Brand vs. Generic

Hi all,

I’ve just read on another board that people have quite a bit of trouble with certain generic brands. Have any of you experienced a problem (less effect) using generic meds?

The topic came up in a board where people take a lot of ACs for epilepsy. If they use generics, they start having seizures. They also complain, and have found studies to support this, that certain generic Klonopin is like taking a sugar pill. They also claim on this board that the FDA allows a 20% variability in bioavailability, but they don’t moniotor it - it’s on the honor system.

A big problem these people have had is that when their pharmacy changes their generic brand, it throws them off - they are suddenly getting either more or less of their med. And if they switch to Brand, they are suddenly getting hit with what should have been their correct dosage and they start having symptoms, neurologic and/or psychiatric.

I haven’t been taking meds long enough to have much experience with this - i’m just wondering if i should get myself on all Brand meds right from the start in order to avoid these problems.



The only brand name that I have taken is Topomax. I don’t think it is availible in generic yet. I haven’t had a problem with generic depakote, but my employers insurance is about to force me to change pharmacies, so I will probably end up with a different generic. Hopefully I don’t run into the problem you mention.

Let me know if you notice a difference, Brian. Since I heard of this potential problem, I called my pharmacy to see what generics they are using for the various drugs I take. I’ve heard the Teva brand is the best, and Actavis (PurePak) is the worst. I’ve also heard that lots of general Klonopin is a problem, but the other benzos are fine in generic form.

just something else to have to consider.


Julie, the FDA does allow 20% variability. Some drugs have a more narrow therapeutic window, and it makes a big difference. The endocrinologists I work with will not allow their patients to use the generic for synthroid. I personally know that my daughter takes generic nortriptyline for MAV. For some reason, she finally got stable when we switched to mail order, which is the Watson brand, and the Teva brand never seemed to do the trick. For her, tiny dose changes made a big difference: 50 mg, and she was down with a severe headache, 25 mg and she was dizzy, 30 mg seems to be the dose that works for her. Her neurologist keeps trying to get her to wean off of it, and she has no desire to go back to feeling lousy. He admitted that some people have a certain dose that keeps them steady: he mentioned another patient who was fine with exactly 65 mg, any lower, and the migraines came back.


I’ve heard the same thing about ACs. It’s about hitting the dose that that particular person needs. Anything more or less, and they’re seizing.

I just don’t like all these variabilities. I’m on the diet, I’m on Zoloft, I’m titrating up on Neurontin, and I’ve taken some Klonopin. I’m feeling better, but I would like to know what is helping and what’s not. Now another variable - the pharmacy keeps switching manufacturers on my generics - one version of my med may have a different bioavailability than another. I think I’ll switch to Brand. I’ve asked my docs to check “do not substitute” but they forget, they’re so accustomed to doing otherwise.

Thanks for the input.