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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 55. This is the beginning of the thread.
Posted by valene on October 19, 2006, at 12:34:56
I have been on xanax for over 20 years and have gone from 3mg. down to 1.75mg. and want to reduce further.
I get the .25mg. white pills scripted from my pdoc as I want to try breaking them; however, the pharmacy uses SANDOZ generic for years and I have had no problems with this except for my current bottle of pills. I am finding that I have withdrawal symptoms and I haven't reduced dosage. IS this possible? I do not have tolerance w/d as far as I know.
I went on some drug board and found a discussion about the generics and that they have a 20% variation in bioavailability. It also said there is a difference in strength of the generics, and that SANDOZ is one of the weakest, and Greenstone (a division of Upjohn?) is the closest to the name brand Xanax.
Can anyone comment on this? Thanks.
Val
Posted by Phillipa on October 19, 2006, at 12:52:47
In reply to Generic alprazolam vs. Xanax name brand, posted by valene on October 19, 2006, at 12:34:56
I sure can. When on xanax I was paying for brandname until a pharmacist told me Greenstone generic is really the manufacturer of the real xanax. Ask your pharmacist to order it for you it's generic , identical in looks to the real thing, same bitter taste, and works the same, and is scored. Love Phillipa
Posted by valene on October 19, 2006, at 13:02:12
In reply to Re: Generic alprazolam vs. Xanax name brand » valene, posted by Phillipa on October 19, 2006, at 12:52:47
> I sure can. When on xanax I was paying for brandname until a pharmacist told me Greenstone generic is really the manufacturer of the real xanax. Ask your pharmacist to order it for you it's generic , identical in looks to the real thing, same bitter taste, and works the same, and is scored. Love Phillipa
Thanks, Jan. I am outraged that drug companies can do this with generics - 20% difference allowed? That means you can go into withdrawal or have a higher dose in your system.
Benzo tapering is supposed to be only 10% at a time. With the current generics being 20% difference either way, how can you possibly know by how much you are tapering the drug?
I will ask my pdoc to order only Greenstone and if my pharmacy won't get it I'll go elsewhere.
Love,
Val
Posted by bassman on October 19, 2006, at 17:55:16
In reply to Re: Generic alprazolam vs. Xanax name brand, posted by valene on October 19, 2006, at 13:02:12
Somewhere I have a reference to a journal article in which subjects taking Xanax were switched to generic and they all showed signs of withdrawal.
The 20% thing isn't as bad as you might think-it isn't that the tabs themselves have to be within 20%, they have to be within about 5% over all. It is the bioavailability that is +/- 20%. That seems like a lot, but what is measured is the blood concnetration of the drug-and that is all over the place for different people and also because the technique usually used to measure blood levels, mass spectrometry, isn't particularly precise or accurate. Check out the data on a package insert some time on blood concentrations of drugs and see the huge range for subjects.
So it's reasonable to have the 20% for bioavailability, but the problem is that you never know if it because of the inherent inaccuracy of the method used or because the generic isn't as bioavailable. As you wrote, with alprazolam, that's critical.
Generics just cost the pharmacist pennies per tab, so they really should at least use a decent generic house. Alprazolam is sold some places for about 12 cents a tab, and that's with an excellent profit.
Posted by valene on October 19, 2006, at 19:22:34
In reply to Re: Generic alprazolam vs. Xanax name brand, posted by bassman on October 19, 2006, at 17:55:16
Right Bassman, thank you for your explanation. I found a web page that is quite concise also:
http://counsellingresource.com/medications/discount-drugs/generics.html
Scary they found a 32% bioavailabilty variance in the blood levels of one patient, this pertains to all generics.
I am having head pressure again tonight and I started on the old batch of alpraz. I guess it takes a while to get back the blood levels. I have been taking the "half-sugar" pills for a couple weeks now. Wondering about the worsening anxiety and w/d symptoms. Hopefully the Greenstone will take care of it. Not feeling so great.
Val
Posted by bassman on October 19, 2006, at 19:44:49
In reply to Re: Generic alprazolam vs. Xanax name brand » bassman, posted by valene on October 19, 2006, at 19:22:34
Maybe take more of the crummy stuff until the Greenstone appears? My symptoms of Xanax withdrawal were anxiety, some depression, and dizziness. If that helps...
32% just isn't going to work with Xanax-take the equivalent of 3 mg's one day and 2 the next? Hum...
Posted by Phillipa on October 19, 2006, at 20:50:40
In reply to Re: Generic alprazolam vs. Xanax name brand » bassman, posted by valene on October 19, 2006, at 19:22:34
If push comes to shovel have your doc prescribe a higher dosage than you take and split them to the correct dose. I think you are on l.75 per day. I'd ask for lmg pills spit to .5 and then split the .5 to get the .25 and get the brandname I did it for years. Love Phillipa
Posted by jealibeanz on October 19, 2006, at 20:52:52
In reply to Re: Generic alprazolam vs. Xanax name brand, posted by bassman on October 19, 2006, at 19:44:49
Has anyone had Mylan and Sandoz? I used to take Sandoz, just recently was given Mylan. I feel like the Sandoz lasts longer, is more effective, and less sedating. However, I'd read that Mylan is one of the best.
Posted by valene on October 20, 2006, at 8:48:07
In reply to Re: Generic alprazolam vs. Xanax name brand, posted by jealibeanz on October 19, 2006, at 20:52:52
> Has anyone had Mylan and Sandoz? I used to take Sandoz, just recently was given Mylan. I feel like the Sandoz lasts longer, is more effective, and less sedating. However, I'd read that Mylan is one of the best.
SANDOZ is one of the weakest! Here is what I found on a drug board: (quoted from my initial post above):
I went on some drug board and found a discussion about the generics and that they have a 20% variation in bioavailability. It also said there is a difference in strength of the generics, and that SANDOZ is one of the weakest, and Greenstone (a division of Upjohn?) is the closest to the name brand Xanax.
Greenstone is a subsidiary of Pfizer,I found out, and supposedly makes the best alprazolam, closest to name brand according to many. Hope this helps.
Val
Posted by bassman on October 20, 2006, at 9:18:38
In reply to Re: Generic alprazolam vs. Xanax name brand » jealibeanz, posted by valene on October 20, 2006, at 8:48:07
You didn't happen to see any reference to how good PAR generics are, by chance?
Posted by jealibeanz on October 20, 2006, at 9:20:43
In reply to Re: Generic alprazolam vs. Xanax name brand » jealibeanz, posted by valene on October 20, 2006, at 8:48:07
Funny, I really preferred Sandoz, especially because it was less sedating. Even so, I don't think the lack of sedation caused it to be less effective at relieving anxiety.
Well, I'm either going to ask for brand name Xanax, although I've never had it, or Xanax XR. I'm not sure how these will effect me, but at least it would be consistent. I don't always use the same pharmacy, so consistency is important.
Is brand name readily available at most pharmacies?
Posted by bassman on October 20, 2006, at 10:49:56
In reply to Re: Generic alprazolam vs. Xanax name brand, posted by jealibeanz on October 20, 2006, at 9:20:43
Yes, but they'd rather sell you generic because they make more money on it.
Posted by jealibeanz on October 20, 2006, at 17:06:41
In reply to Re: Generic alprazolam vs. Xanax name brand » jealibeanz, posted by bassman on October 20, 2006, at 10:49:56
Well the pharmacy doesn't choose whether or not I get generic or brand name. It depends on the doctor's specification.
Posted by Phillipa on October 20, 2006, at 19:40:43
In reply to Re: Generic alprazolam vs. Xanax name brand, posted by jealibeanz on October 20, 2006, at 9:20:43
Jelly no not all pharmacies carry the namebrand. The one's I've used have ordered it for me and had in a few days. But seriously greenstone is the one to ask for and it doesn't cost more as it's generic. Love Phillipa
Posted by Phillipa on October 20, 2006, at 19:42:36
In reply to Re: Generic alprazolam vs. Xanax name brand, posted by jealibeanz on October 20, 2006, at 17:06:41
No not true. You can request namebrand. Love Phillipa
Posted by jealibeanz on October 20, 2006, at 19:59:46
In reply to Re: Generic alprazolam vs. Xanax name brand » jealibeanz, posted by Phillipa on October 20, 2006, at 19:42:36
Yes, that's what I meant. You can request of your doctor to write the prescription for namebrand. The pharmacy doesn't make this decision.
Posted by jealibeanz on October 20, 2006, at 20:03:28
In reply to Re: Generic alprazolam vs. Xanax name brand » jealibeanz, posted by Phillipa on October 20, 2006, at 19:40:43
Well one neither pharmacy I use carries Greenstone. Namebrand prices aren't a problem for me, they are $5 a month for any medication, on or off-label, no authorizations necessary for 2nd/3rd line meds. Generics are $3. Good coverage, huh?
Posted by valene on October 20, 2006, at 20:28:12
In reply to Re: Generic alprazolam vs. Xanax name brand, posted by jealibeanz on October 20, 2006, at 20:03:28
I use the Stop and Shop pharmacy where I live, and I talked with the pharmacy manager, and she told me just to call ahead a few days before refilling my alpraz. and she would order the Greenstone. Either that or I will just ask my doctor for a script for the name brand, like you. I am leery of the generic benzos now! Best wishes.
Val> Well one neither pharmacy I use carries Greenstone. Namebrand prices aren't a problem for me, they are $5 a month for any medication, on or off-label, no authorizations necessary for 2nd/3rd line meds. Generics are $3. Good coverage, huh?
Posted by Phillipa on October 20, 2006, at 20:53:01
In reply to Re: Generic alprazolam vs. Xanax name brand » jealibeanz, posted by valene on October 20, 2006, at 20:28:12
Hey guys I just tell my pharmacist I want the brand name he doesn't have to call the doc they don't care. I've done this in all my pharmacies over the years in different localities too. Love Phillipa
Posted by Jost on October 21, 2006, at 0:01:48
In reply to Re: Generic alprazolam vs. Xanax name brand, posted by jealibeanz on October 20, 2006, at 17:06:41
But you can ask for specific generics. There's a particular generic which, for unknown reasons, really works better for me, with ibuprofen-- and I've found a pharmacy that stocks that generic. It makes a huge difference.
The pharmacy may not order one for you-- but if you call around, you can find a pharmacy that has the brand you want.
Of course, unless your pdoc writes the prescription for the generic--
Jost
Posted by Jost on October 21, 2006, at 0:02:55
In reply to Re: Generic alprazolam vs. Xanax name brand » jealibeanz, posted by valene on October 20, 2006, at 20:28:12
How about an online pharmacy? Maybe one of them would carry the generic you want?
Jost
Posted by jealibeanz on October 21, 2006, at 6:43:45
In reply to Re: Generic alprazolam vs. Xanax name brand, posted by Jost on October 21, 2006, at 0:02:55
I wouldn't have a problem getting the generic I've used in the past. My parents always send the filled prescription or paper script every month since there are no refills allowed where I live, I just have to call my doc to have him write it. This last time I told my mother to send the paper because I figured if it got lost in the mail, I got easily get the script rewritten without problems. If the filled script got lost in the mail, my doc would have to get creative and write it in a different way.
Posted by jealibeanz on October 21, 2006, at 6:49:56
In reply to Re: Generic alprazolam vs. Xanax name brand, posted by jealibeanz on October 21, 2006, at 6:43:45
So, anyway, I figured since I was having problems with generics, now would be a good time to try the brand name version. It may even work better than my old generic, which would be great, especially if I could decrease the dosage. This would make me feel a whole lot better if I could get into the lower dosing range. (although I don't even know which range I consider myself targeting, since I've been a mixture of GAD w/mild panic attacks). I never thought about this before, but the trials were done with brand name, not various generics. This makes a big difference. I feel a little less crazy now that I realize I haven't gone off the deep end in the last couple weeks, it's the meds. I can take up to 5mg a day right now. I was at 3mg before.
Posted by valene on October 21, 2006, at 10:24:00
In reply to Re: Generic alprazolam vs. Xanax name brand, posted by jealibeanz on October 21, 2006, at 6:49:56
Another unpleasant thought is that the amount of bioavailable alprazolam can vary from "batch to batch", so that in any given bottle of pills, you could be getting a different dosage.
I think I have had enough uncertainty and will definitely go with the name brand.
Posted by bassman on October 21, 2006, at 10:47:05
In reply to Re: Generic alprazolam vs. Xanax name brand, posted by valene on October 21, 2006, at 10:24:00
Exactly my sentiments...one's mental health is too important to leave to chance.
One well-kept secret is that there is a little empirical "magic" associated with making a particular drug formulation-that knowledge resides with the guys that first made several formulations and found them to be deficient. If all formulations of a drug substance worked just fine, there wouldn't be any industrial pharmacists.
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