Generic Medications

Usually I haven't noticed any difference between the brand name and generic medications, either prescription or OTC.  The only time I noticed was years ago when the pharmacist filled our youngest's Ritalin Rx with generic.  It just didn't seem to be working the way the brand name did.  After that, we had the doctor mark no generic on the prescription.

The FIRST thing I'd do is switch pharmacies.  I've gotten to the point where I virtually hate Walgreens -- I have had the WORST time with them over Billy's thyroid med and have gone round and round with Walgreens ... and this is something I'm PAYING for ... it's not aninsurance thing, they're just abysmal about what they have in stock, what they will and won't do ... about 18 months ago, Walgreens went to a national "call center" -- when you call them you don't get the local pharmacy -- you get a national bunch of faceless people who simply tell you whatever their script is -- and they'll tell you it's the store's fault and the store people hate the call center.  I went round and round and round with them over trying to get Billy's Armour Thyroid and finally gave up and went to a compounding pharmacy (which is costing me $80 a month rather than $35 -- but at least I GET IT *sheesh*).

But I'd have to wonder if you changed pharmacies if it would help?

Now what I'm wondering is, if it matters with Abbie's meds.... the last few times I've gotten them from the vet (Amyltriptaline) they've been different as well. I hope she isn't feeling any differently..... but I can't ask her, so I will request from the vet the same meds each time or a prescription if I can find a pharmacy that can guarantee it. What a royal P.I.T.A!

Wish me luck with the Advil PM...... I hope I don't lay awake all night staring a the ceiling or worse yet, waking up tomorrow morning a raving lunatic!! BLAH!!

I don't know about other meds, but I do know that with thyroid meds, you HAVE to stay on the same brand. I've tried taking generic and my thyroid levels fluctuated for EVER until I made them give me a certain name brand. I know pharmacies automatically fill with generic if it's available, to save you and insurance companies money. Now when my doc writes up a new rx, he puts "name brand only."

 Did the insurance explain why they would not cover the brand? Some insurances will cover brand if the doctor writes DAW on the script or calls the insurance and does a prior authorization/medical necessity for brand name medication.

As far as differences in generics, which manufacturer did you do fine on? I've been working in a pharmacy for 10 years and the only generic manufacturer for Zolpidem(generic name for Ambien) I've seen is by Teva. Now that's not to say that other manufacturers don't make it, I'm just saying I haven't seen it. However, if you do fine on a particular manufacturer, the pharmacy can special order it for you unless there's a manufacturer back order or the manufacturer does not make it any more. As far as price goes, there should be no difference in price based on manufacturer. One thing to keep in mind is that the price of medication can fluctuate month from month or even from pharmacy to pharmacy in the same chain. If you have insurance and have a set copay(for example, $5 generics or $10 brands) then the copay should not change unless there's been a change in the formulary put forth by the insurance. 

If the insurance is being really difficult, refuses to pay for brand name Ambien even with a DAW or prior auth and you find that Ambien works better for you, have you considered trying Ambien CR? There is no generic for that and a lot of my patients have said that worked better for them then regular Ambien. 

On a side note, someone mentioned the difficulty of getting Armour Thyroid. Armour Thyroid has been on several manufacturer back orders throughout the years and as of last year, it's been on long term manufacturer back order. At my pharmacy, we only have a few tablets of certain strengths in stock. The only way folks can get it is if they manage to find a pharmacy that does not have a demand for it and actually has some in stock. Trust me, we don't like our patients to be without medication and we do our best to keep things in stock or even "inter store" meds from other stores but if a manufacturer does not make enough medication to supply the masses then we cannot fill scripts for it. 

meilani

On a side note, someone mentioned the difficulty of getting Armour Thyroid. Armour Thyroid has been on several manufacturer back orders throughout the years and as of last year, it's been on long term manufacturer back order. At my pharmacy, we only have a few tablets of certain strengths in stock. The only way folks can get it is if they manage to find a pharmacy that does not have a demand for it and actually has some in stock. Trust me, we don't like our patients to be without medication and we do our best to keep things in stock or even "inter store" meds from other stores but if a manufacturer does not make enough medication to supply the masses then we cannot fill scripts for it. 

Yep you're absolutely right Meilani - and I have no problem with that IF they'd figure out a story and stick to it. My gripe is specifically a Walgreens problem -- not an Armour problem or a pharmacy in general thing.

 My problem is that "the right hand never knows what the left hand is doing" and I've had 10,000 stories told to me .... they'll say they got some in, and have X number in stock at the store and I get TO the store and am told they knew nothing about it  -- and then they "volunteer" to call other stores to see if they have it (after getting it out at 11:00 on Sunday nite at one point) only then to have the same guy get snarky with my husband because he "doesn't have TIME to call".

It's just incredibly poor customer service -- and there IS a generic that's supposed to be available that's a glandular and again 10,000 stories about that.  I know Armour -- as in the 'brand' is tough to get hold of -- but gee whiz - jsut SAY SO ... don't blame your in-house lack of communication on each other. 

One of my huge pet peeves in life is to have people in a company "blame" someone else in the company for something.  I mean like you go some where to eat and the server 'blames' the kitchen or bad-mouths the management.  DON'T DO THAT -- just say "I'm sorry you've had a bad experience" or something ... but don't slice 'n dice your co-workers to ME, the customer!!

I was making do with the USP (I think that's the right acronym) equivalent which was fine with me ... but it was the unceasing difficulty with Walgreens own problems within their own organization making it worse than awful.  Don't tell me it's "there" and then when I get TO the store look at me like I have 9 heads and blame the call center.  If you don't have it FINE.  WE all ahve to deal with stuff like that - I'm not the enemy, I'm just the lady who needs it for her dog.

I know Armour's on back-order -- and I wasn't blaming them nor pharmacies in general.  This is just an ongoing problem with Walgreens that makes me crazed -- my husband's gone so far to say that he never wants to buy ahything at Walgreens EVER again ... and 've talked with pharmacists, pharmacy managers, store managers, regional managers and talked on the phone and emailed until I'm blue in the face.  This is just a Walgreens, in particular, problem.  No slam meant to pharmacists generally.

Right now, with the ugly state of insurance in general in the US, people who work in pharmacies have to have the most difficult jobs EVER -- it's gotta be hard for you to deal with all the insurance regs/rejections and people upset because they can't get brand names, etc. -- talk about a thankless job.

meilani

Did the insurance explain why they would not cover the brand? Some insurances will cover brand if the doctor writes DAW on the script or calls the insurance and does a prior authorization/medical necessity for brand name medication.

They never really gave a straight forward answer..... just basically that since there is now a generic available, "that's what they will cover." The Dr. even tried to help. From what I've seen online, this is a common issue for people and their insurance companies - even if the Dr writes DAW or Brand Only on the script. I haven't had insurance for a while now, so I pay for it myself.

Do pharmacies typically keep a history of the manufacturers that a patient's previous script was filled with?? I have no idea the names, but I can describe the pills. In fact, the bottle I just picked up had two different types of pills in it. One is white and oval with a point at the end, not long and thin like brand, but wider in shape. Then there were about 8 light orange colored pills that are the shape of brand, for a total of 30. I am calling them first thing tomorrow. This is ridiculous. I'm sure there are many people out there who are unaffected by the differences in formulations, but my system just cannot tolerate the changes. A nurse friend of mine tried to tell me it's all in my head....... um, NO. I wish......

My Dr did give me some samples of Ambien CR once and I didn't care for it..... it made me feel groggy the next morning. I just took the Advil PM, so we'll see..... I just want to sleep and wake refreshed and feeling "normal." Thank you for the info Meilani!

Callie - I have also experienced issues with Walgreens in the past and switched to a smaller, "neighborhood" pharmacy..... their prices are incredibly low comparatively speaking. Maybe a smaller, privately owned pharmacy could get the Armour Thyroid for you. Just a thought.

Sunshinegirl

Callie - I have also experienced issues with Walgreens in the past and switched to a smaller, "neighborhood" pharmacy..... their prices are incredibly low comparatively speaking. Maybe a smaller, privately owned pharmacy could get the Armour Thyroid for you. Just a thought.

Meilani's right -- trying to find Armour (or even the "generic" USP brand) is like finding a needle in the haystack -- ANYWHERE>  So finally I found a compounding pharmacy (which is literally around the corner from me) who makes their own glandular -- it's USP rated, and it's been really good for Billy.  It's more expensive -- but it's consistent and worry-free to get. 

I'm just OVER Walgreens and all their crud. 

 Callie- I'm sorry to hear you had such a difficult time at the pharmacy. It sounds like they're running around like chickens with their heads cut off over there. Sadly, some pharmacies run really well and some don't and that usually happens when there's budget cuts which means firing quality knowlegeable staff and hiring cheaper uneducated staff or simply not having enough hours which means staffing issues which causes a whole lot of chaos. Trust me, I've seen situations like that, I've worked with staff that doesn't know their elbows from their rear ends and I've been to pharmacies where it's total insanity. I'm truly glad I don't work in a place like that.

Sunshine- I cannot believe that they mixed different manufacturers in the same bottle! That's insane! While we've given patients 2 different manufacturers of the same medication, we always put them in separate bottles, mark the bottles accordingly and inform the patient. If possible, can you tell me what the markings on the tablets are? I'd like to research it further to find out if you're truly getting the correct medication. Which one of the pills do you do well on? That way, I can tell you which manufacturer that is so you'll know to inform the pharmacy that you'd prefer that manufacturer in the future. I do not blame you for being upset at all. It sounds like the pharmacy is really dropping the ball. On another note, if you have Benadryl, take that instead of Advil PM. Diphenhydramine(which is the generic name of Benadryl) is the PM ingredient. Diphenydramine is virtually used in all of the sleep aids OTC because the side effect of it is drowsiness. If you're in need of sleep, it makes no sense to take extra meds such as Advil, which is an NSAID and can cause stomach problems and you really don't want to take NSAIDS unless you're in pain due to that side effect, so it's better to take up to 2 Benadryls if you want to get some sleep.

I don't have any of the ones that worked for me last time..... all I know is they were white and had the same appearance as brand, but were generic. I'll ask the pharmacy if they can tell me when I call tomorrow. I may actually just go in to the pharmacy. From now on, I will open the bottle to view the contents and read the label before paying and accepting anything. It's 1:30 am and I'm still awake, took 2 of the Advil. I'll try the Benadryl next time.... I always have it on hand for the dogs. Thank you!!

Sunshinegirl

It's 1:30 am and I'm still awake, took 2 of the Advil. I'll try the Benadryl next time.... I always have it on hand for the dogs. Thank you!!

I just take generic benadryl and it works well for me. If the Advil PM didn't work for you, benadryl probably wouldn't either. As Meilani said, benadry is the ingredient in almost all those "PM" meds.

I agree that it's crazy that you have 2 different kinds of medicines in one bottle. Something just doesn't seem right about that and I hope you get some straight answers to what they gave you.

I use Walgreens for all of our meds and have never had a problem, so I do think that it probably varies by location. The pharmacists at the one I use have always been really helpful both with me scripts and questions about OTC products.

I've always taken generics, but I don't have any serious outstanding health issues, nor any drug allergies or bad interactions.  To be honest I couldn't care less about what "fillers" are used because the drug and dosage is the same.  My generic costs me $10 for three months, whereas the name-brand would be $40 per month (the generic would be $22 per month without insurance).  My DH used to be on a powerful anticonvulsant drug that had no generic and he had to take 4 a day, so we had the opposite problem, we were desperate to find a generic b/c of the cost.  Our pharmacist is very nice, she would probably do whatever I asked provided it was within her authority.  We also use generic OTC drugs.  Right now we are getting generic Prilosec as a prescription, it's cheaper to use the $10 co-pay than buy a month's worth of Prilosec OTC.

Ok, based on research, the white tablets are manufactured by Northstar. Now the part that scares me is that I have found nothing that describes the peach tablets. I looked at various images of Zolpidem and none come up with that description.  Here's a bunch of images of other manufacturers of Zolpidem. Do any of these look familiar to you? If not, do NOT take the peach tablets at all until you speak to the pharmacy. Please keep me updated.

Meilani -- you ROCK, lady!!