the lack of close scrutiny/testing at big pharmaceutical companies, but it was certainly a bummer to find that these were ineffective. Happy to have the same generics produced by other companies. Otherwise, I would have to have name brand only.

Here is my ONE of a couple experiences I have had with generic lexapro. My pharmacy: Kaiser. I have been taking this generic, escitalopram, for about 10 yrs. Started my refill and about 3 weeks later I began smelling phantom cigarette smoke many times a day. This experience was so strange! I would look around me, no one was smoking. At home, when I smelled the smoke, I would ask my daughter (who had quit smoking a yr before) if she was sneaking a smoke. She thought I was going crazy. Finally, after about a month and a half of smelling cig smoke, having nasty headaches and being so nauseous I could barely eat, I called my PC at Kaiser. He was alarmed and ordered a brain scan. Meanwhile, I explained to the Pharmacist what I was experiencing and they of course “poo-pooed” any link between my issues and my escitalopram. Long story short, my PC contacted the pharmacy. The RX mgr was on the phone very quickly (within a couple of day apologizing for the treatment I recvd From his underling and immediately notated in my file I was not to take that manufacturer’s product again. Within 3 weeks of stopping the BAD generic I no longer smelling cig smoke, experiencing nausea or headaches.

The FDA refuses to test bad pills sent to them and I found this out the hard way. I had some pills that made me very sick. I had not taken the generic before. Because I have a friend whose husband oversees an FDA lab in Kansas, I mailed the pills to her. She gave them to him and he told her that FDA labs don’t really check pills that are suspect. The ‘higher ups” will not allow it and it is FDA policy not to check.

So, she had to return the pills to me. She was afraid to even discuss this over the phone and told me in person. Sadly, she told me her husband can’t do anything to protect the consumer if he wants to keep his job, but he works there in hopes that one day he will be able to do something beneficial. I now refuse to take any generic drug, and I usually pay ten times or more what friends in European countries pay. This is disgusting. Don’t try to tell me America is Great!! We are brainwashed if we believe that.

I know from experience that I don’t need to look any longer for the name of the manufacturer. I can take the medication and tell right away. I get an upset or nauseated stomach or feel really awful. It’s a roll of the dice each time your medication changes. It has taken me many years to get the right manufacturer.

At the end of 2016 my insurance co. decided to change 6 of my medications to another generic, cheaper, alternative. I had tried these drugs before and they didn’t work as well. Here I go again! It’s best to stay with 1 pharmacy and work with them to find the right manufacturer!

I was given Losartan for my high blood pressure. I woke up one morning and was barely able to stand. I felt ill and my blood pressure rose to over 170/95 and pretty much stayed there. My doctor thought it was simply that I was on a lot of meds and did not really respond until I sought help from another specialist. At that point he hospitalized me.

By then, about 3 weeks had passed. I went in Friday night after taking my own meds. I started hospital meds on Saturday morning. About 2 a.m. Sunday morning I awoke feeling much better. I no longer needed assistance to walk. I was discharged later in the day. Once I got home I checked the dates on my meds and realized I had started a new bottle of Larsartan just before I became ill. My blood pressure also came down after I took the hospital’s Losartan. It took several weeks until I felt 100% better but I finally did.

Now, I watch the manufacturer’s name on my drugs and avoid Teva’s Losartan as that was the culprit. My doctor learned from the episode as well. My pharmacists may find me picky but they are cooperating with me. I also check my drugs manufacturers on the internet occasionally to see if there are problems identified by the FDA. And, I warn my friends to be careful. As the Indian manufacturer is quoted in the New York Times “If I make these pills the way the FDA wants, I can’t make any money.”

My history as a 77-yr old woman is nearly 50 years of severe and terrible migraines, where first one thinks “i’m afraid i’ll die” and then when the pain continues unabated “i’m afraid i won’t die”….. when the “triptan” drugs came on the market more than 20 years ago, i was able to alleviate a lot of suffering. two of the 7 drugs work for me, but now that they are generic, they barely help at all.

And believe me, I’ve tried ALL of the generics out there, of these two drugs. my pharmacists have been more than helpful, and they feel the desperateness of the situation for many of their clients, because not only do the generics do nothing for some of us, the companies keep getting bought out by other companies, so a patient really has no idea who made the drugs and what excipients are used, as stated in the above article.

i am forced to buy my brand-name drugs from canada at more than $400 per month. if i didn’t have these drugs, i couldn’t keep working, or even get out of bed, at my advanced age. i am outraged at this situation, and i greatly resent having to pay such a large portion of my skinny income for drugs which in the U.S. are so outrageously expensive. (many thousands per month if i bought them here).

Lucky so far! Sildenafil dropped off the formulary this year so I ordered from “Canada” and Canada was indeed where my credit card was charged. The pills were made in India and shipped from Singapore.

Fortunately they work just fine.

I was on Zetia for cholesterol. My insurance company switched me to pravastatin. I looked the manufacturer up online and saw they were made in Israel, so I took them for 3 months. The next 3 month order came from India and were causing my nose to bleed. My PCP told me to throw them away as many foreign manufacturers use junk fillers. Thankfully, I’m off
cholesterol pills!

Are there other countries that do a better job with these problems than the U.S.?

If manufacturers of generic drugs in foreign countries require weeks or months notice before they allow inspectors to come, shouldn’t that tell us something? It tells me that they need some time to clean up their act. We should stop using those companies and get another manufacturer to make the drugs for us. If this is done often enough, I am sure they will stop their shady practices.

I have taken Celecoxib for a number of years and last year when I had to change the company that I previously had, they used a different dispensing company, Lupin and it absolutely did not take care of my arthritics pain. I asked my doctor to please specify that I wanted my Celecoxib, 200 mgs. a day from “Actavis” which is effective.

But the last time I had a refill the mail-away-company, Optum would not fill it as my doctor wrote the prescription so that it would be from “Actavis”. The local pharmacy said I might have to go to the brand Celebrex, which is terribly expensive so I don’t know what is going to happen. It’s a definite concern and I can’t understand why a pharmacy can’t get Celecoxib from “Actavis?”

I am taking mycophenalate mofetil from Ascend in India and it is not helping at all. I wonder if I can take a blood test to see if it is actually circulating in my bloodstream. My insurance company won’t pay for Cellcept.

The problem is the fda has minimal amount of inspectors, and will be in name only under new administration, big pharmaceutical wins again.

While taking generic Coumadin my INR reading would vary frequently. Coumadin [name brand]
isn’t covered by my insurance. The doctor now writes prescription for BMS NO Generic.
Purchase from Canada. Better price than USA.

Have been taking Norvasc for years for my high blood pressure. We switched our insurance company to one that cost less, and they decided that I had to take a generic instead of the name brand. Two different generics and neither worked, my blood pressure soared…long story short called insurance company….after 10 minutes, I was assured no more questions, Norvasc would be okayed. Thank heaven I still stand up for myself and have the ability to state my case.

I have been getting my Levitra 20mg. from India for the last five years mail order. It cost $25 for ten pills, each vacuum wrapped in a package that holds ten pills. It clearly works just like the US version that I have bought in the past. My insurance agreed to cover it recently so when I went in to get ten pills they said it would be $350. I said I thought my insurance covered this. Rite Aid said it did – without the insurance ten pills would be $700. So I continue to buy the Indian brand mail order 90 pills at a time and I am completely satisfied. I always wondered why more men don’t use these pills and now I understand.

People want prescription drugs to be inexpensive and available to everyone, while still being safe and effective. Unfortunately, these don’t work well together. Inexpensive almost guarantees that drugs will be made in problematic countries with badly sourced ingredients. Brand name drugs are often grossly overpriced, but low cost generics from sketchy places are a less than ideal solution. And cutting back on FDA funding will only make matters worse.

if you have a good drug store they can get around that by mixing their own compound by alterning the mg. i get 10 for $70. i wouldnt know how to begin getting it from dentist wife takes very exspensive med and he said he orders from canada,yet the package may say from india,or philipines

Big Pharma lobbyists with bags of money will see to it that the FDA will not protect us from harmful drugs. As long as we the consumers don’t demand an end to corrupt buying off of our elected officials, if we don’t demand an end to such corruption, things will only get worse and worse. Citizens United is an example of how corporations buy our govt. We need to take back out govt. by speaking out and not stopping.

I am willing to pay a fair price for a drug that works, but I’m angry about having to pay for the pharmaceutical companies’ billions of dollars of advertising. I don’t understand why the FDA can’t protect us from being poisoned and killed by generics. Never mind–“follow the money.”

* Be nice, and don't over share. View comment policy^