Constantly Changing Generic Medication Manufacturers

[Judith]

Maybe I'm the only one in the U.S. who has experienced this problem, since I don't see anyone talking about it on here. A Google search only turned up a rather old, but well-researched/documented article in a women's magazine, SELF. https://www.self.com/story/dangers-of-generic-drugs
Hah!! Now the Google search has turned up SEVERAL articles/publications about this topic! I swear I used the same search words.
My pharmacy here in NY, and the pharmacy a friend goes to, keep constantly changing the manufacturers of our generic medications. Sometimes, I notice the drugs don't work as they had previously, or I get uncomfortable side-effects I didn't get before, and then the pharmacy changes manf. again, and that one will work OK. This goes on over and over, and shows no sign of abating. This practice is not only disconcerting, but I think it could be dangerous for those who take, say, gabapentin for seizures, or blood pressure meds, heart meds, etc. I take clonazepam for sleep, gabapentin for restless legs (both at night); tramadol during day for pain; metoprolol for tachycardia. Each one of these medications has gone through several manufacturer changes. These manufacturers are located in other countries, like Goa, India; Croatia; and elsewhere.
I take the brand CYMBALTA because my Medicare provider approves it each year, so far, but that may change. The reason is that the duloxetine manufacturer's formulation completely shut down my colon. I could not pass ANYTHING for days except liquid and mucus. Finally, I opened one CYMBALTA capsule I had left, and one of my duloxetine capsules to compare. The CYMBALTA capsule contained what may be hundreds of teeny tiny extended relief balls. HOWEVER, out from the duloxetine capsule fell several LARGE, UNCOATED tablets!! I took photos of both, with info under the photos, scanned a copy and sent that to my rheumatologist, who prescribes this drug. She used that, along with a description of what I was going through, to my Medicare provider. They almost immediately approved paying for the brand CYMBALTA, and have done so for a few years now. But in 2017, when I needed to renew the approval, they denied coverage for the brand at first; then one of their medical physicians review the request, and approved it.
SO, is ANYONE out there experiencing this issue? How can we rely on our medications to do what they're supposed to do if these overseas manufacturers are improperly compounding them? Please, read that article above to see what their in depth investigation found out. It's really horrifying! Or any of the other articles listed on Google. I used these search words: SELF magazine article about generic drug manufacturers. But use whatever you feel is appropriate. I'd be interested in any feedback, and if you've found a solution to avoid receiving constant medication manufacturer changes. Thank you for reading! Cheers! Judith
I'm editing by adding two more links:

http://fortune.com/2013/01/10/are-generics-really-the-same-as-branded-drugs/
Quote from article: "The federal action shook the business. Teva Pharmaceuticals which marketed the generic in question, has stopped selling it, and other companies are now testing their versions of Wellbutrin at the FDA’s request. The episode is bringing momentum to a movement that has been quietly building among many doctors and medical societies that are increasingly willing to ask a question that borders on heresy: Are generics really identical to the branded products they are meant to replicate? To a surprising degree, they say, the answer is no." The ANSWER IS NO?! Yikes!

https://www.theatlantic.com/health/archive/2015/03/generic-drugs-the-same-but-not/388592/
Quote: "The distinctions of similarity and difference that we impose on the world of goods are fickle and highly mobile. So too with generic drugs. Is the generic drug the same or not the same? It is both, all at once."
This physician-written article comes down on the side of "generics are good." However, with OTC drugs, for example, he refuses to take generic ibuprofen, but instead believes Advil brand works best! Go figure!

 

[Not dead yet!]

I have this problem. The only way I've dealt with it is to find a non chain pharmacy or a smaller chain like Medicap and they usually are more helpful about not changing it without telling you. Or ordering it from the same manufacturer, even if I have to wait.

Another possibility is to use Walmart because they're so huge, you can sometimes find a helpful pharmacist who will order the same generic brand for you each time, but you may have to wait a day or two.

Finally, there is the compounding pharmacy option. They don't need to compound it for you, but you can be sure that they won't be using some kind of pharmacy management service which constantly switches brands.

Decades ago my Rite Aid pharmacist told me that the generics are permitted to be up to 20% different from the target drug amounts. Ever since, I've bought name brands whenever it made sense.

Too bad about the Walgreeens-Rite Aid takeover now.

 

[Judith]

I have this problem. The only way I've dealt with it is to find a non chain pharmacy or a smaller chain like Medicap and they usually are more helpful about not changing it without telling you. Or ordering it from the same manufacturer, even if I have to wait.

Another possibility is to use Walmart because they're so huge, you can sometimes find a helpful pharmacist who will order the same generic brand for you each time, but you may have to wait a day or two.

Finally, there is the compounding pharmacy option. They don't need to compound it for you, but you can be sure that they won't be using some kind of pharmacy management service which constantly switches brands.

Decades ago my Rite Aid pharmacist told me that the generics are permitted to be up to 20% different from the target drug amounts. Ever since, I've bought name brands whenever it made sense.

Too bad about the Walgreeens-Rite Aid takeover now.

Oh, thank you, you person you! (Hard to call you "Not Dead Yet"!) Yes, yes, a compounding pharmacy might be a great alternative. There is one I had to order Naltrexone from (didn't work for me, BTW; made my BP too low. Such a bummer.) Only problem may be that my Medicare provider ins. co. won't classify it as in their "approved pharmacies," which should be in this area. But, I'll try, and if not, try your other suggestions. I really appreciate your reply! All the best to you and your health. Judith

 

[Remy]

Oh, thank you, you person you! (Hard to call you "Not Dead Yet"!) Yes, yes, a compounding pharmacy might be a great alternative. There is one I had to order Naltrexone from (didn't work for me, BTW; made my BP too low. Such a bummer.) Only problem may be that my Medicare provider ins. co. won't classify it as in their "approved pharmacies," which should be in this area. But, I'll try, and if not, try your other suggestions. I really appreciate your reply! All the best to you and your health. Judith

Up until the last years, Target was really good about ordering in specific brands for me. Now they are a part of CVS and are not allowed to do so. But thankfully, I don't take very many meds nowadays, so it isn't as much of an issue as when I was on all the antivirals and antibiotics.

It's definitely a problem though!

 

[ShyestofFlies]

I have this issue with the changing manufacturers causing problems... luckily my pharmacy seems to have stabalized for now with their suppliers. I understand there’s a lot of reasons they switch around and most people needing meds won’t have the same issue as me.

I had a not anaphylaxis, but an alarming reaction to a generic (itchy swollen throat and mouth for about a month which ended a few weeks after taking it)... for me chemical salt wasn’t the issue, the fillers, coatings, preservatives or most likely dyes were. ((In the past it has even made me doubt generics as a whole when I did not understand that manufacturers ingredients vary a lot outside of that chemical salt.))

You can view ingredients in prescription medications by manufacturer (in the US**) here:
https://dailymed.nlm.nih.gov/dailymed/

I was able to compare a version of the medication I needed and didn’t have a negative reaction to with the one I did react badly to. Then I checked my other meds to eliminate other ingredients I didn’t seem to react to. I now know one of 3 ingredients caused a reaction and know to be wary of ingredients in the future. How helpful this will be, well I don’t know because theoretically the manufacturers can change their formulas. (I know that there are only ~10 safe ingredient manufacturers for my medication so if something changes I need to rethink my treatment, and about 25+ who have one or all 3 suspect ingredients in my reaction).

**(Other countries have similar databases.)