Since some years I noticed that some of my patients complain about generics which do not have the exact same effect(s), like the branded medications. Well, some of my colleagues would say that this can't be true and they are right in the most cases but some exceptions could appear even here.
Every tablet does not contain just the active agent in all cases, several fillers like starch by maize, potato or wheat plus lactose need to be used to give a tablet it's typical shape and weight. Further fillers could be glucose, mannitol, or sorbitol and they could be combined with several food colors. Here is the point where a generic medication can be different from a branded medication. This is completely legal due only the active agent must be equal but it could cause some problems for the patient when for example he or she is lactose intolerant or has other intolerances against other fillers.
So there we have the first reason why generic medications could cause problems for a patient. But theoretically the branded medication could cause similar problems as well, due it uses fillers as well.
Another important point which has to be considered is which generic do you really have in your hands. They are two types of generic medications available. The official ones and the unofficial ones.
An official generic is produced by a license and formulation buyer. This buyer has purchased the license and the formulation for producing and marketing officially from the company which sells the branded medication further called the inventor. In some cases, the inventor gets paid off completely or he gets a small percentage of every produced and sold pill. These generics are equal (except the fillers) and similar save than the branded drug.
But they are the unofficial generics as well. They tend to get to the customer via orders placed on internet pharmacies. Their active agents are not licensed and their formulations are more or less self-made. If they are equal the formulations were bought on shady ways from spoiled employees working on the inventor side. These type of generics are less saver due their active agent is not completely equal with the original active agent.
Now, everybody will ask himself, how to identify which generic is safe and the Food and Drug Administration of the United States has a good solution for that. It is called 'Orange Book' is free to use and can be downloaded here
. Simply search with your PDF-Reader for the active agent your generic contains like 'Sildenafil Citrate' and get a list of manufacturers who officially purchased the license and formulation from the specific inventor (in our case Pfizer) and when. So you know which Generics are official and safer to use.
So if you want to buy a generic get the names of the manufacturers out of the 'Orange Book' and ask your pharmacist for these manufacturers and you are on the safer side.