Question about generic warfarin

[Rosemary76210]

While praying for the people with APS today, this question came to mind. Do some generic brands of warfarin work better than others. Have those that don't respond well to warfarin tried a different generic brand or the name brand before writing it off?

[Rosemary76210]

Thanks. My daughter had noticed that one generic brand of a drug she was taking worked better than another generic brand, but that was not warfarin.

[GinaD]

Name brand drugs are scrutinized very carefully when they first come out. Generics because they are building on the success and diligence of the original name brands – not so much. Here in the states, a doctor once told me that when taking a medicine the dosage of which was effective when averaged out over several days, such as an antibiotic,then a generic was fine. But if taking the medicine where the dosage needs to be very specific over a limited period of time – such as steroids - then the name brand would be a better choice. This doctor used to be a pharmaceutical representative before he went to medical school. And yes, generics do have standards they must meet. But, those standards are not as specific as the ones which the name brand must meet in order to achieve their initial certification. When I first started taking warfarin I stuck to the namebrand Coumadin. But after I became an expert on how my own body's INR reacted I was able to switch to generic warfarin, which is much much cheaper.

[Blue2 in reply to GinaD]

I use a Coaguchek XS to monitor my husband's INR which can be all over the place, despite the days being much alike, so pretty nonsensical. He was taking TEVA brand and when I searched on the net, I found many FDA citations for their poor product and many batch recalls. Which shows you shouldn't blindly trust the manufacturer! My glicazide by the same company also produces idiotic results.

[Lure2 in reply to Blue2]

Hi,

Does your husband have Hughes Syndrome/Antiphospholipidsyndrome as we all have on this site?

We can only answer those with our illness as we are not medical trained only know our illness.

Best wishes from Kerstin in Stockholm

[KellyInTexas Administrator]

Hey Rosemary, my fellow Rose of Texas,

The answer I have found from pharmacists is mixed. I have not asked hematologists. I, however, just made the switch from warfarin to brand Coumadin because my INR is so unstable I'm trying to isolate to cause variable by variable. Luckily my insurance, BCBS of Texas, covers it at the exact same coverage as brand name.

Two very reliable histories, and I encourage you to call these men for yourself for further detail to ouble check my memory, or ask further, more specific questions:

1. Steve Ackman , pharmacist at Walgreens in Kerrville Texas. On Jefferson street. He's an older gentleman who used to own his own pharmacy here for years, before he sold it. Our daughter went to high school with his son- they are 25 now. He said brand used to be a little better than generic, but not any more.- a few years ago, not sure how many- generic was reformulated and it's better.

2. There is a man maned Pete at the emergency clinic ( private- franchise) "Neighbors" in Kerrville. I go there for Doppler sonograms to avoid big hospital ER rooms. He used to run Coumadin labs in Florida. ( collect and graph and analyze Data.) He said brand Coumadin is far superior to warfarin.

I do wonder if he did this job pre or post switch to warfarin making the change in their compounding. I'm not clear on that.

The other huge advantage for me is that with brand Coumadin each tablet is a different color. 1 mg tabs are pink. 5mg are peach. 10 mg are white. They are perfectly round. They are also scored.

I take 16 or 17 mg daily, so it's easy to see what I'm doing when I have the different colors. I also take 5 tablets of anti convulsants, white. The plaquinil. White. Another POTS medication. White... and I'm loosing my vision, oscollopsia, so it's so much easier and safer for me to have the brand Coumadin visually.

I'm much happier.

[Holley]

When I was first diagnosed, I was in my target INR range more often with the name brand Coumadin. Fast forward to a time when finances became worse and I switched to generic warfarin. I seem to be doing okay with it.

[panda60]

Been on warfarin since 2008. Haven't noticed any difference between different brands.

[Rosemary76210]

Thanks, everyone. I learn so much from you all.

[Tofino5]

Some people have unstable INRs no matter if using generic or brand.

I was on Jantoven, which is a "brand generic". This means that the binders and fillers are same, batch after batch, year after year.

Most generics use whatever binders and fillers are the cheapest at time of manufacture, which can influence how the medicine (in this case warfarin) is absorbed by the body.

[nyctapdancer]

My internist and my hemotologist both tell me to stay on Coumadin since both have had patients with issues with generic Warfarin. I've been on Coumadin for almost 20 years, without incident. So, they are telling me: if it ain't broke, don't fix it.

Generic sure would be cheaper, but it's not a chance I am prepared to take at this point.

[Wittycjt]

If you are concerned about the generics ask your ordering physician to just check the " do not substitute" area on the prescription. Then the pharmacist can only use "Coumadin" as written on the prescription. If physician orders it this way I believe insurance will cover it (should this be a concern). Good luck, keep us posted as to how this works for you.