I just wanted to ask if Branded corticoides are better that Generic. I just realised that when I felt really awful before my trip to the US, it was partly because they tapperd down too quickly but also I had started on a different generic. I renewed my prescription and was given the original generic I started on back in Nov when I was first diagnosed and felt immediately better. Most nasty symptoms disapeared within 48h as many side effects of preds are similar to GCA symptoms it was difficult to differenciate. So, I was wondering if I should try to get non generic and what has been people’ s experience with Generic versus Non Generic.
I understand this is more a medical specialised field but hearing about experiences of others will be interesting and usefull.
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Zozoi
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Hi zozoi...I find this with a lot of drugs. I have come to put it down to the fillers they use to bulk out and construct the drug. I don't really think it's about the pred itself so it's about finding a brand that works for you.
Hello, there have been people here noticing a difference when they change brand. I hope they’ll reply. I’m sure I’ve had a seemingly harder run of reductions with my enteric coated Pred, then it felt easier. I then noticed it was a different brand. As it isn’t too bad I don’t bother trying to work it out because I get what I get from a range of brands from my surgery.
I think in the scenario you describe the difference is more likely to be because you tapered too low, and your initial tablets caused the ‘miracle’ a lot of us experience. This I feel that would be unfair reasoning to diss any particular brand.
However, some people do notice a difference, but that would need to be tested whilst not reducing/travelling/flaring.
I know for defo that different brands of metformin and co-codamol have had really different impacts on my digestive system and length of pain relief. Whether it's related or not my sleeping pills changed 2 months ago and I don't sleep as well, but that could be a new drug too.
My Pred is often different brands, even from 1mg to 5mg but there was only ever once l doubted the Pred, l checked l wasn’t taking 2x1mg instead of 2x5mg (you never know) but l changed the packet & l started picking up again, so you never know......
The drug included in generics is the same - but the fillers used in the tablets may differ. Some people have problems even with a branded version of something as it is the fillers that usually lead to the problems. As Poopadoop says you need to find a manufacturer that works for you and then try to stick to it.
I had a new batch of enteric coated 5mg and 2.5mg, the previous variety had been OK, the 2,5mg were fine, the 5mg weren't, they simply didn't work! They were all generic - it was in the UK, you don't get brands if a cheaper generic is available.
They take much longer to work - and inititally you may need a higher dose to get a higher peak blood level.
Chemists get sent the batch that was negotiated as the lowest price from the supplier - and in the UK that may include ones that have been purchased abroad and re-imported! It is a strange system!
Hi. I am a retired pharmacist so can flesh out some of the above comments.
The British Pharmacopoeia has standards for tablet manufacture and these include the type of fillers, lubricants, dyes etc which are included in the mix to enable a tablet to be pressed by the machines. Dissolution testing is also important as this gives standards for how quickly the tablet dissolves after swallowing and where in the gut it dissolves. Most tablets dissolve in the highly acid environment of the stomach but those with enteric coatings or sustained release formulations dissolve in the small intestine where the environment is less acidic. Before a manufacturer can produce a tablet it must prove to the MHRA (Medicines and Healthcare Regulatory Authority) that the formulation they are using complies with the BP standards and that the amount of active drug released also complies. Then the product is issued with a product licence. Each manufacturer will have a slightly different recipe but the tablets will all contain the same amount of active drug. In theory all manufacturers 5mg Pred tablet should have the same therapeutic effect.
But of course we know different!! In the real world some patients do say that brand X doesn't work but brand Y does. I have had numerous conversations with manufacturers over the years only to be told that the patient is wrong and it can't happen.
So PMRPro is correct. If you find a brand that works try and stick to it but these days that isn't easy because of availability of supply and the way the NHS reimburses the chemist shop for the cost of the medicines, but this is another story........
Thank you everyone. This has been very helpfull. I am also wondering how imported drugs, generic or not will be affected by Brexit.
I understood the drug itself was not the issue but the compenents were differents, even on the side effect list varies from one manufacturer to the other. Im doing fairly well on Almus, so I won t tempt the devil by trying something else.
Tappering down by 1mg started this week, let s cross fingers I ll be fine. The consultant realised that she might have been over enthousiastic and now ordered a 1mg down every 3/4 weeks.
PMRPRO, I will fill in my GCA symptoms list. It s being edited as I believe it s about bullet points.
"I am also wondering how imported drugs, generic or not will be affected by Brexit."
Like everything else - so is everyone else!!! There are already 120 drugs used in the NHS on a daily basis that are posing procurement problems according to NHS hospital authorities.
But it was already a problem - and they haven't left yet!! Anyway, now I should have my Italian pension before the UK leaves so I will have medical cover. All we were worried about ...
If you look on the box, there will be an address for the MA (marketing authorisation)holder. For prednisolone they will generally be UK addresses so supply should not be a problem. Years ago when generics started to swamp the market and once we joined the old Common Market, there were Parallel Imports which were over-labelled with UK MAand Product Licence numbers. This happened because some branded medicines were cheaper in Europe than here in the UK, so pharmacies used them to increase their margins and offset the clawbacks in payments which the Prescription Pricing Authority imposed on other items such as colostomy appliances. Pharmacies are businesses and although contracted to provide NHS services they are not owned by the NHS., and the NHS provides only part of their income,
Yes there have been shortages recently but as far as I know some of them have been due to problems in manufacturing the raw drug ingredient. There seems to be a lot of scare-mongering re Brexit with radio-isotopes being cited as one of the things which may be affected. Radio-pharmaceuticals are generally manufactured by specialist pharmacists and nuclear medicine technicians, in house, in hospital. Yes they have to obtain the technetium to do this but individual doses designated for a particular patient are not likely to be stuck in lorries trying to pass through customs.
No longer - many in-house labs have been closed and centralised. But if the stock isotopes are delayed - they can't make the individualised doses. And the delays are not like a delay for a bottle of orange concentrate which doesn't go off. The radioactivity decays, falls off, over time so when it arrives, it is only half what was expected.
You really seem to be in the know, PMRpro. It is a grim scenario, albeit a very realistic one. I always suspected that ''Brexit will not cause a shortage of medicines'' was a con. Hope no lives are lost.
It isn't where the stuff is distributed from in the UK, it's where the manufacturer is - and there aren't that many in the UK these days unfortunately.
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