The People's Perspective on Medicine

Generic Furosemide Disappoints | How to Afford Lasix?

Lasix (furosemide) is an absolutely essential medication. It treats excess fluid buildup (edema). But we keep hearing about generic furosemide problems.

Ask any doctor about the importance of furosemide (Lasix) and you are likely to get an earful. The FDA approved this diuretic in 1966. It is considered an essential medicine by the World Health Organization. Physicians rely on furosemide to treat edema (fluid buildup). This becomes critical for patients with congestive heart failure, kidney disease and cirrhosis of the liver. It is also prescribed for people with hard-to-treat hypertension. But here’s a problem. We have heard from patients and physicians that some generic furosemide formulations are disappointing.

Generic Furosemide Did Not Do the Job:

Q. I was on brand-name Lasix for over 30 years  to treat lymphedema. Now that I can only get generic furosemide, I have found that the generic does nothing to reduce swelling. It only causes allergic skin outbreaks. The generic is not even close to the brand name based on how my body reacts.

Years ago, my parents traveled frequently to Mexico, where they purchased brand name Lasix over the counter. It was less expensive than in the US, but it worked just as well.

Alas, those days are gone. I am 65 and I fear I will not be able to manage my condition in the future because the generic is ineffective. Can you advise me how I could find brand-name Lasix?

How Can Generic Furosemide Fail?

A. You are not the first reader to report problems with generic furosemide. We have even heard from a cardiologist who found that some furosemide formulations did not work well to control edema.

Jean shared this furosemide disappointment:

“I was taking 40mg of furosemide a day. My doctor upped that to 80mg twice a day. The generic
 is not working well. I could be eating jelly beans and they would work just as well. I’ve asked the pharmacist if she can use another generic company that did work. Sadly, the pharmacy doesn’t carry that brand.”

Delores also had problems with furosemide:

“I, too, have found generics from different companies do not work as well, if at all. I keep the slips that come with the prescriptions and try to keep up with what I am taking. I also check the pills when I pick them up each month to make sure I am getting the same ones from the same manufacturer.

“I have had to threaten to move my prescriptions to another pharmacy if they couldn’t get what I was taking. They got it. That still doesn’t mean that the companies don’t change formulations. I am now beginning to have trouble with the furosemide that I have taken all along. It is not doing what it should be doing. I don’t know what the problem is. I need to speak to my doctor.”

Mark is a retired pharmacist with an insider’s story:

“I am a recently retired pharmacist. For many years, I have wanted to believe that generics are as good as brand name drugs. I have been appalled by the prices of brand name drugs and the profits of Big Pharma. I wanted to be able to tell customers that generics are as good as brand name products because that would have been a good way for me to take a stand against the greedy brand name drug companies.

“Like every pharmacist, I kept hearing a significant number of stories from customers who said that the generic was not as good as the brand name. For years I dismissed these complaints outright. But I began to wonder: ‘Can all these customers who complain be crazy? Can they all be simply imagining that the generic is not as good?’

“No matter what city I worked in, it was not rare that I would encounter customers who would say that a generic was not as good as the brand name version. Of course, customers don’t like having a co-pay that is so much higher for brand name drugs compared to generics. They feel their insurance company is coercing them into accepting generics. Can those higher co-pays account for all the complaints about the quality of generic drugs? Are these customers just mad at their insurance company?

“Every pharmacist has heard many stories from customers telling us things like how often they would have to urinate while taking the brand name diuretic Lasix in comparison to the generic furosemide. Every pharmacist has heard lots of stories from mothers who tell us that their child’s behavior worsened when switched from the brand name Ritalin to the generic methylphenidate.

“Some customers tell us that their depression symptoms worsened on a generic antidepressant, or that they experienced more side effects on the generic. Other customers say their doctor has a harder time keeping their clotting in the target range with the generic warfarin for Coumadin. And the examples go on and on. What is a pharmacist to make of all of this? Are all of these customers simply imagining these differences between branded drugs and generics?

“During my career as a pharmacist, I wish I could have had complete faith in all of the generic drugs I dispensed. I wish I hadn’t heard customer complaints about the quality of generic products. I wish I hadn’t seen so many articles and news releases about major quality control issues in the pharmaceutical industry in this country and around the world.”

What Can This Patient Do About Generic Furosemide?

With a prescription from your doctor, you should be able to purchase brand name Lasix from a legitimate online Canadian pharmacy for about one third as much as it would cost in the U.S.

For more information about evaluating reputable Canadian pharmacies and other tips on using generic drugs wisely, you may wish to consult our eGuide to Saving Money on Medicines. This online resource is available in the Health Guide Section of PeoplesPharmacy.com.

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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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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.

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I am on generic Laxis 20 mugs, and it works but my ankles are still swollen. Can anyone reply?

I have worked for nearly 50 years in the pharmaceutical industry, mainly in process development for the drug substance (active ingredient). Although generics have to meet the same criteria for purity and potency of the active ingredient, the actual bioavailability of the active ingredient is a function of the formulation. Generics do have to meet the same criteria for drug dissolution, but this is not always an accurate predictor of bioavailability. “Authorized Generics” where the generic uses the identical formulation as the innovator (brand) product should have the same bioavailability, whereas other generics are products of reverse engineering/best guesses and may not always perform as well as the brand product.

Is anyone aware of an approved or authorized generic version of Lasix ? Or of any listing of makers of generics that don’t work?

Generic drugs, original name brand drugs, hey, why not sidestep the drug route altogether and seek out a person trained to conduct manual lymph drainage. This gentle manual (hands on) treatment can effectively reduce or eliminate lymphedema. Nurses in hospitals and certified massage therapists with specialized training can conduct sessions. If you cannot find a local therapist then contact the Klose training group in Lafayette, Colorado for a referral.

My husband has excessive leg swelling. Like the other patients experienced, the generic had No effect. We are on Medicare, and can only get generic. They should remove it from the market. I agree with the jelly bean remark.

This problem with generic furosemide has literally gone on for years. There has to be something to it. I practiced pharmacy for 30 years, and can truthfully say that not only am I glad to be out of it, but also the FDA is no longer in control of the integrity of our nation’s drug supply. There needs to be a complete overhaul of the way the regulatory agency operates.

Furthermore, the practice of nearly all drugs being manufactured overseas needs to be addressed and monetary incentives offered and/or laws passed that will cause production to be brought back to this country where oversight will be more than ineffective, as it is presently in foreign countries where the FDA basically has no authority. It really is an issue of national security, if war or natural disaster occurs many drugs may simply become unavailable.

With the absurd situation of the contamination of ARBs with carcinogenic byproducts, the FDA’s slow and piecemeal response proves they no longer can be trusted to provide adequate oversight. Congress needs to make themselves useful and investigate this, instead of engaging in fruitless partisan bickering.

I totally sympathize with the pharmacist quoted in the article. I wonder how many people were harmed by prescriptions I dispensed in good faith, believing the generic was equivalent, when that was not necessarily the case.

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