Is it OK to take a generic medication?


A generic” is a drug that is broadly equivalent to a brand name medication, but marketed under its chemical name, without advertising, usually at a significantly lower cost.

In most cases, generic products are available once the patent protections afforded to the original developer have expired, and when this happens free market competition leads to substantially lower prices for both the original brand name product and the generic forms.

Insurance companies and pharmacies will try to contain their own costs by encouraging patients to switch to generic medications with lower co-pays or co-insurance.

A generic drug must contain the same active ingredients as the original formulation. According to the FDA, generic drugs are identical or within an 80-125%  bioequivalent range to the brand name counterpart.

Generic substitution is not usually a major problem for most medication prescribed for common medical conditions like high blood pressure or diabetes.

Generic substitution for epilepsy medications is more contentious.

The problem is that most pharmacies get generic medications from wholesalers, and a patient on generic medication could potentially get drug from a different manufacturer every month.

Think of going shopping for peanut butter at a wholesale store like Costcos.  One month they might have Smuckers brand, the next month Kirkland brand, and then the next month some other brand – they have whatever they could order cheapest that month.  While these products all contain peanut butter, they each have slightly different recipes and taste a little bit different.

peanut butter

If you are taking levitiracetam (the generic equivalent of Keppra) for epilepsy, and you switch drug manufacturers every  month, you could potentially go from a product that was 125% Keppra bioavailability to a product that was 80% Keppra bioavailability, i.e. a 45% drop in effective drug ingredient at the same “dose”, and this could provoke a breakthrough seizure, with all of the ramifications for safety and driving that would go along with that.

That’s the reason that most neurologists and the Epilepsy Foundation have suggested that well-controlled epilepsy patients stick with brand name medications, so that they know they are getting the same thing every month when they refill their prescriptions.

Thankfully, we are beginning to see new mail order pharmacies, like Nuro Pharma, that will guarantee that the patient receive their generic epilepsy medications from the same manufacturer every month – if you know you are going to get Kirkland every month, it’s probably OK to pass on the Smuckers!!

5 thoughts on “Is it OK to take a generic medication?

  1. Let’s quit beating around the bush here, okay? Let’s just admit the truth. Generic drugs, medications for epilepsy should be OUTLAWED. Generic drugs for epilepsy are DANGEROUS. There is just no sane, logical reason why our congress and FDA has not yet outlawed generic drugs for anyone with epilepsy. NO MORE generic drugs for epilepsy. If generic drugs were outlawed for people with epilepsy, the USA would save MILLIONS in unnecessary 911 calls and long, costly hospital stays. Neurologists should be protesting in the streets over this outrageous neglect of patient in healthcare. The epileptic brain does NOT respond well to the fillers and inconsistent doses found in unregulated generics. And NO I’m not a shill for brand name drug companies. Do your research. It’s right there. Ask anyone who has suffered for years from chronic seizures. Or has experienced the ups and downs of generic epileptic drugs. It’s an absolute healthcare nightmare. And it needs to stop now. No more generic drugs for patients with epilepsy. There shouldn’t even be an argument over something so ridiculously obvious.

    • Thanks for your opinion Barry – my only comment would be that sometimes people cannot afford brand name drugs (they may find they have a higher co-pay or no insurance at all), and if you have epilepsy taking a generic is probably better than no medicine at all.

  2. Generic drugs are copies of brand-name drugs that have exactly the same dosage, intended use, effects, side effects, route of administration, risks, safety, and strength as the original drug. In other words, their pharmacological effects are exactly the same as those of their brand-name counterparts. Use this forum to discuss more on this

    • Thank you for you comment Ammy. However, I have to respectfully disagree with you – although generic drugs contact the same active ingredient, as stated in my post the bioequivalence (also know as efficacy or potency) can range from 80 to 125% of the brand name drug. That is how switching from the same dose of one generic (say 125% of brand name dug) to another (say 80% of brand name drug) can result in a drop in active drug efficacy of almost 50%, enough to provoke a seizure in an epilepsy patient.

      • We agree with you Dr. Holland. This is the reason we started Nuro Pharma. We appreciate you bringing this to the attention of Patients with Seizure Disorders

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