The People's Perspective on Medicine

Failing After Switching from Concerta to Generic Methylphenidate

What happens when a child who has been doing well in school while taking Concerta can no longer get that medicine? Failing on methylphenidate is not right!

We first began to suspect the quality of generic drugs nearly two decades ago. That’s because a mother complained to us about a generic form of the brand name Ritalin aka methylphenidate. She knew her son and noted that he wasn’t doing as well in school on the generic methylphenidate. Even the teachers were complaining that he started losing attention on the generic form of Ritalin. Fast forward to a very similar story we recently received. In this case, a long-acting brand name drug called Concerta OROS was also substituted with a generic form of methylphenidate. The result was way too familiar.

When Generic Methylphenidate Didn’t Work So Well:

Q. My 13-year-old son has ADD. He has been on Actavis’ generic Concerta OROS system with excellent results. He has made the honor roll and earned straight As for four years running.

Last month the pharmacy switched to a different generic. He’s now failing math and is symptomatic. I know Actavis was purchased by TEVA. I contacted TEVA and was told Actavis 27 mg was on backorder. No pharmacies in our region have any.

Do you know of an equivalent generic? Or could my son switch to regular methylphenidate tablets and take them breakfast, lunch and dinner? The etended release version works so very well.

My son was in tears when he failed his first math test last week. He’s struggling to focus, and it is breaking my heart.

What is Concerta OROS?

A. The osmotic-release oral system (OROS) was approved for Concerta in 2000 and allows for convenient once-daily dosing (CNS Drugs, Nov. 2014).  Actavis was selling this under an “authorized generic” agreement with Janssen, the original maker of Concerta. However, that agreement lapsed at the end of last year.

Another generic supplier, Teva Pharmaceutical Industries, should be shipping authorized generic methylphenidate early in 2019. We cannot tell you when that will be implemented, however.

What About Brand Name Concerta?

Brand name Concerta is available, though the cost could be around $350 a month. If that is unaffordable, you may have to discuss use of immediate-release methylphenidate with your son’s doctor. It sounds as though both you and your son are motivated enough for him to stick with a three-times daily dosing schedule. Three immediate-release pills a day should be as effective as one long-acting Concerta (Pediatrics, June 2001).

You could learn more about authorized generic medications from our eGuide to Saving Money on Medicines. It is available alphabetically in the health guide section of our store.

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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.” .
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The appropriate us of stimulants for documented ADD at younger ages more likely reduces the later use/abuse of alcohol/drugs that kids /adults turn to as a way of self medicating. Exercise and healthy sleep and eating patterns go a long way in helping ADD symptoms in conjunction with proper medication.

I strongly disagree. I have been advocating for my son who has ADHD for 14 years. Exercise is not a replacement for medication although it is key to health and happiness. When my son is on the medication he needs he is learning, building relationships and making safer choices. There is no harm being done.

We are still experiencing shortages of this medication. I am hoping that our appeal to have the name brand covered is approved. My son tried another generic that was not a therapeutic equivalent and experienced side effects.

You’re exactly right to be concerned. I am a 62 year old male and have been taking Watson (now Actavis) generic Ritalin (methylphenidate) for over 25 years. It saved my life and continues to do so! No other brands work for me (Sandoz, Malinkrodt, KVK, etc). Currently, Actavis is on back order where I live (Richmond VA). Hopefully, it will be back soon. I feel for you and/or child. Ignore the well-meaning people who suggest exercise etc. Not that exercise is bad…I exercise every day but nothing works for ADHD for me except Actavis. This is a chemical imbalance. I’ve been living it for 62 years, 25 of which have been wonderfully successful and productive, thanks to correct medication.

Make a game of taking short activity ADHD meds. Set alarms on a phone or watch every +/- 3.2 hours. Use a neat sound.
9-12:15- 3:32-6:19…

I worked for 20-plus years as a pediatric occupational therapist. In my experience with children and families, these drugs only work temporarily. I found that increasing physical activity was extremely helpful such as swimming, walking, bicycling. Also helping children to find social outlets such as clubs and scouts made a big difference in children’s lives.

From my experience, it’s rarely appropriate or effective in the long term to give children medications that affect their brains. This idea of needing drugs to cope with life gives a message that is easily translated to alcohol and other drugs when they reach adulthood. Is that what we want to teach?

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