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Debunking the Myth That Generic Drugs Are Inferior to Brand-Name Drugs

As a Registered Nurse, I have interacted with many patients who have misconceptions about generic medications.

Brand-Name vs. Generic Drugs

“He ordered what? I am not taking that garbage!” This statement was made by a patient who became visibly upset after being told that her doctor had prescribed a generic medication for her. The patient in this case had never used the ordered medication before—but was positive about its inferior quality.

As a Registered Nurse, I have interacted with many patients who truly believe that generic medications are poor-quality drugs reserved for lower-class people. Some have described generic drugs as watered-down products made from the remnants of brand-name drugs.

I have heard patients insisting that the generic form of their pain medication will not work or has not worked. Patients have gotten angry at their doctors and have gone to the extreme of requesting the services of other doctors who, in their belief, will show respect by prescribing brand-name medications.

These misperceptions about the inferior quality of generic medications seem to be held by many—when, in fact, prescribing a generic product is often a wise and practical decision on the physician's part.

According to the Food and Drug Administration (FDA), there is no support for the argument that brand-name drugs work better than generic drugs.

Finpecia vs. Propecia

Finpecia a generic drug used to treat male pattern baldness. The brand-name counterpart is Propecia.

Finpecia a generic drug used to treat male pattern baldness. The brand-name counterpart is Propecia.

What Are Generic Drugs?

Generic drugs are drugs that are sold under their chemical names and are identical to brand-name drugs in all significant areas. The significant areas are: active ingredient, intended use, route of administration, strength, dosage form, quality and performance. [1]

Generic drugs are not always sold under their chemical names. Generic drugs may be sold under the name of the store that carries them. For example, Benadryl is a brand-name drug. The generic form of Benadryl is sold by Walgreens pharmacy under the name of Wal-Dryl.

Generic and brand-name drugs are not placed on the market unless deemed safe by the FDA. The FDA is a public health agency of the United States that is charged with evaluating the safety of food, drugs, and cosmetics that are placed on the market.

Generic Name Usually Appears Beneath Brand Name

The generic name of a drug is usually written under the brand name of the product label. Pregabalin is the generic name of the brand-name medication Lyrica. Lyrica is used to treat pain caused by nerve damage

The generic name of a drug is usually written under the brand name of the product label. Pregabalin is the generic name of the brand-name medication Lyrica. Lyrica is used to treat pain caused by nerve damage

Evaluation of Generic Drugs

Before a generic drug is placed on the market, the FDA will do an evaluation to determine whether it is bioequivalent to the brand-name drug it is modeled after. Human subjects are used, and blood is drawn routinely for testing.

Generic drugs are bioequivalent to brand-name drugs if they have the same pharmacokinetic and pharmacodynamic qualities as brand-name drugs. [1]

Pharmacokinetics refers to how the human body affects a particular drug product after ingestion. Pharmacokinetics looks at the absorption, distribution, and localization of the drugs within the body. Pharmacokinetics also looks at the biotransformation (chemical changes) and the excretion of the end products of a drug.

Pharmacodynamics refers to the physiological and biochemical effects on the body. Pharmacodynamics of a drug evaluates the drug actions and the relationship between the drug's concentration at different times in the human body.

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A generic drug and a brand-name drug are bioequivalent if they have the same pharmaceutical and therapeutic effect on an individual under similar conditions. Bioequivalent drugs have same bioavailability (the speed at which a drug absorbed) to tissues after administration of a similar dose at the same rate, resulting in the same efficacy, performance, and safety. [2]

According to the FDA, a slight deviation in absorption is not considered clinically significant. As such, a generic drug is still bioequivalent to brand-name drug if it falls within 80-125% of the absorption rate of their brand-name counterpart under similar conditions. [2]

The FDA also looks at purity in its evaluation of drugs. They may allow some slight variation in purity and strength of both generic and brand-name drugs during preparation in plants. [3] However, only minimal variations are allowed and such variations do not affect the efficacy of either a brand-name or generic drug.

Generic drugs are expected to meet the same quality standards as brand-name drugs. There is no discrimination in the evaluation process conducted by the FDA. They expect the same level of performance from generic drugs as the brand-name drugs they are modeled after.

Bioequivalence of Drugs

The blood concentration time curve of the generic drug Bupropion is within the 80-125% absorption range of the brand-name drug Wellbutrin, making them bioequivalent

The blood concentration time curve of the generic drug Bupropion is within the 80-125% absorption range of the brand-name drug Wellbutrin, making them bioequivalent

Cipro

Cipro and Ciprofloaxin are comparable in all aspects

Cipro and Ciprofloaxin are comparable in all aspects

Comparison: Generic vs. Brand Name

I have outlined the comparison between a commonly used brand-name and its generic counterpart. Cipro is a brand name antibiotic commonly used for urinary tract and abdominal infections. Ciprofloxacin is the generic form of Cipro, and it is also used to treat urinary tract and abdominal infections. The adult dose of both Cipro and Ciprofloxacin for treatment of an uncomplicated urinary tract infection is 200 mg by mouth every 12 hours.