- Are generic medications
just as good as the brand?
I'm gonna talk about why you may notice
a difference when you take
certain generic medications.
I'm Dr. Tracey Marks, a psychiatrist,
and I publish weekly
videos on mental health
education and self-improvement.
So if you don't wanna miss one,
click subscribe and notifications.
So to cut to the chase, in theory, yes,
generic medications are just as good
when it comes to clinical
effect and safety,
but for some medications
you can see differences
in how they work for you.
And I've seen this variability most
with Buproprion, which has the brand
name Wellbutrin, and that's what I'm gonna
use as an example in this video.
When a new drug comes to market, the FDA
gives the drug company exclusive rights
to produce and market the drug
until their patent runs out.
GlaxoSmithKline lost
their patent protection
for Wellbutrin in 2006,
paving the way for other
companies to come in and make Buproprion.
In order to do this, the new company
has to show the FDA that their version
of the drug is bioequivalent
to the original Wellbutrin.
What does it mean to be bioequivalent?
There's a very complex definition of that
on the Code of Federal
Regulations website,
and I have a link to
that in the description
if you wanna read through
it, and have fun with that.
Here's a very simplified definition.
According to the FDA, a generic drug
is bioequivalent if there's no significant
difference in the way
that the active ingredient
of the drug becomes available in your body
if you take it at the
same dose as the original.
There's a couple of
key words here that get
to the heart of how generic medications
can work differently.
The first is no significant difference.
This is not saying that the
drugs have to be identical.
They just can't be
significantly different.
So what's considered a
significant difference?
A significant difference is defined
by bioequivalence limits, which the FDA
sets as 80% to 125%.
These percentages refer
to the range of the peak
concentrations of the
drug and how much of it
is absorbed over time.
For you science enthusiasts, that would be
the area under the curve.
So let me show you what I mean.
This is what a drug
activity curve looks like.
You take the medication, it's digested,
and goes into your bloodstream.
Then, it goes to the part of the body
that it's supposed to be used for.
In this case, our brain.
So looking at this curve, after the drug
gets into your bloodstream, it reaches
a maximum concentration in your blood.
Then, as the drug is
metabolized and broken down,
the levels drop.
With bioequivalence, let's say, Wellbutrin
reached a concentration
of 100 in five hours,
then drifts down to really
low levels in 24 hours.
This section here is how
much stays in your body
and for how long.
The generic can come
along and reach a peak
that's 25% higher than
Wellbutrin or 20% lower.
How long it takes to get to this maximum
can also fall in this window.
Do these differences matter?
Maybe.
It depends on your
sensitivity to the drug.
It could be that this
is just what you need
to have enough in your system.
But then, the next time the pharmacy uses
a different manufacturer and
your curve looks like this.
This lower concentration
may be just enough
difference to change how it affects you.
Alternatively, the next month you get
another manufacturer, and
your curve looks like this.
This higher spike may give
you more side effects.
Okay, so maybe you aren't that sensitive
to that 20% difference in
concentration and absorption.
Here's the main reason though that I think
you could see a difference
in the generics.
The rule of bioequivalence
refers to the active ingredients.
Buproprion is the active
ingredient, but with all
medications, there's lots of inactive
ingredients, and they're call excipients.
These inactive ingredients are things
like fillers to bulk up the medication,
coatings, flavorings, disentigrants,
which are the agents
that help dissolve it.
Another active ingredient
is called a vehicle.
The vehicle is the substance that's used
to get it down, so an example of this
would be the liquid form of a medication.
A common liquid used is mineral oil.
So different manufacturers
can use different
agents to produce the
drug, and those different
agents can make a difference
in the side effects
that you experience and how
it's absorbed in your body.
So does this mean your
generics aren't as good?
No, it doesn't.
For many drugs, there
just isn't much difference
between the brand and
the generic, so you don't
wanna just insist on
brand for every medication
just because you think that it's gonna be
or that it's not as good.
And this goes for over the counter
medications as well,
'cause you could end up
spending a lot of money unnecessarily.
But if you've been taking a medication
for a while and you notice that you don't
feel the same on it, or you have new
side effects, check to
see if the pills look
different or if you have
a different manufacturer
than you had before.
You can usually see what
company made the drug
if you look on the label.
It's typically at the
bottom of the bottle,
and it'll say MFG.
Sometimes you can request
a certain manufacturer
and you can still get the generic price,
but sometimes the only way to control
for side effects or effectiveness
is to request the brand only.
And some insurances
will pay for the brand,
but just make your co-payment higher.
Last tip.
There's an online site called GoodRX,
and they have an app, if
you prefer using an app.
On this site, you can
use, you can get coupons
for discounted medication,
and you don't even
need to register with the site.
It's also good for seeing
how much medications
cost at different pharmacies.
You can enter your zip
code and the medication,
and then see how much the price
is from pharmacy to pharmacy.
So it's good for checking on prices
even if you don't wanna use the coupon.
Share this video with
someone who you think
could use it, and like
the video if you like it.
Thanks for watching.
See you next time.
(upbeat music)
♪ I am what I am today ♪
♪ 'Cause I did it my way ♪
♪ Nothing y'all can say ♪
♪ And this life for the next one ♪
