I'd say switch to brand (are you taking generic to save money or could you opt to get brand?) and figure out which generic is more close to the symptoms you get from brand. Generics can waiver 10% from the formula of the brand I believe. I try to stick to brand partly because I don't trust the facilities/countries where many generics are created.
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Could generic antibiotics give me different symptoms/reaction?
- Thread starter mamaScarlett
- Start date
K
Keepercjr
Guest
Get your baby on some probiotics! Any time you are taking antibiotics you both should be on probiotics. Even though not much gets through your milk it can still change his gut flora. Looks like that is what is happening. Glad you are feeling better.
K
Keepercjr
Guest
Get your baby on some probiotics! Any time you are taking antibiotics you both should be on probiotics. Even though not much gets through your milk it can still change his gut flora. Looks like that is what is happening. Glad you are feeling better.
K
Keepercjr
Guest
Get your baby on some probiotics! Any time you are taking antibiotics you both should be on probiotics. Even though not much gets through your milk it can still change his gut flora. Looks like that is what is happening. Glad you are feeling better.
Yes, I think changing generics can make a big difference in how you feel. We've had the issue here with a couple different meds and now stick to filling any generics we use by the same manufacturer each month. As posted above this can be a HUGE issue with something like seizure meds (we found this out the hard way- if Emily doesn't get the gabapentin manufactured by Greenstone, she is in BIG trouble!) But I can see how it would be an issue with abx, too- when getting tobra levels checked they were SO precise with the dosage, and when Emily needed a dose change it was adjusted in very small increments. Switching mfr's that could vary in formulations a dramatic amount just doesn't seem safe to me.<br><br>According to the regulations governing the production of generic medications (the Hatch Waxman act), they are given what is imo an INSANE amount of leeway in the manufacturing process. For a generic to be approved, it has to be proven 'therapeutically equivalent' to the branded version. Equivalent, at least to ME, would imply 'the same'. However, that is not the case. Active ingredient can be dramatically different (and inactive ingredients can be different as well.)<br><br>Here is a good overview of the act: <a target="_blank" title="" href="http://www.regulatorypro.com/FDLI%20-%20Overview%20of%20Hatch-Waxman%20Act%201984.pdf">http://www.regulatorypro.com/FDLI%20-%20Overview%20of%20Hatch-Waxman%20Act%201984.pdf</a> <br>quote from above link:<br><div class="FTQUOTE"><begin quote>A number of assumptions were made in enacting Hatch-Waxman. One major assumption underlying the Hatch-Waxman Act was that duplicates of pioneer drugs would be the same as the innovator's drug. FDA still uses the plus-or-minus-twenty percent test to determine blood serum bioavailability (i.e., the amount of active ingredient in the blood over a period of time has to come within plus-or-minus twenty percent of that which is observed when the innovator's drug is ingested). Twenty percent is a fairly good margin, and many medical professionals believe that for drugs that have a wide index of tolerance, twenty percent is not important at all; in such instances, twice as much or half as much of the active ingredient in a generic product will still work. <br><br>For drugs where there is a very narrow therapeutic band, for example, where a patient gets antiseizure medication, plus-or-minus twenty percent may not be appropriate. This is true particularly if a drug is at that higher end of bioavailability and a patient is titrated on the higher end (plus twenty percent) and then a second generic is dispensed where the active ingredient was at the lower end (minus twenty percent); mathematically, that is a fifty percent swing and may not be safe or effective. It is a curious thing that FDA has not altered its regulatory approach to this situation. With the advances in modern pharmaceutics, those standards could be tightened. Although such tightening might not be to the advantage of the brand name companies, it could be to the advantage of patients.</end quote></div><br><br>to add: this paper was published around 1997 I believe, from what I could find in the references. There has since been further legislation refining some parts of the act, but I couldn't find anything indicating that the standards of manufacture have changed. <br>
Yes, I think changing generics can make a big difference in how you feel. We've had the issue here with a couple different meds and now stick to filling any generics we use by the same manufacturer each month. As posted above this can be a HUGE issue with something like seizure meds (we found this out the hard way- if Emily doesn't get the gabapentin manufactured by Greenstone, she is in BIG trouble!) But I can see how it would be an issue with abx, too- when getting tobra levels checked they were SO precise with the dosage, and when Emily needed a dose change it was adjusted in very small increments. Switching mfr's that could vary in formulations a dramatic amount just doesn't seem safe to me.<br><br>According to the regulations governing the production of generic medications (the Hatch Waxman act), they are given what is imo an INSANE amount of leeway in the manufacturing process. For a generic to be approved, it has to be proven 'therapeutically equivalent' to the branded version. Equivalent, at least to ME, would imply 'the same'. However, that is not the case. Active ingredient can be dramatically different (and inactive ingredients can be different as well.)<br><br>Here is a good overview of the act: <a target="_blank" title="" href="http://www.regulatorypro.com/FDLI%20-%20Overview%20of%20Hatch-Waxman%20Act%201984.pdf">http://www.regulatorypro.com/FDLI%20-%20Overview%20of%20Hatch-Waxman%20Act%201984.pdf</a> <br>quote from above link:<br><div class="FTQUOTE"><begin quote>A number of assumptions were made in enacting Hatch-Waxman. One major assumption underlying the Hatch-Waxman Act was that duplicates of pioneer drugs would be the same as the innovator's drug. FDA still uses the plus-or-minus-twenty percent test to determine blood serum bioavailability (i.e., the amount of active ingredient in the blood over a period of time has to come within plus-or-minus twenty percent of that which is observed when the innovator's drug is ingested). Twenty percent is a fairly good margin, and many medical professionals believe that for drugs that have a wide index of tolerance, twenty percent is not important at all; in such instances, twice as much or half as much of the active ingredient in a generic product will still work. <br><br>For drugs where there is a very narrow therapeutic band, for example, where a patient gets antiseizure medication, plus-or-minus twenty percent may not be appropriate. This is true particularly if a drug is at that higher end of bioavailability and a patient is titrated on the higher end (plus twenty percent) and then a second generic is dispensed where the active ingredient was at the lower end (minus twenty percent); mathematically, that is a fifty percent swing and may not be safe or effective. It is a curious thing that FDA has not altered its regulatory approach to this situation. With the advances in modern pharmaceutics, those standards could be tightened. Although such tightening might not be to the advantage of the brand name companies, it could be to the advantage of patients.</end quote><br><br>to add: this paper was published around 1997 I believe, from what I could find in the references. There has since been further legislation refining some parts of the act, but I couldn't find anything indicating that the standards of manufacture have changed. <br>
Yes, I think changing generics can make a big difference in how you feel. We've had the issue here with a couple different meds and now stick to filling any generics we use by the same manufacturer each month. As posted above this can be a HUGE issue with something like seizure meds (we found this out the hard way- if Emily doesn't get the gabapentin manufactured by Greenstone, she is in BIG trouble!) But I can see how it would be an issue with abx, too- when getting tobra levels checked they were SO precise with the dosage, and when Emily needed a dose change it was adjusted in very small increments. Switching mfr's that could vary in formulations a dramatic amount just doesn't seem safe to me.<br><br>According to the regulations governing the production of generic medications (the Hatch Waxman act), they are given what is imo an INSANE amount of leeway in the manufacturing process. For a generic to be approved, it has to be proven 'therapeutically equivalent' to the branded version. Equivalent, at least to ME, would imply 'the same'. However, that is not the case. Active ingredient can be dramatically different (and inactive ingredients can be different as well.)<br><br>Here is a good overview of the act: <a target="_blank" title="" href="http://www.regulatorypro.com/FDLI%20-%20Overview%20of%20Hatch-Waxman%20Act%201984.pdf">http://www.regulatorypro.com/FDLI%20-%20Overview%20of%20Hatch-Waxman%20Act%201984.pdf</a> <br>quote from above link:<br><div class="FTQUOTE"><begin quote>A number of assumptions were made in enacting Hatch-Waxman. One major assumption underlying the Hatch-Waxman Act was that duplicates of pioneer drugs would be the same as the innovator's drug. FDA still uses the plus-or-minus-twenty percent test to determine blood serum bioavailability (i.e., the amount of active ingredient in the blood over a period of time has to come within plus-or-minus twenty percent of that which is observed when the innovator's drug is ingested). Twenty percent is a fairly good margin, and many medical professionals believe that for drugs that have a wide index of tolerance, twenty percent is not important at all; in such instances, twice as much or half as much of the active ingredient in a generic product will still work. <br><br>For drugs where there is a very narrow therapeutic band, for example, where a patient gets antiseizure medication, plus-or-minus twenty percent may not be appropriate. This is true particularly if a drug is at that higher end of bioavailability and a patient is titrated on the higher end (plus twenty percent) and then a second generic is dispensed where the active ingredient was at the lower end (minus twenty percent); mathematically, that is a fifty percent swing and may not be safe or effective. It is a curious thing that FDA has not altered its regulatory approach to this situation. With the advances in modern pharmaceutics, those standards could be tightened. Although such tightening might not be to the advantage of the brand name companies, it could be to the advantage of patients.</end quote><br><br>to add: this paper was published around 1997 I believe, from what I could find in the references. There has since been further legislation refining some parts of the act, but I couldn't find anything indicating that the standards of manufacture have changed. <br>
mamaScarlett
Active member
Thank you for all the info. The nurse didn't really buy in to my thoughts regarding the manufacturer of the new generic I was given. She felt it was probably a virus and just a coincidence. However, she said it is possible, and it won't hurt to just request brand drug or the old generic brand I had gotten. <br>I know in my gut (no pun intended) that I got a reaction from this brand, and more importantly, that it wasn't working for me either! Ceftin is a big go to drug for me. It usually has almost as good an effect for me as Iv's, after the 2nd dose. Not only did I feel no improvement in my symptoms, but I got a bad reaction 6 hrs after the first dose. <br>Now, I stop it and I wake up with no more symptoms, and finally an improvement in my lungs beginning to set it.<br>Unfortunately, no pharmacy with my plan has it in stock-can you believe that? No Ceftin. Fortunately I have enough of my old prescrip to hold me for now.<br>Ughghgh....<br>
mamaScarlett
Active member
Thank you for all the info. The nurse didn't really buy in to my thoughts regarding the manufacturer of the new generic I was given. She felt it was probably a virus and just a coincidence. However, she said it is possible, and it won't hurt to just request brand drug or the old generic brand I had gotten. <br>I know in my gut (no pun intended) that I got a reaction from this brand, and more importantly, that it wasn't working for me either! Ceftin is a big go to drug for me. It usually has almost as good an effect for me as Iv's, after the 2nd dose. Not only did I feel no improvement in my symptoms, but I got a bad reaction 6 hrs after the first dose. <br>Now, I stop it and I wake up with no more symptoms, and finally an improvement in my lungs beginning to set it.<br>Unfortunately, no pharmacy with my plan has it in stock-can you believe that? No Ceftin. Fortunately I have enough of my old prescrip to hold me for now.<br>Ughghgh....<br>
mamaScarlett
Active member
Thank you for all the info. The nurse didn't really buy in to my thoughts regarding the manufacturer of the new generic I was given. She felt it was probably a virus and just a coincidence. However, she said it is possible, and it won't hurt to just request brand drug or the old generic brand I had gotten. <br>I know in my gut (no pun intended) that I got a reaction from this brand, and more importantly, that it wasn't working for me either! Ceftin is a big go to drug for me. It usually has almost as good an effect for me as Iv's, after the 2nd dose. Not only did I feel no improvement in my symptoms, but I got a bad reaction 6 hrs after the first dose. <br>Now, I stop it and I wake up with no more symptoms, and finally an improvement in my lungs beginning to set it.<br>Unfortunately, no pharmacy with my plan has it in stock-can you believe that? No Ceftin. Fortunately I have enough of my old prescrip to hold me for now.<br>Ughghgh....<br>
Pharmacies can get any drug the very next day. I deal with a very small pharmacy who doesn't carry a lot of stuff because they aren't sure they will sell it. They get me a few pills that day so I can start it and get me to the next day or through the weekend. I believe they get these few pills from another pharmacy. Then the remainder of the prescription comes in the next day.
Pharmacies can get any drug the very next day. I deal with a very small pharmacy who doesn't carry a lot of stuff because they aren't sure they will sell it. They get me a few pills that day so I can start it and get me to the next day or through the weekend. I believe they get these few pills from another pharmacy. Then the remainder of the prescription comes in the next day.
Pharmacies can get any drug the very next day. I deal with a very small pharmacy who doesn't carry a lot of stuff because they aren't sure they will sell it. They get me a few pills that day so I can start it and get me to the next day or through the weekend. I believe they get these few pills from another pharmacy. Then the remainder of the prescription comes in the next day.
M
MCGrad2006
Guest
Loulou..that only works if the pharmacy has it in the warehouse. I went through this last week with Hyper-sal. Rite Aid's providing warehouse did NOT have it in stock and were not going to get it. I had to call around to find a pharmacy that either had it or could get it quicker than a week. Luckily CVS was able to get it from their warehouse the next day.<div><br></div><div>Also, yes, my pharmacy if they do NOT have a full dose will give me whatever they have in stock (obviously that wouldn't work with HTS, since its boxed). And USUALLY can get it next day or two days max. Keep trying to find your med and definitely call around. Your pharmacy needs to know that you need your med and if they can't get it you WILL GO somewhere else. </div><div><br></div><div>Also, your nurse sounds very much like my doctor! They don't want to admit that we know more than them because we are living it... <img src="i/expressions/face-icon-small-wink.gif" border="0"></div><div><br></div><div>Good luck and glad you are feeling better!</div>
M
MCGrad2006
Guest
Loulou..that only works if the pharmacy has it in the warehouse. I went through this last week with Hyper-sal. Rite Aid's providing warehouse did NOT have it in stock and were not going to get it. I had to call around to find a pharmacy that either had it or could get it quicker than a week. Luckily CVS was able to get it from their warehouse the next day.<br>Also, yes, my pharmacy if they do NOT have a full dose will give me whatever they have in stock (obviously that wouldn't work with HTS, since its boxed). And USUALLY can get it next day or two days max. Keep trying to find your med and definitely call around. Your pharmacy needs to know that you need your med and if they can't get it you WILL GO somewhere else.<br>Also, your nurse sounds very much like my doctor! They don't want to admit that we know more than them because we are living it... <img src="i/expressions/face-icon-small-wink.gif" border="0"><br>Good luck and glad you are feeling better!
M
MCGrad2006
Guest
Loulou..that only works if the pharmacy has it in the warehouse. I went through this last week with Hyper-sal. Rite Aid's providing warehouse did NOT have it in stock and were not going to get it. I had to call around to find a pharmacy that either had it or could get it quicker than a week. Luckily CVS was able to get it from their warehouse the next day.<br>Also, yes, my pharmacy if they do NOT have a full dose will give me whatever they have in stock (obviously that wouldn't work with HTS, since its boxed). And USUALLY can get it next day or two days max. Keep trying to find your med and definitely call around. Your pharmacy needs to know that you need your med and if they can't get it you WILL GO somewhere else.<br>Also, your nurse sounds very much like my doctor! They don't want to admit that we know more than them because we are living it... <img src="i/expressions/face-icon-small-wink.gif" border="0"><br>Good luck and glad you are feeling better!
mamaScarlett
Active member
They're getting it, they just don't get shipments on weekends so if I request on fri, it won't come till monday. But I have enough to get me to monday. If had put my foot down they would have just gotten it from another pharmacy.<br>I hate the weekend thing, wish they shipped on saturdays.<br>
mamaScarlett
Active member
They're getting it, they just don't get shipments on weekends so if I request on fri, it won't come till monday. But I have enough to get me to monday. If had put my foot down they would have just gotten it from another pharmacy.<br>I hate the weekend thing, wish they shipped on saturdays.<br>
mamaScarlett
Active member
They're getting it, they just don't get shipments on weekends so if I request on fri, it won't come till monday. But I have enough to get me to monday. If had put my foot down they would have just gotten it from another pharmacy.<br>I hate the weekend thing, wish they shipped on saturdays.<br>