ADHD Medication: Are Generics The Same?

When a new medicine is developed, it is under patent for a number of years. When the patent expires, that medicine can be made by other manufacturers. The original medicine is called the ‘trade name’, and the later one is called the ‘generic’.

For example: “Kleenex” is the trade name of a brand, but “tissue” is the generic term.

Another example: “Tylenol” is the trade name, and “Acetaminophen” is the generic.

To use an [tag]ADHD[/tag] example, [tag]Ritalin[/tag] is a trade name, and [tag]Methylphenidate[/tag] is the [tag]generic medicine[/tag].

Why is a medicine under patent?

The medicine is protected under patent for a number of years to allow the Research and Development [tag]Pharmaceutical Companies[/tag] (i.e. the companies that develop the medicine and do all of the research and testing to bring it to market) to market that medicine exclusively, so that they can recoup the investment that they have made into the development of the drug.

It costs approximatly $900 million USD to bring a medicine to market now. That is a lot of money – and means that the company should be given time to earn income due to their extensive investment.

After the patent runs out, other companies can make the same medicine, as a generic. In the same way that many companies can make tissues, but only one can market under ‘Kleenex’.

What is the immediate benefit of a generic?

Mainly, it is the same medicine and it is cheaper.

In Canada, one can buy trade name ‘Ritalin’ (with a prescription, of course), or alternatively, one can get ‘Apo-Methylphenidate’, or ‘Novo-Methylphenidate’. The ‘brand’ of medicine which is given is often determined by the insurance that pays for the pills. Often the insurance will specify that if the generic is available, then that is what they will cover (because it is cheaper and will save them money).

Are generics the same as the trade name medicine?

The rules for generics are:

  1. they have to be the exact same chemical
  2. they can only have a 20% variance in the amount of active medicine getting into the blood stream.

The difference in absorption from one preparation to another has to do a lot with the ‘binders’ in the tablet, etc.

Generally, if someone is started on one generic preparation and then stays with that generic, it is not a concern.

The issue comes if someone’s pharmacy or drug plan changes the generic – there could be a swing of a maximum of 40% difference in the amount of medicine hitting the blood stream.

For example, if someone is on Methylphenidate A, and the amount that gets into the blood stream is 20% higher than Ritalin; and then the pharmacy switches the generic Methylphenidate to Methylphenidate B, and methylphenidate B is 20% lower than Ritalin, the patient could be on the same dose, and end up with a 40% change in medication in the bloodstream.

In general, the changes are much more minor with generics, and most people have little if any problem or issues with them.

However, this can be a real problem for some people who are more sensitive to medicine.

If you find that a change in the trade name or generic medicine is a problem, speak to your pharmacist and your doctor. Your doctor can write 2 words on the prescription to force the pharmacist to stick to a specific preparation of the medicine.

Those two words are: “No Substitution”. That means that the pharmacist has to dispense the exact medicine written by the doctor, and cannot substitute it for a cheaper generic form of the medication. You will need to check with your insurance, though – as they may refuse to pay for the more expensive version.

Which ADHD medication is generic?

In general, the longer a medicine has been out, the more likely it is generic.

Ritalin and Dexedrine are generic. Newer preparations like Concerta, Metadate, Adderall XR and Strattera are not generic. Neither is Focalin, Ritalin LA, etc. These will likely go generic in approximately 10-20 years.

Have you had experience with this? Maybe trouble with generics? If so, please share your experience by posting a comment on this blog.

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Comments

  1. Here in New Zealand we are changing from Ritalin SR to Rubifen LA. Apparently this is not used in many countries – I am not to concerned now because on the Ritalin SR my son is having major highs and lows so on our next appointment am hoping we can change to something else as apparently Ritalin SR is known for this … is that correct?? What is the most “popular” drugs over there which has had the best results???

  2. Thank you, Jackie for your question.
    I have to say that I don’t know ‘Rubifen LA’. I presume it is just a generic form of Ritalin SR.
    Ritalin SR is not a very good preparation of a long acting methylphenidate.
    In my experience, only a small percentage of kids benefit from it.
    Many only get 4 hours of medication coverage, some less.
    In Canada, there are other long acting preparations of methylphenidate – inlcuding Concerta (which is excellent) and Biphentin (which is new and I am just testing out).
    In the US, they also have Metadate CD, Ritalin LA, Focalin XR (and I may be missing one or another).
    The benefits of these newer ones is that they deliver very steady doses of methylphenidate throughout the day.
    The drawback is that they are generally 3x as expensive.
    I used to work in New Zealand for 6 months in 2001 (at the Starship Children’s Hospital), so I understand how only certain medicines are funded.
    It is worth asking your doctor if your son could be moved onto a newer medicine if the old ones aren’t working.

  3. Hi. My son has had a very bad experience using Rubifen SR. His behaviour got far worse than before, aggressive, aggitated, irritable, lack of focus, argumentative, distracted. When on the same dose of Ritalin his appetite would be suppressed until 5/ 5:30pm. He would be hungry at 3pm on Rubifen.
    I had an article posted in a local newspaper, which can be viewed on http://www.stuff.co.nz/stuff/sundaystartimes/auckland/4091471a6016.html
    after that article, I have had many parents phoning to say they have experienced the same problem, primarily aggression. All have had to pay for the non-subsidised alternative. Many adults have reported that Rubifen is in-effectual for them. The ADHD association here (in New Zealand) is starting a petition to try and get Ritalin to be subsidised for those people that Rubifen is having bad side-effects.

  4. Hi Ms. Di Celliers,
    Thank you for sharing your story.
    And kudos for getting some press on it.
    I did work in Auckland in 2001 – at the Starship Children’s hospital for 6 months, so I have some familiarity with your system.
    You describe a perfect example of how a generic preparation can lead to a real problem. In this type of situation, getting the name brand is very important.
    I hope that your ADHD organization can do well with your advocacy.
    Just for your reference, there is a Canadian parent advocacy organization called: CADDAD – http://www.caddac.ca
    Good luck!
    Dr. Kenny

  5. Hi
    Since the first article was published in the local papers about the adverse effects of Rubifen in NZ a month ago, many people have contacted me. I have 22 people who hve written about how their child has been severely affected by the drug switch. Mostly a huge increase in aggression and dangerous behaviour to themselves and others. Articles are appearing in newspapers around the country and MPs are being contacted more and more regularly. There are written questions for the Health Minister to answer this week in parliament about the adverse affects of Rubifen. The ball started rolling and is now gathering momentum. Lets see if Pharmac are prepared to admit that this controlled drug should have actually been tested and monitored on young people before letting it loose on the unsuspecting patients. What are they going to do to help the many people who have been badly affected and simply cannot take this drug? young people’s education have been severly affected. Families are now having to pay substantial amounts of money to help their children stay focussed in class.
    Thanks for this very informative website.

    Regards
    Di

  6. Hi– I was just switched to the new generic focalin (dexmethlphenidate 10mg by Teva) by Walgreen’s after having been on the same dosage of the brand-name Focalin for over a year. It does not seem to have the same effect (it seems weaker) and I wanted to let you know. I am contacting my psychiatrist to see if we can switch me back and still have it covered by my insurance. I seem to be having to use more of it for the same effect, which is difficult since it is a controlled substance, and I will likely run out of it before I am allowed a refill. If you have any experience or advice here I would appreciate it.

    And if anyone else has been switched I would appreciate comments as to whether this is all in my head—

    thanks, scott

    • Scott-My son has been on focalin XR for over 5 years and his last prescription was filled with the generic and it doesn’t seem to be working at all for him either. He actually has been on focalin XR twice a day since it doesn’t last as long as it’s supposed to for him. So by the time noon arrives, his meds are worn off. They had tried 30 mg focalin XR once a day and that didn’t work either. It was too much at once and by noon he was a complete wreck. The generic focalin XR doesn’t seem to last as long as the name brand and it doesn’t seem to work as well either. So it’s not in your head. The formula just isn’t the same. I am working with his doctor and insurance as well to get it back to the name brand asap before he has any more problems in school. Generics might be less expensive but they are not identical formulas. If they were, there would not be any problems. Best of luck to you. ~Lisa

  7. Hi Scott,
    Thanks for sharing your experience. Sorry it’s not working out.
    I don’t have any direct experience with Focalin – as it is not available in Canada (where I work and practice as a Psychiatrist).
    However, your issues with generic focalin are quite consistent with what happens to many people who go onto a generic.
    Basically, as described above, the generic has to be within 20% as strong (either stronger or weaker) to get approved.
    For you, the generic focalin seems to be weaker.
    Best to talk to your doctor about it and see if you can get the brand name.
    Doctors can write prescriptions for that by means of writing: ‘no substitution’ on the prescription. The question is then will your insurance cover it?
    All the best,
    Dr. Kenny

  8. Hi, to Scott S. and this general website: I too just switched from focalin (5mg) to the generic. I consulted 3 pharmacist who told be that the active ingredient is the same as the brand name version. I have had a very similar experience with the generic as Scott S. The effect of the medicine seems so different it may as well be an entirely different medicine. Aside from it’s apparent “weaker” effect on my system, it upsets my upper G. I. and seems to act in a more acute manner and then quickly the medicine ceases to have any beneficial quality- only adverse effects which include very pronouced feelings of nervousness and just an all around “bad” feeling. Im seeing my guy in 2 days and am going to ask him about this- I am certain that has nothing to do with my imagination- i’ve been taking the stuff consistently for a while and know that this generic differers dramatically from the brand name.

  9. I have been taking Focalin for narcolepsy for about 4 years and never had a problem with it. Well, my wonderful insurance company convinced my doctor to write my new scrip for the generic “equivalent”, Dexmethylph (phenidate?). OMG, what a difference. It is a dirty, nasty drug. I had anxiety from it so bad, I could hardly stand it. Also i had heart palpitations and felt just plain lousy. I got so stressed out from it, i ended up more tired than i was to start with! How dare them call that an equivalent.

  10. I was switched to a new generic of adderall about 3 months ago now and I have felt it is significantly less effective. However, I am also Bi-Polar so have been unsure if I am experiencing mixed episodes or if it is in fact the switch. I’m glad I read this though because I will be bringing this up with my doctor just in case this is the issue. I even rear ended someone about 8 weeks ago because I was totally in another space in my thoughts- this never happened before

  11. I once came across a website that had a great example of ADD. It made you try and read while images faded in and out in the background. Does anyone know where to find this?

  12. I just started on the generic Adderall XR 4 days ago – not liking it AT ALL. Does not seem to have the same effect…I can’t focus, can’t get anything done, head feels shaky…I just don’t like it. Apparently, my insurance won’t cover the regular AddXR – so, I will have to pay $160+ for it if that is what I want.

  13. I too am having a bad experience with the new generic form of Adderall XR. Have been on it for 3 weeks now and it has been rough.

    This weekend, I found 4 brand name Adderall XR capsules in a travel bag, thankfully. And, by switching back, I feel back to normal. No aggitation, edgeiness, insomnia, stiffness, etc.

    I hope my insurance won’t balk when my doc checks the “NO SUBSTITUTIONS” box on my next Adderall XR 20 MG prescription!

    @Stac: Maybe your doctor and/or employer can help work with your insurance to get it covered? Good luck!

  14. I have been recently switched from the real adderall xr to what I call garbage. I have taken adderall for 11years, not 1 side effect. Now with the fake adderall, not only is my add worse, I have severe side effects. And as most people its the insurance company,that dictates what the doctor can prescribe.Generic adderall should not be allowed to be sold. I had the same problem with ritalin as a child. This is really infuriating to me. The generic drug companies need to leave the add drugs alone. Is’s bad enough having add, and I have a full bottle of this garbage. The cost of the generic adderall shows what it is worth $4.00. People with real add, are already sensitive to drugs, this was the only one that didn’t make me feel like I was dying.

  15. I recently switched from Adderall XR to the generic version, and I am very displeased. I didn’t realize that it was generic until I began to experience vertigo, nausea, cramps, and cloudy, disconnected thoughts. I checked the label of the medicine and realized that it wasn’t Adderall XR; it was generic.
    I noticed a -huge- difference in the quality and effectiveness of the medicine. I thought that I was coming down with some kind of illness until I did some research and realized that the generic version was allowed to be so much different.
    I agree wholeheartedly with the other comments here; the quality and effectiveness of the generic Adderall XR are virtually non-existant. I’d rather not take anything instead of taking the generic.
    I will be switching back promptly. It’s 40 extra dollars a month for me, but the worth is incomparable.

  16. I think that what’s interesting here is that there do appear to be consistent variation in the effectiveness of generic medications across different medications themselves. My understanding is that amphetamines are innately more likely to have food effects (acidic foods reduce absorption). There are some generic dexedrine formulations that are widely considered less effective than brand (e.g. Barr) and others that appear to be comparable (Mallinckrodt).

    With Ritalin, however, I haven’t seen any variation between different generics, and I am untroubled if I am prescribed generics.

  17. I have been using Focalin (10mg) for several years after a number of years on Ritalin, all without incident. A few months ago, our drug plan removed Focalin from its formulary list and sent me the generic equivalent. While I did notice a drop in effectiveness (which any Ritalin or Focalin user would detect), I was determined to make the best of it. Within a few weeks of changing over to the generic, I began to feel unusually drowsy during the day, which I attributed to a cold-type virus that I was suffering around the same time. I could not shake the feeling of drowsiness and my doctor could find nothing wrong with me. I am not depressed nor has my sleep been affected but I found myself fatigued and almost unable to function normally at work. It was my wife who suggested that it may be the generic Focalin. Sure enough, when I stopped the generic and started taking the few pills left over from my previous scrip, the drowsiness disappeared like a curtain being lifted. Has anyone else had a similar experience with this side-effect? Is there an explanation?

    • I ool 40mg generic adderall for over a year and switched to 60mg generic ritilan because of the “hyper-focusing” side effect from adderall was wearing me out. Let me tell you, I took my first nap in over a year! I felt so sluggish, lethargic and dazed. The sleepiness and frequent bad headaches didnt subside after 3 or more months, so I switched to 30 mg Vyvanse. Vyvanse did nothing for me. I was paying $160 to still have every symptom of my combined ADD…….So, was prescribed 20mg generic focalin. I feel fatigued once again. I wonder if I am having a hard time with fimding the right one because I have the combination ADD.

  18. I’m 51 and just diagnosed with ADD. My insurance (Blue cross/Anthem) does not cover anything related to ADD for anyone over age 18 which seems like illegal age discrimination to me.

    My doctor prescribed Concerta 36 mg but OMG, the cost is $140 for 30 pills at Costco. I explained my situation to the doctor and she gave me Ritalin. After 3 weeks of taking generic Ritalin and realizing that I was having side effects such as bad headaches, nausea, blurred vision and the crash and burn when the drug wore off, I contacted my doctor who is now prescribing Concerta again.

    My insurance won’t even pay for the monthly doctors visit if it is to check on my medication. I can’t afford $100 per month doctors visit and $140 medication out of my pocket. Any suggestions?

    • Hi,
      I’m not sure what the answer is. Maybe generic Adderall XR can be an option. I am a Canadian doctor – so I work in a completely different healthcare system. Maybe one of the blog readers can share a suggestion as to how you can get coverage and help.
      Best,
      Dr. Kenny

  19. On Friday 7-31-09, I picked up me script and “assumed” it was my brand name Adderall XR 30mg.

    In the last 5 days I have experienced swollen ankles and feet (I’m 33 and have never had swollen ankles before and I play soccer.), nausea, headaches, cramps, dizziness, poor concentration and disconnected thoughts and I’m extremely aggravated. I NEVER have had these side effects on the brand name Adderall and I have been on Adderall for 6 years.

    Wallgreen’s pulled a switch and did not advise me that they gave me the generaic CRAP! I’m furious and in HELL!

  20. This afternoon I was made aware of the difference between real Adderall XR and generic. I’m a college student…diagnosed with ADHD my senior year of high school. I’ve been taking 60mg of Adderall for the last three and a half years now and my life has turned around completely. I was close to not graduating high school due to my poor grades, but in college I have been on the dean’s list nearly every quarter thanks to my medicine. About a week ago I used up one bottle and my mom gave me the new one (we get them in the mail). I kept taking them just like always, but this entire week I have been finding it impossible to do things and have been putting off everything. It finally got to the point today where I just broke down and lost it because I haven’t felt like this since high school and I didn’t know what was wrong with me and why everything was falling apart. Then my mom remembered seeing that this new bottle was generic, but she didn’t think it made a difference so she didn’t mention it. But as soon as we figured that out we realized that was it. So many of the things I have done (or not done) and thought and said can be explained perfectly by this HORRIBLE GENERIC WORTHLESS CRAP.
    And to the person up there who said it’s purely psychological, you are completely wrong. Maybe in some cases it can have an affect on how you perceive the effects of your medicine, but I have always been VERY aware of all the different medicines I take and their effects on me, and am very in tune with myself and my reactions and side effects to each and every one. I had NO idea this medicine was any different, and was fully under the impression that something was wrong with me and that I was a failure and that everything had suddenly changed somehow for some inexplicable reason. I was totally unaware of the switch that had been made and yet the effects were huge and now in retrospect I can now see just how obvious it all was. I am one quarter away from graduating, and have been doing sooo well. In just this one week (the week before finals) I managed to completely cause myself to fail a class. Now, because of this awful generic “medicine” i have to retake this class and my graduation has been pushed back an entire quarter. All the extremely hard work I put in to this class these past nine weeks has gone down the drain because of the lack of effectiveness of this fake drug. I might as well have been taking nothing this entire week.
    I detest insurance companies and our country’s immoral health care policies. I can’t wait until things change.

  21. I completely agree with the Grace’s post above! Them same thing just happened to me! GENERIC ADDERALL XR IS WORTHLESS! I was diagnosed with ADHD in 2nd grade. I used to take dexedrine (which worked great, by the way). Then I was switched to adderall xr while in junior high. The name-brand adderall works great! I’ve always been an A/B student, and succeeded in everything I do.

    For reference: I took 40mg of Adderall XR in 8-12 grade. Since graduating high school, my dosage has fluctuated between 45-50mg.

    II’m a Mechanical Engineering Senior in college now and have managed to keep a cumulative 3.51 GPA. I was just switched to the generic crap! I’m pissed!

    Initially, I had NO idea this medicine was any different; I was unaware of the generic. But I could tell the INSTANT I took it that it was NOT the same (after the medicine started working). I thought it could be time for another dosage increase. Then my mother told me my prescription was filled with generics. I can’t seem to focus enough to get my work done. This entire week I have been finding it IMPOSSIBLE to do things and have been putting off everything. I feel half scatter-brained.

    I’m double pissed because this happened at the beginning of the Summer and I spoke with my doctor and told him the generic doesn’t work for me. My prescriptions have been noted as “DAW” (dispense as written) and were being filled with the name-brand Adderall XR. Then, for some reason, this month the were filled with the generics. Now I’m stuck with this crap for 30 days! I would rather have NO pills for one or two days knowing my name-brand prescriptions are on the way than get stuck with 30 Days of generics!

    After reading other posts above,
    BOTTOM LINE: NAME-BRAND ADDERALL XR IS MORE EFFECTIVE THAN GENERIC.

  22. I told my boyfriend to put the pill in my mouth without me knowing which one I was taking–it was between Adderall XR and the Teva generic ER. The deal was he wasn’t supposed to tell me ’till the end of the day which one I had taken so that I could make an unbiased analysis. However, I knew within the hour that it wasn’t the real stuff. He finally admitted I was right, it was the generic. So, I took the other half of my 40 mg prescription.

    Usually I take 20 mg in the morning & the other 20 mg about 5 hours later. With the generic, I took all 40 within 2 hours. Nothin. I thought maybe I just had gotten enough sleep the night before, and I was just really tired. I took the Adderall XR the next day & gave the generic another try today. I am tired; I’ve been irritable all day, and I really haven’t gotten much done. I slept 10 hours last night, but I’ve been ready to go back to bed all day. After reading the other reactions on here–spacey-ness; foggy memory; depression–I am afraid to continue taking the generic. Unfortunately, I only have enough of the real stuff for about a week, and I have no idea when I can another real prescription. I don’t know how I’m going to last a month with this bullshit.

    I’ve been taking Adderall for 4 years. It’s like someone suddenly took my medication away.

  23. Hi, I’m a college student and I’ve been taking Concerta for around a year now. I was on…I’m not actually sure what I was on before because it was my mother who always gave me the medicine, and now I take it myself because I’m abroad. But either way, they changed the brand of my medicine because I was recommended a higher dose as I grew older (I’m not sure why, but anyhow this is what happened). If I can remember correctly, my dosage is around 74 mg at the moment, and Concerta works very well for me. I find no side-effects, except of course those days when I take the medicine too late and have trouble sleeping later at night. Concerta is said to last about 12 hours, I’ve found this true, although I can’t really tell myself the effects. My grades have risen higher and I concentrate better, I used to be very depressed sometimes and aggressive–I no longer am. It does suppress my hunger sometimes, but I eat a big breakfast meal before I take it so it’s fine. And also it does keep you up if you take it too late– recommended to take it in the morning. So I guess I’m saying Concerta is a really good brand, at least in my experience :)

  24. I have been on 20 MG XR of Adderall for the past year and I just 2 days ago got my RX filled at the walgreens and it was generic. I have never had any problems with generic brand medication in my life, when I took it about 30 minutes later, it was like I was in a daze. I could not go to sleep, i ended up staying awake until 4 am and woke back up at 6am because I could not stay asleep. I have been on the generic for about 3 days now and everytime I take it I get very jittery and get very sick to my stomach. If I could afford the 250 dollars a month to get it filled it would be worth every penny, I would rather not take this generic crap, it does not work for me at all. I never had any jitters or shakiness or problems eating when I was on the name brand medication, hopefully I will be able to get back on to the name brand because otherwise I don’t know what I am going to do.

  25. Can a dr. write a “no substitution” prescription for a given manufacturer of generic? Or does one need to inquire at the pharmacy (if they will tell you the mfg ahead of time)?

    FF

  26. Greetings Dr. Handelman,

    I’m early 20′s and I’ve just been diagnosed with ADD by a psychiatrist, which is a huge relief by itself. To get to the point, I’ve been prescribed 20mg Rubifen SR tablets (I’m in NZ), which I’m suppose to take up to two of a day. The first tablet on the first day was pretty good, I only got my prescription in the afternoon so I took it at 3pm, but had huge trouble getting to sleep around midnight(my usual bed time). However, during the time it was working it opened my eyes to what I’ve been missing out on for the last 20 odd years. Needless to say I was very positive about the treatment, and felt ready to begin my life again.

    However, every day after that, the effects have been sporadic and intermittent. Some spots it’s great, the rest of the time I feel slightly irritable, sleepy and can’t really focus well.

    Is it possible the SR is causing erratic dosage? I have also had GERD for the past 6 years or so if that matters. Would it be worth asking a doctor to be moved manufacturer or type? I’m really afraid they’ll conclude the drug itself isn’t working and pull it, as when I do feel it working I’m immeasurably better and don’t think I could go back knowing that there’s another better way of living. Should I perhaps stick it out for a few weeks and see if things level out?

    Thanks so much for your time, your website has been a great help for me through the entire process.

    Regards,

    Chris

    • Hi Christopher,
      Great to hear from a Kiwi. I worked in Auckland years ago at the Starship Children’s hospital so I have a soft spot for Kiwis :-)
      Rubifen SR is like Ritalin SR in the US and Canada, and it is often pretty patchy in its delivery of the medicine.
      Ask your doctor if you can get Concerta, or another formulation of Methylphenidate (I don’t know what NZ has approved right now) which is newer and more reliable in its delivery of the medicine.
      Search this site for rubifen – there were a couple of posts on that, and there were good discussions from NZ’ers who may be able to help you out with suggestions.
      Good luck,
      Dr. Kenny

  27. I am a long-time ex-amphetamine user. I grew up during the diet craze of bennies and green-dex expansions. Last Saturday my shrink prescribed adderall. When I picked up the script from the pharmacy I was elated when I read Amphetamine and Dextroamphetamine. I had no idea it was generic. I was told to take two pills a day. 10 mg. each.
    First I took one. I waited about 20 minutes. Nothing. Then I took another one. I waited another twenty minutes. Nothing. Eventually I took the third one and then it hit me. I felt good. It wasn’t the amphetamine rush that I expected, but it was good enough. I was only given 28 pills. Two per day so I cannot take more or I will crash. Therefore I must wait until I can obtain another script. This time I will ask for 30 mgs.
    Was I expecting too much? Is this not the same amphetamine that was made years ago? Or is the problem Generic vs. Brand name? Can I mix with 5 mg Ritalin until I see doc?
    Any info or input will help.
    Thanks

    • Vera, the prescription medicines are ‘medical amphetamines’. Although they are in the same family, they will have a different response than amphetamines you may have bought on the street in the past.

  28. I was told by my pharmacist that there wasn’t a generic for Dexedrine (which seemed odd, since it’s over 70 years old). It’s Dexedrine Spansules 15mg + 10mg. The long duration, halloween-looking pills. Was I misinformed? Or is only the fast-acting stuff available in a generic brand?

  29. I have a question regarding a specific generic brand of Ritalin. I’ve been on Novartis/Ciba Brand Ritalin for close to 20 years now, for ADHD. I’d initially tried some generics, but found the variance between batches each month to be too much of a variance. In the past two years, the company I work for only has a ‘generic’ drug plan. So, if I want Brand Name Ritalin, I pay $175 each month. Here’s the thing. This past month, my psych forgot to write DAW on the script, and I allowed the pharmacist to give me generic. For the first time, I was given Sandoz (generic division of Novartis)generic (SZ 790 on the tablet). And I only had to pay $10. Unbelievably, these agree with me. Being so sensitive to meds, I never would have believed it, but they do. Here’s my question. Can I ask my doctor to write a prescription where he specifies that I want the Sandoz SZ 790 generic, and no substitutions? In other words, would US pharmacies allow such a script written up that way? My pharmacy is CVS. I can save so much money if they can continue to give me the SZ 790 Sandoz methylphenidate. Can anyone let me know about this? Thanks so much! – Chris (in Portland, Maine, USA).

    • Chris – I think you can ask your doctor to do that.
      Additionally – you could just ask the pharmacy (probably each time your give in your Rx) whether they are carrying the Sandoz generic.

  30. I also noticed when I switched from Focalin to Generic brand of Focalin. It made me have negative energy instead of positive like the real Focalin. It also wore off so quickly,then left me more down and rattled. I went back and forth twice changing from Focalin to the Generic form Thinking it was all in my head. Now I am switching back to Focalin for good even though I will have to pay for it. It is not all in your head. Generic Focalin is NOT Focalin.

  31. August 28, 2010

    Hello,

    My name is Barbara. I think I am 52 years old but I am not positive. I have been treated for psychiatric disorders since 1968 and have been on every known anti mental medication like Valium, Ritalin, Prozac, and many more that I can’t remember since then. I was first diagnosed with ADHD combined with Dysthymic Disorder in 1992. I had taken Ritalin 10 mg three times a day along with an antidepressant cymbalta and Buspar for about six years but earlier in 2007 I was having difficulty with deadlines, failing courses in college and was kicked out of the school for dropping below a 1.0 GPA. My physician prescribed Straera, then Adderall XR 20mg capsule SHI once a day along with Citalopram HBR 40mg once a day. I improved in some areas except for school work which is still suffering from tardiness and lack of concentration.

    Before the Adderall I was taking Vyvanse 40 mg but I don’t remember why it was changed to the Adderall. Two months ago the pharmacy switched the Adderall XR to Amphetamine salts ER 20Mg cap. I have become very easily stressed, I haven’t been in any of my online classes for three weeks, and I have missed important assignments, and am becoming ill from some unknown source. I sleep most of the day away, when I finally wake up to work on school or job related paperwork I fall asleep at my desk and some times collapse to the floor. My blood pressure is way too high, I am unable to prepare meals for myself and so eat what ever I can find in the kitchen when ever I can.

    My back and legs are in constant pain with swelling of the ankles and knees. I sweat profusely day and night; I get stomach pain every time I take my medications or eat a meal, followed by either constipation and or diarrhea. I am very agitated and disorganized to the point that I can’t remember what I am supposed to be doing at present nor do I remember anything I did yesterday. My family members are very anxious about my mental state and the amount of pain I am experiencing. Mind you I take Naproxen 500mg twice a day, Celebrex 200mg (when needed), Tramadol HCL 100mg four times a day, Hydrocodone-APAP 7.5-500 TAMAK, and Mirapex 0.125mg 3 times a day just for the pain. I also take Zolpidem Tartrate 10mg and Nortriptyline HCL 50mg to sleep at night which should last only eight hours a day but at times can last for days while on others I remain awake no matter how much I have taken. Twice I have been rushed to the hospital from collapsing in a classroom and being unresponsive to EMP personnel and recently my doctor sent me to the ER thinking that I was having a heart attack. It turned out to be a severe case of acid reflex.

    I have allergies and take Singular 10mg once a day, Guaifenex PSE 600 mg twice a day, Zyrtec at bedtime during the summer and Xyzal 5 mg at night in the winter. . I take Lisnopril 10 mg once a day for my blood pressure, Klor-con 10mg for unknown reasons, and 324mg of Ferrous Gluconate three times a day for iron deficiency. I was supposed to take Nifedipine ER 30mg for my blood pressure but the first week of taking it caused me to bloat out three to four sizes and I gained over twenty pounds in one week.

    I forgot to mention that I have been diagnosed with Acid-reflex disorder and irritable bowel syndrome. For these I take Mirapex with 8oz. of water daily and I am supposed to be taking Protonix twice a day. However my insurance company MVP has ordered my physician to prescribe Prilosec OTC twice a day which the pharmacy was ordered to change to Omeprazole DR 40mg capsule twice a day. While the Omeprazole manages the acid reflex it does nothing to help with the constant stomach pain and diarrhea which, I believe, the Protonix did control. Actually my insurance company has been dictating the treatments for my medical needs and which medications I am to take for some years now.

    At the present I am on twenty medications. I am in terrible pain from the neck to my toes, I don’t eat proper meals, I sleep most of the day, and I am very depressed. I have been experiencing delusions and dreams, both night and daytime, of events out of reality and at times I dream of murder and suicide, I would assume from watching too much CSI and television. I am unable to read books or the computer any more; I can’t concentrate on any tasks especially my school work at Kaplan’s Online University. Recently my vision has become blurry and I am having headaches and earaches. My mouth is constantly dry and I am very thirsty all the time.

    As much as I love and trust my physicians I wish that there was a clinic with a Dr. House where I could go to for detoxifying and proper analysis of my physical and mental health. All I want to do these days is to become clear headed, healthy, and able to take care of myself so that my daughter can live her own life and not be responsible for my well being.

    I have not mentioned that I also have been diagnosed with arthritis in my hands and spinal chord with stenosis in the lower, middle, and upper back as well as my neck and to top it off degenerative spine through out the lower lumbar region. I refuse to have the spine and neck fussed or have rods installed the length of the spine and neck. When I feel up to it I try to walk two to four miles a day partially with an 18° incline plus some stretching and bending exercises I was taught in physical therapy. However this routine is becoming more difficult to achieve every day.

    I think I have covered most of the bases, I know that I am not your patient and that you are limited by ethics to advise me but I would like your professional opinion concerning the medications I am taking, their interactions with each other on the overall grand scale, and some advise I can pass on to my Doctors and pharmacist. I would be happy to supply their names if this letter were private. But since it is not I await hearing from you directly in the near future.

    Sincerely yours,

    Barbara

  32. My son has ADHD and I will attest to the differences in the same medicine manufacured by different companies. He has tried MANY different medicines over the past 5+ years, trying to find one that would work with out a lot of bad side effects, and has had many different reactions. We found that Mallinckrodts IR dextroamphetamine worked the best with little to no side effects. When the perscription was filled with Barrs version he had a terrible reaction. Unfortunately Mall. quit making Dextro. Now he is on Watsons Methylphenadate 5mg tabs for a dose of 10 mg q 4 hrs. This works well for him it is just too bad it doesn’t last longer. He tried Concerta which made his tics really bad as did the generic Sandoze IR tablets. I find it quite disturbing that there is that much variability between manufacturers.

  33. I have been on Adderall XR 30mg for 4 years and my doc writes no substitutions brand name and the pharmacy always feels the need to do what they want and give me generic and I have to argue with them. Then the insurance company decided I didn’t need brand name and I had to tale generic Adderall XR or pay out of pocket and that was not an option. I took the generic for about 5 days and thought I was going out of my mind extreme agitation, headaches, body aches, anxiety, felt like I was out of it mood swings couldn’t pay attention for 2 seconds. I called my doc and the insurance company they said if had tried all other otions and my doc sent proof then I could appeal and get brand name Adderall XR my doc did this I was approved. Problem is the pharmacy they always feel they have to change it and argue there is no difference and there is they do not take it and everyone reacts different. I just came home from the most embarrassing moment I went in to fill my Adderall XR same place I have been for a year and they had a new pharmacists who proceeds to yell across the pharmacy BRAND BRAND WHY? Wanted to know who prescribed it what kind of doctor, what insurance I have why do they pay for it and argued in a very nasty way that their generic is the same he didn’t know where i got my other generic. made a huge scene in the store everyone herd what I was taking my information and I told him it doesn’t matter to him if I get generic or brand he still gets a pay check and the prescription is still paid for and he is not a doctor and had no right. Adderall XR not only helps me with my adhd but help with my moods and anxiety many think I tale it for energy and I do not I am wound up with out it it slows my mind down so i can focus and concentrate and with that racing thoughts slow down and my anxiety goes away. They need to do something about this issue generic is in no way the same and it messes people up. They need to get rid of the generic Adderall XR

  34. I have experienced a problem with the generic Adderall XR as well. I have noticed that one brand (Corepharma) made me jittery and not quite as focused. But I am in a much more positve mood and I feel more connected emotionally with others around me, which is important to me because I have a husband and 2 kids.

    The other brand (Barr) makes me feel disconnected from my loved ones and sightly depressed. Intrestingly, I still feel very anxious- partly because I can sense my family notices my emotional distance and partly because this brand of generic Adderall XR descends upon me like a ton of bricks and when it wears off I can feel it lift as a fog does when the sun comes out. According to many blog sites that I have read, most people experience the same results as do with with each brand.

    I only take 5mg in the morning and 5 mg in the afternoon because I only want to allieviate the anxiety of being a working mom and wife. I prefer to manage my ADHD by eating healthily and exercising regularly. In addition, I simply do not take on more than I can handle.

    Unfortunately I am still very bad with time management and everything takes me 3 times longer to complete than the average person- but with structure, organization and discipline- I can cope and do quite well.

    Pharmacies do a great deal of harm to me when they switch my brand without notifying me. This, perhaps, should be a legal requirement imposed upon all pharmacies. Insurance companies should be required to allow a patient to purchase the non- generic form of the medication at a slightly higher cost, without exception.

  35. I have been prescribed Adderall for nearly 7 years. In that course of time, I have had numerous experiences with both generic and name brand. When my insurance expired a while back, i had to venture toward generic. I have found myself to be highly sensitive to the differences between each generics, depending on the manufacturer. CorePharma was THE WORST… resulting in instant and intense anxiety followed by a Tachicardia like episode (Immediately contacted my doctor…) This generic version CorePharma produces should not even be on the market. I’d discovered that Barr, at the time, produced a generic that was decent, as did Sandoz but I still get a markedly higher amount of anxiety and grouchiness. Then Teva was discovered to be the closest generic I could take to rival the name brand short acting adderall. There is a huge difference between the generic and name brand, and it defInitely varies between each generic maker as well. It’s pretty frustrating to say the least…

  36. My 8 1/2 year old son is taking two 5mg. capsules (d-amphetamine sa barr – generic for dexedrine spansule 5 mg) in the morning and one or two in the afternoon. They seem to have little effect. He still has some appetite (which is a plus, as he only weighs 48 lbs.), but focus and being able to comply with home and school directions and requests is very difficult. I want to switch him to regular release tablets in hopes of a quicker and stronger result from the meds. He has been on various other ADHD meds (Vyvance, Daytrana, Focolin), but side effects have necessitated taking him off them. While researching, I’ve read lots of positive feedback about Dexedrine, which is why I wanted to try it, even though it seems to be viewed as “old school”. My pharmacist here checked and found that brand would cost about 200 a month, which I can’t do month after month. We are now using pills made by Barr, and I have read over and over that the pills manufactured by them do not work as well, have more side effects, etc. Any suggestions on what manufacturers currently make the regular release and extended release that work well, and where those can be found? I live in Florida. Thanks.

  37. Thank you everyone for your comments, I have been thinking recently that my concerta(generic) just isn’t working the same. I have gained weight and have just struggled alot more with my school work. I now realize that it is because of the switch to the generic brand. I am going to go to the doctor this week and ask if they can write no substitutions on the prescription and even if i have to pay i’ll take the real thing. It just feels as if it doesn’t work at all sometimes, and before I was a machine in my graduate studies, and now I am barely able to get through reading. I will ask about the co-pay but it may not be in Manitoba as of February 2012. Thank you again for the information!

  38. another issue that bothers me is multiple generics even the effective ones being rotated when I went to get certain meds caused the new med side effects.

    I know I am the oddball but the 10 mg Teva generic focalin is my favorite medication. Brand Focalin and xr used to give me this feeling in my body hard to explain but it was almost jittery.

    Also, my insurance only covers generic and if it is over 20 mg (the ir limit), it has to be dosed four hours apart like the 40 mg xr and my insurance refuses to give me an afternoon dose so I am switching to the 10 mg barr tabs 20 mg 3x daily. I like both for different reasons but I am starting summer classes and need to be covered for late in the day and I don’t understand the big deal. My friend’s little brother is 11 and sits and plays xbox all day but he takes 3 of the 40 mg XR focalin at lunch… I used to take way more than I do now too as a kid but I hope that it is just the insurance being cheap because although most women I have met take a one a day xr med that is less than I took at age 4, some of us, who spent our lives on these meds and have exceeded the dose set by the FDA because there is no “legit” dose or form that is better or worse than others… it varies.

    • Also, Mallinckrodt Dex made me have a psychotic episode and Mallinckrodt Methylin ER made me anxious, panicked paranoid etc… IDK what it is but one of those fillers must make the drug more bioavailable to my brain or something because both of these brands at the smallest dose felt like I was on crack.

      I used to think Dex was a no go but after the rotating between brands and having pure hell each time with that one brand with Ritalin SR and spending years on Dex and having none of those problems…

  39. Apparently the generic form of Metadate CD just came out. My pharmacy was all excited when they told me I was now getting generic. I was upset because I told my doctor I don’t do well on generics, but he didn’t indicate this on the prescription.
    Since being on the medicine for 5 days, I feel like my ADD is not treated at all. I have constant headaches, cloudy thinking, and am cranky and weepy. Even my 17 year old son asked me if I’ve been taking my medicine. He has looked right at me and told me something and I either didn’t hear it or forgot it. I don’t like feeling this way.

  40. My son is has been on Adderall XR for several months now. He is 8 yrs old, and several months ago, during the fall, we had a visit with his Dr and after some consideration began a very low (5mg) dose of Adderall XR for ADHD. It’s been about 6 months now, and we inched our way up from 5mg to 10, then 15, then 20mg, which was really seeming to have a good effect without making him have any negative effects (drowsiness, etc). At his visit with the Dr the week after Christmas his Dr decided not to increase the dosage again and gave us a prescription for his next month of the 20mg. This whole time we have been getting the generic prescription of this rx, and we got it filled on New Years Eve…and we have had instant problems with this month’s prescription. Granted with staying up til midnight with us New Yrs Eve, we slept in a lot the next day, but after taking his med that day, the following night, he STAYED UP ALMOST THE ENTIRE NIGHT!! Probably fell asleep around 4 or 5am, just to have to wake up at 6:15am, incredibly tired for the day. I thought it was connected to the staying up for New Yrs Eve and didnt even think about the new prescription we’d just started (because it was the same 20mg and we hadnt changed, I thought it couldnt be that). However, since taking this new prescription, Tyler’s behavior is almost like he is not even on any medication…all his previous behaviors, irritability, inability to focus on anything, constantly moving, unable to hold in comments or talking when he wants to say something, even when it gets him in trouble, and just …basically like if I didnt give him the medicine at all. Which is awful, because right before Christmas break at school he’d been doing SO WELL, and really had been able to catch up and have much more control over himself and everything.
    Ok, so the thing I didnt say was that we had to get THIS prescription at a NEW pharmacy, one we’d never used before to get his medication. Usually I would use either the Meijer Pharmacy or the Walmart pharmacy to get it filled, but this time I went to the Walmart one on New Yrs Eve, and they said they only had 10 pills of Adderall XR (generic) 20mg at that point and wouldnt have more til that Friday…and they werent allowed to dispense part of the med because it is controlled. We were going to be out before Friday, so I opted to go across town and check with the Walgreens to see if they had some in stock, and they did, so we got it there. We’ve never gotten it there before and the only thing I can figure is it is possible that the manufacturer of the generic Adderall XR 20mg from Walgreens (Global mfg) was different than the Walmart generic manufacturer (Teva)…and this is causing the distinct difference in my child!! :/ It totally makes sense what Dr Kenny’s previous post says about there being a possibility of a 40% variant to the rx, because if the regulation says that there is only a 20% difference allowed, if he’s switched from one generic to another generic, it could be a 40% potentially. The Dr is making us go back in to have a visit sometime in the next few weeks, she wont consider anything else, so as soon as we can get back in there, we’re going to see what we can do about getting another prescription and getting it back at Walmart with the Teva manufactured generic. I think the Dr thinks that his body “suddenly” became adjusted to the 20mg rx and he may need to have an increase, but his behaviour changed so radically and so quickly, with the only change being the new prescription, that after reading some of the info on this, this is the only thing I feel like it can be. And until thinking about it just a little while ago, I dont know how I didnt think that the “staying up all night’ bit on New Yrs night wasnt connected…oh well. Guess we’ll see what happens. Until we get in to the Dr and get this resolved, I’ll have a kid on my hands without the ability to control himself, which is sad, because with the rx he has been doing so well and this really helps his self confidence, relationships at school, etc. Sigh.

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