Parkinson’s UK put out a warning when a 65-year-old man who had been successfully managing the condition for 17 years suddenly needed help eating and getting dressed.
This happened after his branded medication Sinemet was changed to a cheaper form of the drug.
This is an important finding, one that affects almost all PwP. It is not just a case that the generic is less good than the branded drug, though this may or may not be the case. But, rather that, changes of the drug's strength may cause problems.
Bioequivalence is defined as:
"The products are considered bioequivalent if the 90% confidence intervals for the ratio (generic/innovator) of the means of Cmax and AUC are within the range 0.80-1.25 ... The 0.80-1.25 acceptance range accounts for statistical error and is internationally considered to be clinically insignificant ...
The actual difference in exposure to the active ingredient between generics and innovators is typically less than 5%. "
medsafe.govt.nz/profs/PUArt....
In most diseases a change of 5% in the size of a dose would not be noticed, but in PD the effect is noticeable. In the best case a dose of 100 mg levodopa every 3 hours, 5% equates to about 10 minutes. In the worst case, where the patient was only medicated to just reach the "on" threshold, the generic may never reach the threshold. And, it's not only lower doses that create problems. Another possibility is that an increase in effective dose can take the patient above the levodopa induced dyskinesia threshold.
John
That happened to me several years ago switching from a generic to a brand name (non-Parkinson’s) med. The pharmacist said that people can even be affected by different binding agents. And when you consider John’s info, little wonder there are problems.
I hAD A SIMILAR EXPERIENCE. I SWITCHED PHARMACIES AND WAS GIVEN A DIFFERENT GENERIC C/L PILL. AND I NOTICED THAT I WAS HAVING SHORT TERM RESPONSE TO THE MEDICATION. SO WHEN I USED THIS UP I SWITCHED BACK TO MY ORIGINAL PHARMACY. AND THEY SUPPLIED ME WITH DIFFERENT PILLS. I HAVE TOO MUCH TO MANAGE WITH PD TO FIGHT THIS BATTTLE WITH DIFFERENT GENERIC MANUFACTURES.
this is so sad, but i am not surprised... as i posted in another healthunlocked response:
I manage my wife’s medication and she got a notification from her Medicare part D insurance company that the carbadopa/Levadopa ER she was taking was no longer covered. I also had to change our address since we had moved in December.
I tried to change the address online but was directed to call an 800 number. To my surprise a very helpful lady got the address changed and then forwarded me to another department to get my wife’s medication pre-approved for the whole year.
I was amazed that I was able to get everything done with a single phone call and found not one, but two very helpful ladies that were able to make my day! I was pleasantly impressed with the attitude of both ladies that made it their goal to solve my problems.
My wife always says that “if you don’t ask you don’t get .”
What is the 800 number?
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