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Is there a difference between branded and generic Lamotrigine? Generic £4 for 28 days but Lamictal (GSK) £56.

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ecossaise profile image
ecossaise

I don't have an answer as such to your question but just wanted to add that I live a lot of the year over here in South West France and I am on Lamotrigne, which has always totally controlled my seizures; I have been on the generic form for 5 years now - both in the UK and here. Then, a few months ago, when, out of the blue, I started to have nocturnal seizures again, my French GP changed my prescription to Lamictal - the new prescription marked in very bold letters "NOT TO BE SUBSTITUTED FOR THE GENERIC FORM"! At the pharmacy which I always use, they all, the senior pharmacist included, said they had no idea at all why this would make any difference. I put the query to my GP and she said there was new information available which said that there were some subtle differences which meant it that it could make a difference to my seizure control. My pharmacist is still very skeptical about this as she can find NO difference whatsoever in the constituents of the two "brands"!!!!! Additionally, there has been no obvious change in my seizure control using Lamictal!!!!

I don't know if this adds anything to the question but I thought it might be of interest at some point.

shanomeara profile image
shanomeara in reply to ecossaise

I have been on lamotrogine for grand mal seizures for about maybe six months now. Since I started the lamotrogine last October, I have had no seizures. I even asked my doctor if there was any difference. Why would there be different names for a drug that does the same exact thing. The doctor told me that the brand name could have a soluble coating on it that would make it easier to swallow. It seems the brand name might have some inactive ingreients that the generic does not have.

EpilepsyInst profile image
EpilepsyInstPartnerEpilepsy Research UK

Hello pezenas

Further to ecossaise's response, generic and branded forms of a drug have the same active ingredient, but sometimes they are in a different chemical form. This means that the way in which they are absorbed (their absorption profile), and even the way they act, can be different. Regulations state that the absorption profile of a generic must be very similar to the branded drug; however this can be within a certain range. Therefore if the profile of a branded anti-epileptic drug (AED) lies at the top end of that range and the profile of the generic version lies at the bottom end, changing from branded to generic could potentially lead to breakthrough seizures. If a person's seizures are well controlled with a branded AED, it is not recommended that they are switched to a generic form. As Ecossaise says, you can ask your GP to write NOT TO BE SUBSTITUTED FOR THE GENERIC FORM on your prescription and the pharmacist will be obliged to give you the branded version. I hope that this is helpful. All the best, ERUK_RI

pezenas profile image
pezenas in reply to EpilepsyInst

These are very interesting points. I have been prescribed 5 different drugs over the last 10 years but I knew nothing about branded as opposed to generic. The change each time was because of undesirable side effects from depression to thoughts of suicide. I have been using Lamotrigine now for a year which has been successful apart from brief periods during the last 6 months. I took more interest recently when the tablets being supplied changed to soluble and then the following month to a diamond shape tablet rather like an oversized Viagra. These changes with three different pills in 3 months coincided with a series of petit mals. I took this up with my doctor and he had no hesitation in changing my prescription to Lamictal but added his comment about the cost. Has there been any warnings from the powers that be. I remember some time ago attending a lobby at the House of Commons in protest about the use of generic drugs but don't know if there was any reaction from the government following the lobby.

ecossaise profile image
ecossaise in reply to EpilepsyInst

Hi there - I really appreciate this very interesting info about Branded versus Generic versions of certain drugs - I had never heard of it before until my GP wrote this on my prescription - luckily for me, she was taking me "UP" the ladder from generic to branded so I had no unpleasant side effects. It is great to understand more about why we are swallowing certain types of meds!!!! Sometimes doctors forget that we might like to know a bit more about our prescriptions!

Like Pezenas, I noticed the change of shape and also the swallow versus dissolve in mouth versus chew instructions given with different versions/shapes of the drug

Thanks again for the info - that's one of the great things about this forum

EpilepsyInst profile image
EpilepsyInstPartnerEpilepsy Research UK

Hello there, thank you for your messages. Please note that the difference between generic and branded medications mustn't be over-stated. Generics should be as close as possible to the branded version, and for a lot people will 'work' just as well; in which case there isn't a problem (many people are prescribed a generic from the start and find very good seizure control). It's just that it is possible that branded and generic versions will lie at opposite ends of the 'range' I described above, and so switching when seizure control is already good (and the drug is well tolerated) isn't advised. A breakthrough seizure can have enormous implications (as you know), and so the bottom line is if seizures are well controlled and the drug(s) well tolerated, the decision to change to a different form must be very carefully considered (by both the person and their doctor). All the best, ERUK_RI

Hello I find my Pharmacy alternate with my Epilepsy Meds, I fortunately do not have health issues with generics. I take Lamotrogine & Levetracetam.

pezenas profile image
pezenas

Since my original post I had a discussion with my epileptologist and it seems the problem stems from the difference in formulation of generic drugs, not only between them and the branded version of Lamictal. To quote him exactly he says "The bio-availabilities of different brands of medication may vary by up to 45% and this may lead to breakthrough seizures or the emergence of side effects. It is on this basis that we usually recommend that the patients stay on the same brand of medication. This is sometimes difficult to achieve unless the original branded medication, Lamictal, is prescribed as pharmacists will stock different generic preparations at different times". I have since discussed this with him and he says that provided the generic version remains the same each time and gives full control it would not then be a problem. It's the continual change from one generic to another which is the problem. They all contain Lamotrigine but in different formulations. You can always see by the box containing the pills if they are generic or branded. Generics are simply called Lamotrigine but branded Lamictal.

Sambla profile image
Sambla

I noticed the difference. my pharmacy tried to convince me there was no difference. I spoke to my neurologist and she said she would write a letter to my GP and he still didnt want to prescribe it saying there was no proof of difference. The neurologist the wrote a letter with statistics proofing there is a difference. Its to do with the cost of the drug. The chemist tried to fob me off as well by giving me cheap brand then I stood my ground and they gave me the original brand.

gerrymob profile image
gerrymob

My pharmacist told me this week that he dispenses Lamictal to all pprescriptions received