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THIS IS WRONG!!! Psychiatrist states 30% dosage disparity allowed by FDA


Panayotis77

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Hello community - My psychiatrist has informed me that “The FDA allows for a 30% upward or downward margin of error on Zoloft pills.” He explained that a 50mg  Sertraline (Zoloft) may have up to 65mg or as low as 38.5mg. Another example, a 25mg Sertraline may have have as much as 32.5mg and as low as 17.5mg. Can anyone validate this? If this is true, it is unimaginable for those of us who have a sensitivity to the medication.
 

2012 - Zoloft 50mg (pill)

2013 - Zoloft 75mg

2018 - Cold turkey, return to 75mg

2019 (July) - Zoloft 50mg

          (August) - Zoloft 45mg (liquid)

          (Sept) - Zoloft 42.5mg (pill)

          (Oct) - Zoloft 75mg

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Your psychiatrist is wrong.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 1 month later...

In the US it’s a 20% variance in strength that is allowed generic vs name brand medication.  Each generic can be up to 20% stronger or weaker than the name brand.  

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I don't believe the allowed variation is so great. Please post informational links for that kind of assertion. @brassmonkey has some information about this.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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According to the FDA website:

 

"A generic medicine is the same as a brand-name medicine in dosage, safety, effectiveness, strength, stability, and quality, as well as in the way it is taken and should be used."

 

Generic medications are manufactured and inspected using the same criterion as brand name drugs and can only vary in Shape, Color, Packaging, Flavorings and Inactive ingredients.  Except for those five areas they must be exactly the same.

 

There is also a major misconception that the active ingredient is not mixed evenly through out the tablet or capsule.  Many years ago there was a case come up of a unlicensed generic manufacturer that had poor mixing quality and even some batches that didn't have any active ingredient at all.  This was a one off problem that has plagued the industry ever since.  If you buy from a reputable manufacturer you should be getting a quality product.  There are manufacturing standards that the makers have to adhere to or they face heavy fines and loss of their license.  In regards to even distribution of the active ingredient in the filler there is no problem with dry cutting tablets or taking the powder out of capsules. The same goes for commercially made liquid products.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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  • 2 months later...

The 20% variance allowed is in blood concentrations. Blood concentrations are affected by a huge range of factors including the composition of the pill (binders etc) and how much/when you ate food. The dosage in generics is the same as the brand in countries with good regulation.

Dx: complex PTSD

Discontinuation/taper history: sertraline, trazodone, prazosin, mirtazapine, diazepam

Took 200mg quetiapine for 0.5 years and 150mg for 1.5 years until 01/2020. Now microtapering daily at an overall rate of 12.5mg/month.

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  • Altostrata changed the title to WRONG Psychiatrist states 30% dosage disparity allowed by FDA
  • Administrator

Thanks, @lxjuice, for bringing sense to this question.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 7 months later...
  • Moderator
On 2/26/2020 at 7:02 PM, lxjuice said:

The 20% variance allowed is in blood concentrations. Blood concentrations are affected by a huge range of factors including the composition of the pill (binders etc) and how much/when you ate food. The dosage in generics is the same as the brand in countries with good regulation.

This is correct. Note that the variation is tested in a very small number of volunteers at the time of generic approval - seem to remember something like 20 usually young males.

 

Supplements on the other hand have been known to have variations in the quantity of active ingredient in the pill (not just blood concentration) when tested by various third parties.

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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  • Altostrata changed the title to THIS IS WRONG!!! Psychiatrist states 30% dosage disparity allowed by FDA

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