![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by ravenstorm on August 25, 2004, at 10:53:34
OK, I started on generic WB SR (bupropion Sr) 100mg twice a day for about four weeks. I was really tired at first but that seems to have mostly subsided. Depending on the day, however, I do seem to have different reactions to the medication!
I tried switching to the brand WB XL 300mg but had much more stomach upset with the XL and had to switch back to the SR. The interesting thing about that whole experience is that I had more energy on the XL than I have ever had on the SR. I don't have extra energy on the SR, I just don't feel as horribly sedated as I did in the beginning.
I was wondering if the difference in reaction was due to the generic versus the brand name? I have a friend who is in drug research and he said that some drugs, such as ADs etc have a narrow therapeutic index (NTI) and that the brand name is required to do in vivo (or vitro) studies (?) that generics aren't (OK, obviously I don't know what I'm talking about at this point--but he said for some people this can make a difference. He thought it would be worth trying the name brand. Then I saw this on another website:
"For medications classified by the FDA as
having a narrow therapeutic index (NTI),
Blue Cross of California discourages the
use of these generic substitutions."Hmmm that makes me wonder. According to Blue Cross, not all generics are the same as thier counterpart name brand."
OK, me again. I felt ready, after four weeks, to up my dosage to 300mg (150mg SR x 2). I was going to ask for the brand name, but then decided to stay with the generic on the rationale that my body had pretty much adapted to the generic version of the coating/fillers and that if I switched to the brand, maybe I would have to go through even more adjustments.Well, I picked up my prescription and brought it home and discovered that the 150mg pills are a totally different generic, from a totally different company! (100mg were from Eon, and the 150 are from Teva and aren't even called bupropion!!!!) If I knew I was going to have to start over with all new fillers/coatings etc etc I would have switched to the brand name. I called the pharmacy and they said they don't usually stock the Eon version of the 150mg, and that I should just try the teva and if I had a problem they would special order the Eon version.
Anybody heard of this NTI and how it affects generics? Should I just call my doctor back and get the brand name? Anybody done better on a brandname than a generic?
HELP!
Posted by Sebastian on August 25, 2004, at 12:10:06
In reply to Questions about generics. Wellbutrin. HELP PLEASE!, posted by ravenstorm on August 25, 2004, at 10:53:34
There is no difference between the brand and generic. The thing you did differently was the amout of medicine you were taking. You took 300 on XL, but only was taking 200 on the SR. If you increased the SR dose to 3 pills a day, or 300, you would feel the same.
Posted by ravenstorm on August 25, 2004, at 12:44:13
In reply to Questions about generics. Wellbutrin. HELP PLEASE!, posted by ravenstorm on August 25, 2004, at 10:53:34
Actually, I tried dropping back to the 150mg XL and I still had more energy than the 200mg SR generic. Unfortunately, I also still had the horrible stomach pains on the 150XL. Something about the XL coating doesn't agree with my stomach. I just wish these 150mg SR generics were made by the same company as my 100mg SR. The pills are HUGE in comparison and have a VERY weird, chemically smell that the others don't.
Posted by King Vultan on August 25, 2004, at 12:53:45
In reply to Re: Questions about generics. Wellbutrin. HELP PLEASE! » ravenstorm, posted by Sebastian on August 25, 2004, at 12:10:06
> There is no difference between the brand and generic. The thing you did differently was the amout of medicine you were taking. You took 300 on XL, but only was taking 200 on the SR. If you increased the SR dose to 3 pills a day, or 300, you would feel the same.
I'm afraid I have to completely disagree with you. Brand name drugs can differ in their effects from generics, as can generics from each other, depending on how the particular pill is formulated. There is considerable evidence that the choice of fillers, binders, etc. can affect the absorption rate and subsequent effects of the drug, even though the amount of the active ingredient may assay the same. The notorious reformulation of Nardil last year would probably be the best example, but there are others.Beyond that, there is a considerable difference in absorption rate between the SR and XL versions of Wellbutrin/bupropion, and one or the other may work better for a particular individual. As for the NTI issue, Wellbutrin is a drug that is an excellent example of one having a narrow therapeutic index, and it may be worthwhile to just stick with the brand name instead of screwing around with the generics, assuming that the cost is not prohibitive.
Todd
Posted by dazedandconfused on August 25, 2004, at 14:12:15
In reply to Re: Questions about generics. Wellbutrin. HELP PLEASE!, posted by King Vultan on August 25, 2004, at 12:53:45
I agree with King Vultan in theory.
I did not try the generic version, but I found the SR to work better for me than the XL. For some reason, I found the XL to be more sedating for me. Of course, idiot PDOC (who I have since fired) stated that wasn't true.
dazed
Posted by HappyGirl on August 25, 2004, at 17:21:54
In reply to Questions about generics. Wellbutrin. HELP PLEASE!, posted by ravenstorm on August 25, 2004, at 10:53:34
Hi:
I've been on WB sr for the past two and a half to three years period, from 450 mg. to 200 mg.(currently) along with other meds.Upon having changed/switched from the brand to the generic, I asked the pharmacist(I've been through Mail-order, three months' supply), she said that generic(Watson) is EXACTLY the same as the brand one. However, her persistent-insistence didn't convince me, ... then I researched it by my own, first through Internet and then a friend working at the pharmacy. My final finding on this, 'brand and generic' is EXACTLY the same in regard to effectiveness and all other components. However, this is ONLY in USA, No other countries. Because, unlike USA, other countries has NO regulation or rule(I just forget a techinical words for this)on the generic. Then, if you would purchase overseas, things must be VERY disappointed due to the effectiveness along with S.E. from WB sr.
In regard to 'XL' and 'SR,' ... in my knowledge, this depends on person to person. Some are happy, and some aren't. Because, XL is 24 hours' effectivenss that makes some of S.E. and along with effectiveness changes occur, such as 'not sleep well' or 'VERY slow-effect' - in comparison to SR. The SR version is a sort 'quick' act, but 'XL' seems 'slowly' working on your chemical/brain. Some folks complain about 'too slow' to get desired effectiveness.
In regard to the name for 'Generic form' of WB is 'Bupropion' ONLY, not other name. If you got different name upon purchasing WB sr, you must be entitled to get the money back! Normally, when I get any meds. from local pharmacy, I check a med. bottle carefully to make sure the
right' name on the bottle and 'right dosage.' Because, there is/are some mistakes occur in local pharmacy, ... not often but 'human-error/innocent mistakes.'
H.G.
Posted by 4mygrls on August 25, 2004, at 19:28:20
In reply to Re: Questions about generics. Wellbutrin. HELP PLEASE!, posted by dazedandconfused on August 25, 2004, at 14:12:15
i use to take the sr version. when i switched to the xl and swore up and down that i didn't get the same affect as with the sr. my doc said it wasn't possible.but i know that i felt better on the sr version. i would feel the effects more when i took the sr version. i chose to listen to my doc when i should've listened to my gut.:(
Posted by ravenstorm on August 25, 2004, at 20:54:33
In reply to Re: Questions about generics. Wellbutrin. HELP PLE, posted by 4mygrls on August 25, 2004, at 19:28:20
Well, now I don't know what to do.
The drug I was given is called Budeprion SR which the pharmacist says is bupropion. It is made by TEVA. My 100's were manufactured by EON. These TEVA pills are HUGE. I thought I was going to just bump up dosage from the same generic. Why the hell would walgreens stock one generic at 100 and another at 150mg. That just seems asinine to me. If I am going to have to change fillers and coatings again, I feel like I should just switch to the brand. The cost would be considerably more. Its $5 for generic and would cost about $65 for the name brand.
I want to call the pharmacy back and ask them to special order the EON, since I know I can at least tolerate that. I am so freakin' med sensitive it is unbelievable.
So, if I try the TEVA's and start to have side effects, how will I know if it is from the new version, or if its from the dose increase? I won't!! Which is why I wanted to stick with the EONs to begin with!
I am afraid to call them and make them special order the EONS. God, I wish I wasn't such a whimp about this!!
Thanks for the input everybody. I guess I'll take the TEVA tomorrow and if I don't like it, I'll call the pharmacy and make them special order the EONs.
REally, aren't medication switches complicated enough without this cr*p?
Posted by HappyGirl on August 25, 2004, at 23:00:35
In reply to Re: Questions about generics. Wellbutrin. HELP PLE, posted by ravenstorm on August 25, 2004, at 20:54:33
Hi:
In that experience like yours, I will go to other pharmacy/pharmacist. Because, once the problem happened with, there is some 'residual' unpleasant experience to deal with. At least, I want to get some 'pleasant' feelings in order to get psycho. meds., knowing my mental disorder needs those psycho. med. It's TOUGH for me to think and cope with those 'sad' feelings inside.In my case, 'Watson,' one of the Generic manufactures for the WB sr, ... I'm VERY satisfied in all respects, its size and effectiveness, except its color that is purely/bland 'white' round pill. It's easy to swallow. At first, I felt a bit different from the brand one with some 'stomach' problem, but it went away VERY quick with the time, ... about within three to five days. Otherwise, I'm VERY happy with the generic form of WB sr 100 mg. I, too thinking about the 150 mg. in the morning and 100 mg. before the supper-time(due to some stimulating effect not sleep well), but so far I can't make a decision, due to my past experience in 'heart racing' once when I was more than the 300 mg.
In my case, I take it for mostly 'ADD' that seems coming from the depressive side of my Bp. Because, I never had one before Bp dx. Besides ADD, WB sr has a some good effectiveness on my depression. Then, I plan to stick with this med. due to 'less' S.E.s from WB sr.
H.G.
Posted by HappyGirl on August 25, 2004, at 23:56:28
In reply to Re: Questions about generics. Wellbutrin. HELP PLE, posted by HappyGirl on August 25, 2004, at 23:00:35
Hi:
One more thing about which I forgot is the name of WB sr/generic form and its manufacturers. In my knowledge, TEVA has offices/manufactures not only in USA but also other foreign countries, somewhere in Europe, ... but I forgot which countries(plural, not singular), I believe. Then, the pharmacist might be right,... the one you got is truly 'the generic form' of 'WB sr.' But, it says "TEVA USA?"As knowing those complexities, I normally ask the pharmacist at local store, whether the med./generic form is REALLY made in USA, ... not in any other/foreign countries. Also, I choose a fairly decent pharmacy, like CVS and repubable pharmacies. Because, due to my 'limited' knowledge in regard to 'generic form,' I can NOT distinguish 100% whether the med. is REALLY manufactured in USA.
H.G.
Posted by waki on August 26, 2004, at 1:22:43
In reply to Questions about generics. Wellbutrin. HELP PLEASE!, posted by ravenstorm on August 25, 2004, at 10:53:34
i passed up the SR 3 years ago because it did nothing. I recently tried the xl and it was the ticket. I tried sr again just to make sure and it (sr) still did nothing.
point being there is something seriously different in the xl then the sr that it also gives me that much energy.
Posted by ravenstorm on August 26, 2004, at 18:52:26
In reply to Re: Questions about generics. Wellbutrin. HELP PLEASE!, posted by waki on August 26, 2004, at 1:22:43
Hello again everybody. Not doing well on the TEVA-lots of stomach upset. Walgreens claims they can not get the EON formulation. I have been too sick to do anymore calling today. They think it is from the dosage increase, but I never had heartburn from the EON even when I started out on it. Also, am having tons of dry mouth on the TEVA which I never experienced on the EON. Apparently there is also a bupropion generic from Watson. I'm going back to the 100mg SR's by EON for the rest of the week/weekend while I see if I can find the EON brand anywhere or if anyone can order it. I don't know. Maybe if I stuck it out for a few weeks it would get better. Its just weird to have different side effects than I had on the other generic. But I have a really sensitive stomach. Got really sick on prozac and that never passed even after eight weeks.
Thanks everybody. Just sucky to feel like crap again physcially when I was finally starting to feel a little better.
Posted by HappyGirl on August 26, 2004, at 22:06:46
In reply to Re: Questions about generics. Wellbutrin. HELP PLEASE!, posted by ravenstorm on August 26, 2004, at 18:52:26
Hi:
In my knowledge, once the med. is home with you, there seems a policy NOT able to get a replacement(money back) for it. In my guess, it might be 'SAFETY' reason on this. At least, the region/state where I live. I normally get most of meds. by 'Mail Order' through my Health Insurance. Then, I have to be REALLY careful. Upon sending a rx slip, I usually send a letter describing a name of the med., its dosage and all my personal information just in case they need.In regard to the Walgreen, it is one of BIG chain stores, then it makes me quite surpirse as reading your posts. I feel it's bad this happened in the middle of 'Generic form' transition.
BTW, my other med., Nefadozone/a generic form of Serzone is manufactured by 'TEVA USA.' But, the Bupripion SR is 'Watson.' Both are EXCELLENT in terms of 'effectiveness' and all other components along with its S.E.s.Hopefully, on the 100 mg. Bupriopion, you're doing well.
H.G.
Posted by ethel basset on August 26, 2004, at 22:54:33
In reply to Questions about generics. Wellbutrin. HELP PLEASE!, posted by ravenstorm on August 25, 2004, at 10:53:34
Hi
I hope that you are doing well with your medication now. Thanks for sharing.
I, too, feel tired on Wellbutrim and my doctor said that that was unusual. After listening to others' comments, I realize that it isn't so unusual, after all.
I have also been told that generics and brand name meds are the same, but I, too, have had different reactions to both.
The point is, that we need to have more confidence in ourselves, our "gut reactions" and our body wisdom.
I also have a pdoc that swears that antidepressants don't cause weight gain! HA!
Just ask any of us who have taken antidepressants and who have gained 40 or more pounds.
Have faith in your own feelings and reactions.
(I also once had a doctor tell me that the pain I was suffering was all in my head and that I was just anxious and hysterical, when it turned out I had a uretor that had been severed in surgery and it was leaking urine into my peritoneum!) I realize that sometimes we know better than the doctor does.
Anyway, good luck with your meds and have faith in yourself and your instincts. God Bless You.
Ethel
Posted by ravenstorm on August 27, 2004, at 8:21:51
In reply to Re: Questions about generics. Wellbutrin. HELP PLEASE!, posted by ravenstorm on August 26, 2004, at 18:52:26
Yeah, I know I can't return it, but it only cost $5 so I'm not worried.
Thanks Ethel for your comment to trust my gut. I actually have a call in to Eon to see if they sell the 150mgs to any pharmacies in my city. I had already called four pharmacies and decided instead of calling each one, it might be easier to call the company. So, its back down to 100mgx2 for a while longer until I can figure out what to do. I supposse next refill I could try the watson, but I really want to get this med kicked up so I can drop the remeron before winter sets in.
Thanks for the support everybody. It really helps
Posted by HappyGirl on August 27, 2004, at 18:09:06
In reply to Re: Questions about generics. Wellbutrin. HELP PLEASE!, posted by ravenstorm on August 27, 2004, at 8:21:51
Hi All:
If you would like to get your 'generic' med. made by your specific/'favorite' Generic-manufaturer, your pdoc. needs to write down a specific manufacturer's name, such as Watson, Eon, and TEVA USA and list to go, since there are 8(eight) altogether, here in USA.
Besides 'manufacturer's name,' your pdoc. writes down the following two words:--- "Medically Necessary" along with a manufacturer's name("Watson" - in my case.) ---
Otherwise, a pharmacist/pharmacy picks whatever they have on their shelf.
H.G.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.