I was diagnosed in 1989, and I'm sure I have taken several generic brands for hydrocortisone due to the cost of Cortef. A few days ago, the phamacist gave me a mixed 90 day script containing 2 different generic brands (these 2 types were separated by cotton, so there were not mixed together). About 5 days ago, I started taking the first of the script. After a few days, I started to feel like I was heading toward a crisis. I had muscle cramps, several nausea, headche, weakness, etc. I retraced my steps to see what I had differently in those past few days, and the only thing I could think of was that I took a different generic brand for hydrocortisone. So, I quickly switched to the other pills at the bottom of the bottle, which I did recognize has having taken these before. I doubled up on my usual doses, and I am feeling so much better!! I called the pharm and explained to her, but she said that there is no difference in generic hydrocortisones. Would you please state your opinion on this matter? Thank you!
Your pharmacist gave you the only answer she can give you without losing your business. The background facts resulting in that cotton being stuffed in your pill bottle are as follows:
Big name pharmacy chains control inventory at all pharmacies, including selection of generic drug manufacturers. This way whatever generic is available on the market for the least expensive price is distributed to their chain of pharmacies, thus saving the chain money. You pharmacist told you there is no difference, and what she means by that is all generic prescription drug manufacturers are put through the same FDA approval process before their product is made available for distribution. However, since adulterated prescription drug products are known to have reach patients and since you yourself testify to noticing a difference between two different drug makers, I think it is safe to say, in some cases, that this approval process and the quality of the drugs it safeguards is not 100% perfect.
What I would do if I were you is stop using a chain pharmacy and switch to an independently-owned drug store. Independents have greater freedom to help patients with specific issues. Take the pill from the generic brand you prefer to an independent pharmacy. They can I.D. it, transfer your prescription to their pharmacy, and order that specific brand for you each time. Some chain pharmacies will offer to do this as well, but you have to search for the right pharmacist willing to go above and beyond for you.
There is a difference. I have a friend who has addison's disease and she can only take one brand of generic. The others do to her what that one did to you. See if your pharmacist can keep a supply of the brand you need. Tell her if she can't you will have to change pharmacies. The generics all have different inactive ingredients and that can change the absorption of the med.
I have had to take name brand corfef for my Addison's since 2001. They first put me on prednisone which caused tons of side effects along with me being allergic to it. Then I was switched to hydrocortisone generic with much improvement in side effects but finding myself increasing my dose to obtain enough strength. My endocrinologist wanted me on minimum 30 mg per day but it put me in the ER every weekend with a crisis and low cortisol blood levels. Once I requested name brand Cortef I was only facing a crisis about twice a year when a bad stomache flu hit or other big stressor. I'm currently facing the potential of having to go to generic again and am terrified this is going to happen again. My pharmacist said there is a difference in generics and I'm hoping that is true. But does anyone know which generic is best? It is nice to know there are others who can understand how hard handling Addison's can be. But yes there is different generics that can be better than others according to my pharmacist.
- Cortef Information for Consumers
- Cortef Information for Healthcare Professionals (includes dosage details)
- Side Effects of Cortef (detailed)
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