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Generic vs brand - change in drug manufacturer

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Altostrata

Yes, some people are sensitive to the differences between name brand and generic or even between different generic brands.

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btdt

 

 

After reading more personal experiences on here - online - and becoming way more informed than before, I am disgusted, angry, fearful and generally at unrest watching psuedoscience hard at work  putting people into chemical straightjackets. 

I see you are new. 

This is something most of us have come to know sooner or later sadly all the emotions that come with the knowing hamper you healing... so if you can please try to step back from this just now and focus on your healing.  I know that is a tall order when in withdrawal but it is paramount that you heal that is more important than the truth right now... the truth will still be here when you well it has been here for years and is not going anywhere. 

I wish you peace 

peace is the state in which our bodies heal best....

peace.

 

Yes I am new to this board but not new to coming off vi tapering from SSRIs - unfortunately.

 

Unable to find work despite college degree and a return for a tech degree - I cannot afford brand - hence the need to switch to generic. I was just turned down for assistance due to skewed incorrect presumption about income.Had to draw the last of my IRA to survive - and it wasnt much - but with a astounding tax penalty that did more harm than good. 

 

I am not in withdrawal right now. Its not a return of my depressive state. It is pure unadulterated disgust with the lies I was sold and an RX now dependent on. The day I have to choose over eating food and dependence on an RX that never did anything to help and costs more than I spend on gas in a month is outrageous. 

 

There is no reason a generic should provide less quality though the discontinuation syndrome is very very real when I have taken it. I had anticipatory anxiety in the switch presuming the medicine potency was the same. I was told there is no difference by the pharmacist as well as a second MD I went to. Considering the unfavorable scenarios people go through in DS, the disparity is something that can cost someone their mental well being and possibly their life. 

 

Your not alone in your outrage! 

Effexor is expensive my drug coverage would not longer cover E when the generic came to market so I too paid out of pocket for it.  I was left with a few hundred dollars worth of meds when I quit not to mention a few other bottles of varying doses when I tried to go back on... all went in the garbage eventually. I know I should have taken them back to the drug store but I didn't.  I was in an angry mood and went through all the old pills in my possession and toss them all.  I thought I should keep the bottles so I have dates and did that ...but all the pills were bagged and tossed.  

I wonder how many millions of dollars in pills have ended up in the landfill. 

 

I am sure this does not make you any happier know people are throwing away drugs you need... it is stupid but laws mean people can't pass you off their old drugs or I would have easily... so would others I am sure. When I think how poor I am now and how I have not worked in years ...all the money I wasted on Effexor just pisses me off even more. 

 

Nope you not alone in your outrage I just can't keep the intensity year after year it waxes and wains.. bet is the same for other long timers.  

I wish you peace....

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NewMe

 

 

 

After reading more personal experiences on here - online - and becoming way more informed than before, I am disgusted, angry, fearful and generally at unrest watching psuedoscience hard at work  putting people into chemical straightjackets. 

I see you are new. 

This is something most of us have come to know sooner or later sadly all the emotions that come with the knowing hamper you healing... so if you can please try to step back from this just now and focus on your healing.  I know that is a tall order when in withdrawal but it is paramount that you heal that is more important than the truth right now... the truth will still be here when you well it has been here for years and is not going anywhere. 

I wish you peace 

peace is the state in which our bodies heal best....

peace.

 

Yes I am new to this board but not new to coming off vi tapering from SSRIs - unfortunately.

 

Unable to find work despite college degree and a return for a tech degree - I cannot afford brand - hence the need to switch to generic. I was just turned down for assistance due to skewed incorrect presumption about income.Had to draw the last of my IRA to survive - and it wasnt much - but with a astounding tax penalty that did more harm than good. 

 

I am not in withdrawal right now. Its not a return of my depressive state. It is pure unadulterated disgust with the lies I was sold and an RX now dependent on. The day I have to choose over eating food and dependence on an RX that never did anything to help and costs more than I spend on gas in a month is outrageous. 

 

There is no reason a generic should provide less quality though the discontinuation syndrome is very very real when I have taken it. I had anticipatory anxiety in the switch presuming the medicine potency was the same. I was told there is no difference by the pharmacist as well as a second MD I went to. Considering the unfavorable scenarios people go through in DS, the disparity is something that can cost someone their mental well being and possibly their life. 

 

I don't care what they say is in the drug or how they are suppose to be the same the meltdown I had was not because I had anxiety about the drug switch as I did not notice it had been changed till after the damage was done.  

I no longer have a problem going against the norm or what they tell me as I know what I know and generics do not act the same inside my body as the brain name no matter what crap they are trying to sell... I am not buying.

 

Totally agree!

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NewMe

 

 

 

After reading more personal experiences on here - online - and becoming way more informed than before, I am disgusted, angry, fearful and generally at unrest watching psuedoscience hard at work  putting people into chemical straightjackets. 

I see you are new. 

This is something most of us have come to know sooner or later sadly all the emotions that come with the knowing hamper you healing... so if you can please try to step back from this just now and focus on your healing.  I know that is a tall order when in withdrawal but it is paramount that you heal that is more important than the truth right now... the truth will still be here when you well it has been here for years and is not going anywhere. 

I wish you peace 

peace is the state in which our bodies heal best....

peace.

 

Yes I am new to this board but not new to coming off vi tapering from SSRIs - unfortunately.

 

Unable to find work despite college degree and a return for a tech degree - I cannot afford brand - hence the need to switch to generic. I was just turned down for assistance due to skewed incorrect presumption about income.Had to draw the last of my IRA to survive - and it wasnt much - but with a astounding tax penalty that did more harm than good. 

 

I am not in withdrawal right now. Its not a return of my depressive state. It is pure unadulterated disgust with the lies I was sold and an RX now dependent on. The day I have to choose over eating food and dependence on an RX that never did anything to help and costs more than I spend on gas in a month is outrageous. 

 

There is no reason a generic should provide less quality though the discontinuation syndrome is very very real when I have taken it. I had anticipatory anxiety in the switch presuming the medicine potency was the same. I was told there is no difference by the pharmacist as well as a second MD I went to. Considering the unfavorable scenarios people go through in DS, the disparity is something that can cost someone their mental well being and possibly their life. 

 

Your not alone in your outrage! 

Effexor is expensive my drug coverage would not longer cover E when the generic came to market so I too paid out of pocket for it.  I was left with a few hundred dollars worth of meds when I quit not to mention a few other bottles of varying doses when I tried to go back on... all went in the garbage eventually. I know I should have taken them back to the drug store but I didn't.  I was in an angry mood and went through all the old pills in my possession and toss them all.  I thought I should keep the bottles so I have dates and did that ...but all the pills were bagged and tossed.  

I wonder how many millions of dollars in pills have ended up in the landfill. 

 

I am sure this does not make you any happier know people are throwing away drugs you need... it is stupid but laws mean people can't pass you off their old drugs or I would have easily... so would others I am sure. When I think how poor I am now and how I have not worked in years ...all the money I wasted on Effexor just pisses me off even more. 

 

Nope you not alone in your outrage I just can't keep the intensity year after year it waxes and wains.. bet is the same for other long timers.  

I wish you peace....

 

OMG since the RX company refuses to pay this yr based on my tax return (which is a joke) the cost has about buried me in more debt.

 

I have been able to get a 6mos script and have Walgreen pharmacy fill 5 at a time. This way I won't end up with extras when I get off Satan's vitamin (Effexor). 

 

I appreciate your input. Thank you!

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NewMe

I can't say I noticed any major difference between effexor XR and the generic until I started bead counting to try to taper off. There seemed to be a wide discrepancy with the size of the beads. The effexor beads seemed much bigger so if I was removing 100 beads from an effexor XR capsule then trying to remove 100 beads from a generic was never going to be the same. This led to some unpleasant side effects so now I insist on effexor only.

Harmonica

Thanks for your reply.

 

I have yet to get a scale so now I count beads that appear relatively uniform in size. I tend to pick the biggest ones. 

Your observations re gen and brand bead size is interesting. 

 

Thanks!

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Tabby

My husband was placed on Effexor in 2006 for anxiety.   He’s been on generic version I guess since it became available—I’m not sure.  I don’t know if he had any side-effects going from the brand name to the generic, and it’s been too long for him to remember.  Due to “Effexor” causing him so many problems, he’s been weaning off it for the past year—he was on 150 mg and is now hanging out at the 37.5 mg pill level (we dropped him 5% each 3-4 weeks with a few longer stays whenever he felt increased “emotional” sensitivity, etc.).

 
Anyway, at his last refill, the pharmacy gave him the script broken into 2 bottles—one was his usual Teva generic and the other was Greenstone (which is “real” Effexor).  He’s about to start on the real Effexor, and I’m worried this might cause added problems in his withdrawal, side-effect process.  Any thoughts?  I just hate seeing him change “brands” during withdrawal from one, especially since I read something about someone going from generic back to brand and experiencing anxiety, etc.  Hubby cannot afford to get messed up with his new, highly visible job he just started on a few months ago.  
 
One thing I can do is fill our own capsules.  As I was researching here for info, I realized I had TONS of little beads (Teva brand) in a container from this weaning process.  I could get some empty capsules and fill them.  Then I need to know if the capsules themselves being different could cause problems (different dissolve rates).  Any ideas?
 
Thanks so much!

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LexAnger

I can share some of my experience with shifting between the brand and generic although its for lexapro. I started with brand name on 2.5 mg for headache for years, when insurance changed it to generic, I had to increase the dose over the time to 10mg to help with the anxiety. Been on generic for 1 and half year, the killing jaw pain made me decided to tapering. I tapered from 10 to 2.5 in 3 months then could not going down further because the worsened jaw pain and panic attack. I stated there for another 4 months until I read the generic can cause jaw problems then I switched back to name brand. All kinds of withdral problems started in like 2 months after the shift so I had to increase the dose again to 3.7 then 4.5. One good thing is the jaw pain was gone after 7 months post shifting. In the last month I started tapering again from 4.5 to 3.8 now. I am scared to find the jaw pain came back yesterday. So in summary, the 2 shifts caused lots of problems and I suffered so much with various and severe symptoms also ended with much worse condition now. My feeling is shifting can trigger more damage and make your brain more sensitive. If the shift is for the consideration of cost, I would not suggest shift. Drug equivalence defined by industry or FDA is based on the potency of the active ingredients, but our problem now is Ssri induced problems not even the efficacy of the drug. Any tiny difference can mess up more of the brain then lead to unpredictable situation. Just my thoughts.

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Altostrata

Tabby, your prescription was filled with two generic types of Effexor, from different manufacturers.

 

As LexAnger indicated, if your husband is sensitive, the changes in generic brands might cause him problems. Many people are not that sensitive, however.

 

To avoid the risk, you should make sure the prescription is always filled with the same brand, whether generic or name brand.

 

Are the beads you saved all from the same manufacturer and same dosage of generic Effexor? If they're beads from different dosages, such as some from 150mg capsules and some from 37.5mg capsules, it's unlikely you can make up consistent 37.5mg capsules from them, there can be bead variation between dosages.

 

(If they're all from 37.5mg Teva capsules, you might be able to make up 37.5mg capsules from them if you have a digital scale. First, you need to empty a few intact 37.5mg Teva capsules to get the average weight of the beads in each capsule, then you need to weigh the loose beads you have to approximate that.)

 

Please start a topic in the Introductions forum for your husband so we can go into more detail about his particular taper. The topics in the Tapering forum are for more general information.

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Tabby

Thanks for the replies!  

 

I've called our pharmacy to see if they can specifically get the Teva brand of venlafaxine for us, and they're to call me back.  Otherwise, I will call around and see if any others have it.  

 

You all are right--if his brain is used to the Teva brand, and we're "successfully" coming down off of it, we don't need to go changing something else in the mix that might make things worse.  He's already feeling "iffy" enough to need to hold at this dosage awhile, I don't want him having to feel even more iffy because of a manufacturer change.  

 

The thing about our excess beads, though--I haven't kept them separate between doses.  They all look EXACTLY the same.  It makes sense to me that the manufacturer would make the bulk compound, venlafaxine, and then "dose" it out in the capsules.  To do it differently doesn't seem to make financial sense for them, but I'll do some digging around to see if I can find any more info.  

 

His psych. says she'll do whatever we want (prescribe whatever dose, etc.), but she doesn't think he'll ever be able to get off it!   We intend to show her!  I think his health depends on it.  

 

Thanks again!

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Altostrata

Tabby, please don't assume those beads are all the same.

 

Please start a topic for your husband in the Introductions forum, that's where we discuss individual tapering situations.

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Tabby

Good news is, our pharmacy was able to get his current "brand" of venlafaxine.  They are even able to fill it before his current pills are finished (because almost half were the other brand).  

 

Thanks everyone.  

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Altostrata

Good to hear. Please let us know how he's doing in an Introductions topic.

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laineyk

I have been on Zoloft for almost 14 years (on and off a few times. used to be on this forum all the time until I realized I have to get off the benzo 1s then work on getting off the AD

 

question is I have been taking sertraline from Auborino?sp?  for a year now and just got new script from Camber. I hae no idea what pharmaceutical company I was taking prior to that, never paid any attention.

 

but being in w/d from valium I am super sensitive. was just wondering who has opinions on which generic sertraline is best

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Altostrata

I don't believe there is any information about what generic sertraline is best. If your system is accustomed to a drug from a particular manufacturer, AND you are one of those people sensitive to differences among manufacturers, ANY switch in manufacturers may cause problems.

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sunshine01

Hi everyone. Quick question here. If someones antidepressant was changed form brand name to generic, if they were going to notice anything would it normally be in the first little while? as in the first few days??

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cymbaltawithdrawal5600

It could be at any time while they are taking it and not everyone notices any change at all.

 

Would you like to start a topic about yourself in our Introductions forum and tell us about yourself:

Please start a topic about yourself in this forum

Post #5 is very helpful.

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sunflower

Hi Sunshine,

 

Most people don't have a problem going from brand name to generic. However, many people do and there is research that shows that some people have a negative reaction to being switched. At I've heard of instances where people have to slightly increase their dose of the generic to equal that of the brand name.

 

A number of years ago I was on brand name Zoloft and was switched to generic due to medical insurance issues and I noticed a difference like 6 weeks later. I felt like I had tapered the Zoloft.

 

Hope this helps.

 

Sunflower

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Altostrata

People are sometimes even sensitive to the differences between generic brands.

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LoveandLight

So what did you do you then sunflower..?

 

Dunno if I'm reacting to this new brand and I cannot get hold of the brand I normally have...this brand is the only type I've found that will make a suspension..I had a window the day of changing the brand (after reacting to liquid sertraline) and an immediate uplift in mood after taking it but the day after and since things have been really bad..could I be reacting to this even although I had an immediate uplift in mood the first day?

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holmaster5000

Hello, I am new to this forum. I hope this is the right place to start this thread. Is it dangerous to switch between generics...spefically mirtazapine? (from Teva to Aurobindo)

I'm going to try to get my pharmacy to keep it the same but I don't know if they will.

I've had trouble with switching clobazepam (teva to actavis).

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wantrelief

I realize this topic is old but it is relevant to a situation I think is happening to me.  The brand of Klonopin I am taking was changed from one generic to another and am noticing a difference.  Has anyone had a problem initially with a generic but then gotten used to it?  I called all of the pharmacies in the area and no one carries the generic I was on previously.

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manymoretodays

I did.  I initially had increased difficulties on generic Lexapro........stayed on it..........  So I guess you could say I got used to it.  It wasn't too long after that switch over by the pharmacy and insurance company that I really began getting off of it completely.  The irony.

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Flowers

I so wish I had found this topic before I changed from one generic to another a few weeks ago. 

 

For 17 days I took a different generic brand from the Pharmacist and thought nothing of it. At first things were fine and I did feel a little nauseos and headachey but nothing serious. Over the days different WD symptoms began to rear their ugly head and suddenly the penny dropped that it might be the drugs.

 

The symptoms I am now facing are:

 

Nausea

No appetite

Giddiness

Heart Palpitations

Fatigue

Cortisol Spikes

Low mood

Anxiety

Muscle twitching in legs

 

So this is almost like when WD first hit but not quite so bad thank goodness.

 

I have been tapering very successfully  and did my last drop weeks ago so I cannot think of any other reason why this should suddenly happen. I have always been sensitive to any meds.

 

I have managed to get my usual generic now and have been taking it for 5 days. Can't see any improvement so far but guess my CNS has had a shock and I will have to use all my skills to get through this and get back to where I was.

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JamesF

Hello, 

I previously thought SSRI pills were standardised across different manufacturers. I.e. that 100mg sertraline looks and weighs exactly the same from 2 different manufacturers. 

I recently got a new prescription and found that 50mg sertraline weighs about 8% different from 2 different manufacturers. From one, pills are 0.150g, from the other, 0.160g. I had previous never checked the total weight, because I'd always been breaking them in half and crumbling them down to the appropriate weight. I'm very glad I checked before starting to use them.

This has big implications when it comes to tapering, because an equal weight of the pill contains a different amount of SSRI. 

This leads me to a question I'm wondering if anyone knows...

Are all SSRI pills all homogenous?

(That is, is the active ingredient always evenly distributed with the filler ingredients? So that breaking off any particular part always contains the same % active ingredient as the % volume of the total pill. E.g. breaking off 50% of the pill always contains 50% of the total active ingredient?)

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brassmonkey

Hi James-- this question comes up quite frequently. Yes, the pills are homogeneous. The only part that doesn't have active ingredient is the XR coating, which, if the pill has one, is a very tiny percentage of the tablet.  Because of this it is better to crush the tablet into a fine powder instead of breaking pieces off.  However, the ratio of coating to tablet is so small it won't make any difference in the dose amount.

 

If you're going to be getting pills that are different each time then it would be a good idea to calculate your dose using the active ingredient/ pill weight ratio as a basis instead of using a straight percentage reduction. The AI/PW ratio is determined by dividing the active ingredient concentration (the strength listed on the bottle) by the average pill weight. So using the numbers you gave above:

 

Pill one  is;  50mgai / 150mgpw = 0.33mgai per 1mgpw

Pill two is;  50mgai / 160mgpw =  0.31mgai per 1mgpw

 

Using these ratios you would determine the mgpw of your dose by dividing your target dose by 0.33 or 0.31 depending on which pill you're using.  So if you wanted to take a dose of 18mgai it would be 18/0.31 = 58mgpw for pill two or 18/0.33 = 55mgpw for pill one.

 

When it comes down too it though, there is only a 2/100 mgai difference between the two pills.  Even at a full dose this isn't enough to make a difference for most people and at the lower doses the amount is so small you couldn't even manipulate the powder to make corrections.  Unless you are showing an extreme sensitivity to the drugs I don't think the extra book keeping and calculations would be worth the bother.

 

I hope that helps.

 

Brassmonkey

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Altostrata

Different brands sell different tablet weights. Even within the same brand, there is no consistency from dosage to dosage; within dosages, tablets or capsules will be close in weight.

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JamesF

Yesterday I got another prescription for sertraline. The pill was another brand I had to not used before. Colour was different. Pill weight was much different. (I worked out to take the same mg active ingredient of course)

 

Asssumed it was normal when I took it, but now I feel like I've taken a significant updose or cut. I read that the amount of active ingredient entering the blood stream from different generics is not tightly regulated. I've seen some figures that it only must be within "80 to 125%" of the leading brand.

 

http://articles.latimes.com/2007/dec/17/news/OE-WAX17/2

 

https://www.webmd.com/depression/features/generic-antidepressants-what-you-need-to-know_

 

Feeling a bit desperate because I can't get another script for 2 days. Not sure whether to keep taking it or what.

 

I didn't know this even happened :(. Any advice ?

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Centime

I’ve had the same experience with generic Paxil. It simply doesn’t work for me. There’s no way it’s identical to the brand name drug!

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brassmonkey

The only thing a brand name tablet and a generic tablet have to have in common is the dose weight of the active ingredient.  All of the fillers and time release materials are up to the individual manufacturer.  The size and shape of the tablet is sometimes dictated by the local regulatory agency as every different tablet must be identifiable from every other type of tablet via size, shape or identifying markings. These differences can cause the tablet to react differently between people because they can affect the absorption rate of the medication.  Because of the difference in the fillers etc, some generics will cause problems for some people while others won't.  It's a trial and error thing to find out which will work and which will not, but experimenting can be painful.

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ChessieCat
14 minutes ago, brassmonkey said:

Oh Nick were do I start? 

 

The cross tapering plan that you have worked out is quite good and I would suggest that you use it when changing between different brands of the medication.  Over the years we have found that some people have problems switching between brand name and generic or between two different generic manufacturers and a cross taper makes the transition much smoother.  There are small differences in the fillers used by different manufacturers that cause some people to react differently to them.  It is not because there are different strengths of medication in the tablets. A 20mg tablet is a 20mg tablet no matter who is making it.  Unless you get a hold of some counterfeit drugs and then who knows what you're actually getting. 

 

What you are referring to above is called "the 80% - 125% Bioequivalence Rule".  It has nothing to do with the actual dose strength of the medication. But rather is a statistical analysis of the bioavailibility of a generic compared to the brand name. Once you work your way through the analysis (I'm not even going to try) it comes down to the fact that there may be up to a 3.5% variation in dose strength between a generic and a brand name or even between different batches of the brand name.  This appears to be accepted as a standard manufacturing fluctuation for the industry.

 

There really is no way around it, we are going to be faced with small variations in the strength of our doses no matter what we do.  This is why we recommend cross tapering between brands, between delivery methods and if you really wanted to get OCD about it, each time a person picks up a new batch of pills.  In the end it comes down to the fact that we just can't control things to the minute degree that some people would like and have to push through as best as we can.

 

I'm very glad you asked about this, and hope this helps put your mind at ease.  Yes, it would be a good idea to do a cross taper to switch over.  But don't let the mathematics, analysis and advanced chemistry of comparing brand names and generics freak you out.

 

Brassmonkey

 

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crhawk

Hi everyone....so I have read the troubles people have had when getting their meds from a different manufacturer.  Well, now I am in that boat.

 

I went to pick up my Diazepam prescription over the weekend and was told that the pill might look slightly different because it is a different manufacturer.  I thought, uh oh....and I told them I wanted the same manufacturer.  They said they don't have that one available anymore, and so this was my only option.  So I hoped for the best.

 

So last night I took the new pill (Teva instead of Mylan)....and knew instantly it was different because although it looked nearly the same, is was a much harder pill that my old brand when I split it... and within about 20 minutes I started getting really dizzy.  Felt out of sorts, headache, racing heartbeat, "manicky".  So I knew this wasn't going to work. 

 

I called the pharmacy today and asked them if they could order my old brand, and was told that they couldn't, that they can only get what the warehouse has available, and that this is it.

 

I have called literally every pharmacy in town and it is basically the same story.  They are telling me that the Mylan brand is on backorder and Teva is all that's available in the 2 mg pill.  That means either they could be waiting days to months, or they might not be making it anymore, or that maybe Teva bought out Mylan.

 

So what in the heck do I do?  I cannot continue taking this new manufacturer.  There was one pharmacy that thought they could get the Mylan in the 5mg tablets, but that would make splitting a little trickier, but that is ok.  Is there an easier way to find a pharmacy that has the kind of manufacturer/pill that is needed?  Do I try and go with the 5mg?  Do you think that will work?

 

Thanks for your help!!!  Getting desperate because I am OUT of my old ones, but I do have a few 5 mg Mylan pills from earlier in my taper that I am hoping to use until this is figured out.

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crhawk
35 minutes ago, Altostrata said:

 

Thank you Alto... Unfortunately she said all they have at this time is the teva brand as well, but that it can change day to day. 

 

My pdoc gave me a new prescription for the 5mg Mylan, but will be harder to cut accurately. And... Pharmacy says they're running low on that one too and teva might take its place. 😔

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ChessieCat
4 hours ago, crhawk said:

My pdoc gave me a new prescription for the 5mg Mylan, but will be harder to cut accurately. And... Pharmacy says they're running low on that one too and teva might take its place.

 

At least it will give you the ability to do a crossover.

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