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I came across this article on The Controversy over Generic Antiepileptic Drugs. (Sorry if someone else has posted it)
I found it very interesting in that they actually talk about the problem of bioequivalence (or lack thereof) between generics vs brand-name drugs (generics can be within 80% to 125% bioequivalent of brand name (Link)) and how this can have serious consequences for people using drugs to help control their epileptic seizures.
I was told a long time ago to always take brand name Dilantin and always have. So I haven't had the problems of generic bioequivalence. However I recognize how seriously they could affect me since my blood levels tend to vary even on Dilantin. I think this is totally due to life-style changes including stress. The last thing I need is for the bioequivalency of the Dilantin to actually change.
A very interesting point is brought up that
I personally wouldn't trust switching to generic phenytoin from brand-name Dilantin given my personal history. But I hadn't truly realized the bigger problem in switching generic suppliers since that could give you a boost (or drop) of up to 45% in bioequivalence.
The article also does point out that
A most interesting article in understanding generics vs brand-name AEDs.
I found it very interesting in that they actually talk about the problem of bioequivalence (or lack thereof) between generics vs brand-name drugs (generics can be within 80% to 125% bioequivalent of brand name (Link)) and how this can have serious consequences for people using drugs to help control their epileptic seizures.
I was told a long time ago to always take brand name Dilantin and always have. So I haven't had the problems of generic bioequivalence. However I recognize how seriously they could affect me since my blood levels tend to vary even on Dilantin. I think this is totally due to life-style changes including stress. The last thing I need is for the bioequivalency of the Dilantin to actually change.
A very interesting point is brought up that
While the drug concentration differences between the brand name drug and each generic formulation are unlikely to be substantial, the differences with generic-to-generic switches will be greater and potentially clinically significant.
I personally wouldn't trust switching to generic phenytoin from brand-name Dilantin given my personal history. But I hadn't truly realized the bigger problem in switching generic suppliers since that could give you a boost (or drop) of up to 45% in bioequivalence.
The article also does point out that
In contrast, a 10% decrease in AED concentration may cause a previously seizure-free patient to suffer a breakthrough seizure, which has considerable consequences such as injury or death to the patient or others, loss of driving privileges (up to one year, depending on the state), loss of employment, and emotional distress. There is also the added burden of hospitalization, increased doctor visits, time off work, and cost of other medications to address the effects. Thus, for the individual with epilepsy, the stakes are higher in the generic/brand debate.
A most interesting article in understanding generics vs brand-name AEDs.
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