Are generic medications safe?

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I just finished reading the book "Bottle of Lies" by Katherine Eban. It is an inside look at the generic drug industry. To answer the question I put in the title of this blog post - maybe or maybe not.....

I won't give the complete rundown of the book but would encourage you to read it if you are at all concerned about the medications you or your family take. One of the things that jumped out at me was that U.S. drug manufacturing plants can be inspected any time any place with a surprise inspection from the FDA. Foreign plants in India and China, which is where many generics come from, get six weeks notice before an inspection. SIX WEEKS!!!!!! I can't help but thinking of how my house looks if I know I have company coming over vs someone just pops in unannounced.

I have seen this first hand in our office. Latanoprost is a medication to lower pressure in the eye. There are currently at least 19 different manufacturers of this medication. I have many patients taking the generic form and most do well. I have seem some not do well where their eye pressure is right back to where it was before we started, almost like they were not taking the drug at all. I put them back on a branded product and boom - good to go.

A few things that you can do to protect yourself since the FDA has very little power or controls over these foreign plants are:

1. Take a branded U.S. manufactured drug if you can afford it.
2. If you do take a generic try and get one made in the U.S., Israel, or the EU.
3. If you are on an Indian or Chinese generic it may be fine, but if things are not going well don't assume the medication is ok. Your doctor or pharmacist have no way to check that the drug that was prescribed is manufactured correctly and the FDA certainly does not inspect all the medicine that comes in. 

None of these things guarantee that you would never have a problem with your medication but I think it would improve your odds. Better yet would be making lifestyle changes to get off of medications, if you can.

That is all for this week - I encourage anyone interested to read the book and feel free to post any comments.

Dr. Jason




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