Ask the Pharmacist: Some generics not up to snuff

I’ve always been a proponent for generic medications because they are more affordable and supposedly contain the same biologically active ingredient as the brand.

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But the generic industry is starting to worry me. It rakes in over $104 billion dollars a year from sales in the United States alone, but about 90 percent of them are manufactured overseas. We should feel completely safe about the medications we take, right?

The generic version of a drug is supposed to have only slightly different things in it, for example, the flavor, the colorant or the inactive filler. But the active ingredient is supposedly the same.

The problem is that United States FDA doesn’t have the time or person-power to fly over the world and inspect all these places prior to our country importing the medications, which then get sold to you without further inspection at the distribution or pharmacy level. What exactly are we importing?

This causes me to pause. The world is so different now than it was when I graduated as a pharmacist in 1989. Everyone is cutting corners, things aren’t made like they used to be. Perhaps this is also more reason to visit holistic practitioners who don’t order prescriptions right off the bat.

Here are some scary facts:  

• FDA visited an overseas facility and found out that the pharmaceutical company was hiding negative results from their tests, but because we had a shortage of that drug, we still continued to import it. 
• Our investigator went to another overseas facility and had suspicions that the company was faking and manipulating their generic drug data to make it match the brand name’s data. A warning letter was issued by the FDA but importation continued. (Really, that’s it?) 
• One pharma company abroad diluted the main ingredient with something else, but made it just potent enough to pass lab tests. (Isn’t that called counterfeiting?!)
• Contamination is a problem. Case in point, one company was guilty of using dirty and corroded sterilizing equipment while making generic insulin and another drug commonly sold in the US to treat arrhythmias.

Despite all this, I still feel that there are more good generic companies than there are bad ones. If the generic maker’s facility is based in the United States then I wouldn’t worry because the FDA is routinely inspecting them.

If you’ve been taking a generic medication and feel well on it, you should continue. There is absolutely no reason to panic or even question your pharmacy. They do a good job and when there is a recall, they are very diligent about quickly pulling drugs off the market. 

Your generic medication may change from time to time. You open your pill bottle and the pill looks completely different. This is because the pharmacy is using a different generic. You will be told, or the pharmacy will apply a sticker that says, “This is the same medication you have been getting. Color, size or shape may appear different.”

This is a good time for you to take note about how you feel on this new generic version which may or may not have been imported from non-inspected facilities from China, India or other countries abroad. 

I realize this is difficult to navigate, and for some of you, this is the last thing you want to hear. It’s up to you to decide what to do and how much you want to pay for medication (ie brand vs generic). It’s unfortunate that in the drug industry, like many other industries, profit is more important than safety.

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Suzy Cohen is a registered pharmacist. The information presented here is not intended to treat, cure or diagnose any condition. Visit SuzyCohen.com.