How to use generic drugs? Part 4

TREATMENT FOLLOW-UP

Are Generic Drugs the Same? However, specific shapes are less suitable for certain patients (comfort).

You are right: the composition of generic drugs is not always precisely the same as that of the corresponding brand name drug. Indeed,  a generic drug has the same active principle in the same quantity  (a component of the drug having a therapeutic efficacy)  but not necessarily the same—excipients (inactive ingredients) as the original drug.

Thus, if it has the same efficacy and the same safety of use as the original drug, its shape, taste and size may indeed be different depending on the excipients used for its manufacture and less suitable for some patients.

If the inconvenience you are talking about could affect your compliance with your treatment, talk to your doctor or pharmacist. Your doctor may take this into account in his prescription by entering, for example, additional information for your pharmacist (such as "vigilance on the size of the tablets"). Your pharmacist can then offer you another generic drug: this is also the point of generic medications.

As a last resort, if there is no generic sugar-coated and scored drug, you can always refuse the substitution and ask for the original prescription: the coverage by Social Security is not called into question but delayed.

According to the laboratories, why do not the same drugs have the same shape or color? This can bother especially the elderly.

A generic drug can only be marketed when the patent for discovering the active principle, the molecule active that it contains, expires. When a prescription is developed, it is protected by different patents, covering other areas: the discovery of the active principle, the shaping process, the synthesis of the functional code, manufacture, etc. These patents are obtained at different times in the life of the drug. The patent for discovering the active principle is filed very early, as soon as it is located. It can therefore expire faster than other patents. For example, patents can prevent a laboratory manufacturing generic drugs from using the shape, color, method of manufacture, etc., when the latter may already use the molecule.

This explains why the generic drug may differ from the original drug on the dosage form, the composition in excipients, appearance, etc. In practice, these variations result in differences in shape, color, consistency, taste, etc. Without being strictly identical, it has the same efficacy and safety in use as the original medicine.

You are right, as with any medicine, so there may be a risk of confusion between several medications. Identify which drug is replaced by a generic drug. Also, ask your pharmacist to indicate it on the box if he has not already done so.

Finally, be aware that pharmacists pay special attention to the elderly because the substitution may require increased support when they take several drugs. Aware that any change (color of the box, the shape of the tablet, etc.) may cause a risk of confusion for these people, pharmacists have made a strong commitment: to dispense the same brand of generic drug all year round to older adults: over 75 years, several molecules used in the treatment of common chronic diseases. In 2015, 93% of patients over 75 years of age benefited from this "stability" of the dispensing: each patient received the same brand of generic medicine all year round.

Why can the same pharmacist very frequently and successively dispense different generic drugs for the same prescription?

When giving you a generic drug, your pharmacist chooses a drug belonging to the same generic group as the original drug. To do this, it refers to a tool called "directory of generic drugs," published and updated by the National Agency for the Safety of Medicines and Health Products (ANSM), which allows it to substitute in complete safety. Also, several generic drugs can correspond to the same original drug.

When dispensing, your pharmacist indicates the name of the generic drug that he distributed to you on the prescription. This facilitates the monitoring of treatment, especially during renewal.

If you want to get the same generic medicine, you can ask your pharmacist for it. Do not hesitate to ask him to order it if he does not have it in stock.

Why does the pharmacist give me a different generic each time for the same prescription from my doctor?

Since 1999, your pharmacist has been authorized to substitute the medication prescribed by your doctor with a generic drug that corresponds to him.

To do this, he chose, from a tool called the "generic drugs directory," established by the National Agency for the Safety of Medicines and Health Products (ANSM), a drug containing the same active substance at the exact dosage. Then the one prescribed for you. Including this generic drug in the repertory guarantees efficacy and safety of use identical to those of the original drug.

Do not hesitate to talk to your pharmacist: you can always ask him to give you the same generic or to note on the box the name of the original medicine that he is replacing.