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trying to understand difference b/ 2 generics of ritalin
  1. #1
    drcassie8 is offline New Member
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    Default trying to understand difference b/ 2 generics of ritalin

    Hi--

    I have an autoimmune condition called PBC (primary biliary cirrhosis), which tends to affect middle-aged women of North European extraction ("me").

    With it has come an incredible constant level of fatigue. My gastroenterologist suggested I take methylphenidate, as it's being used sometimes with cancer patients with high levels of fatigue. I actually sat it on a shelf for several months when I found out it was essentially ritalin, but finally took it because I need to work! And luckily have done ok with it though the effects seem to go up and down (I skip a couple of days a week so that I don't become a "desperate housewife.")

    My question is this--initially the mail order pharmacy actually sent methylin ER and since it agreed with me, I was fine with that. However, once, when the medication hadn't arrived in time, a local pharmacy filled the order with 'methylphenidate' also I guess ER.

    I know those are supposed to be the same...but the methylphenidate made me sick as a dog every minute of the 2 days I had to take it--as well as MORE tired?! So I'm wondering if there is indeed a difference--I have a lot of allergies etc. so would like to know in case my new insurance company does a switcheroo.

    Thank you in advance for any help you can give me--I've read up a bit on generics and understand that they are not indeed always 'quite' the same.

    Cassie

  2. #2
    rph480 is offline New Member
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    Default Re: Methylphenidate

    Cassie,

    First things first, check with your local pharmacy and make sure they filled the Rx correctly. Although it doesn't happen often, mistakes can and do occur. If it was the wrong drug (ex. Methadone instead of Methylin), or you were given the plain Methylphenidate (instead of the ER), that would account for your bad experience.

    Also, do you have any of those tablets left? You might try using the Pill Identifier on this site to see what drug you have.

    If, in fact, you were given Methylphenidate ER in the same strength and dosage as the Methylin ER, you could still be experiencing an intolerance to the generic (usually it's one of the inert ingredients that causes the problem, and not the active drug itself.) From now on, you might want to ask your doctor to write your Methylin ER prescriptions for the brand only - no generic substitution permitted.

    Hope you get the situation straightened out!

  3. #3
    drcassie8 is offline New Member
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    Smile trying to understand difference b/ 2 generics of ritalin Reply to Reply

    Dear kind and knowledgeable rph480 !!

    Thank you so much for taking the time to help me with this--really. And I have a more recent development if you have time to weigh in on that one!

    First, I did check the pill identifier on this site just now for the 'bad' (for me) medication. The bottle says methylphenidate SA, 20 mg. "Tasan." Checking the actual markings on the Web site confirms contents are in line with the label, except that the site indicates the manufacturer is Sandoz; I don't see any mention of Sandoz on the bottle and thought Tasan was the manuf. Oh well.

    Here is my newer quandry: Since writing to the forum, my insurance carrier and hence mail order pharmacy changed and ah ha, another mystery entered my life.

    This time, my doc wrote 'methylin er' for reasons already mentioned, but did not specify 'as dispensed.' New pharmacy sent 'methylphenidate er' tabs with note on the label that this was a generic substitute for methylin er. This time I checked the markings, which are identical, and saw the manuf is the same, Mallinckrodt.

    Assumed and hoped they would of course be identical. Was surprised, when I switched to the new bottle (leaving some of the 'old' just in case any more surprises) to find that after taking about these for a couple of days I was getting kind of dizzy/woozy at day's end (felt like I was a few seconds away from blacking out). Went back to the 'old' ones because I had some important meetings at work so really needed to be alert.

    Recently, called my mail order pharmacy. First person on the line insisted only one generic is available for any drug but moved me to a pharmacist when I differed on that point. New pharmacist agreed the 2 versions should be essentially the same, but also agreed it was puzzling that the manufacturer would go to the trouble of calling the exact same medication by 2 names, changing the label, etc.

    I remember reading that generics are deemed essentially identical if the active and inactive ingredients are within a certain percentage of what they are in the related brand name; since I have had some odd reactions to fillers etc., she agreed there might be some very slight difference between these 2 generics that for some reason I react to. Or she was just humoring me, though I appreciate it?!

    She suggested as you did, that my doctor specify as dispensed, though she added that the company might be leery if they get a new prescription this soon given it's a controlled substance, my fear as well. I told her I would give the new version another trial and I have, for about the last 2, 3 weeks. Wooziness got better, but after a couple of weeks, what I have realized is that there is a brief welcome period after I take it, during which pistons usually start clicking mentally--but all the time, a lingering effect of feeling emotionally distant--per my earlier training as a therapist, almost dissociated/floaty.

    And honest, this doesn't happen with the methylin er?! There, the only problem (as with any of these variations) is that the 'wakening' effects are inconsistent over the week, I guess related to the dose. My original prescribing physician is a gastroenterologist and very supportive about trying to help w/ the fatigue but not an expert on this medication beyond having had some of his patients who benefitted from it. Otherwise, given the other AI stuff going on, I haven't been able to find a specialist to help me figure out optimal dosing for me as an adult using this for the off-label purpose of fending off intractible fatigue (or finding me another medication espec one that isn't controlled?!). Gosh knows I also try the saner non-medical approaches that do not require a guru.

    Anyway, I responded mostly to say 'thank you' and instead throw another conundrum out: "No good deed goes unpunished"? But if you don't have time to respond to this one, I still thank you very much for your kindness to a stranger--Cassie



    Quote Originally Posted by rph480 View Post
    Cassie,

    First things first, check with your local pharmacy and make sure they filled the Rx correctly. Although it doesn't happen often, mistakes can and do occur. If it was the wrong drug (ex. Methadone instead of Methylin), or you were given the plain Methylphenidate (instead of the ER), that would account for your bad experience.

    Also, do you have any of those tablets left? You might try using the Pill Identifier on this site to see what drug you have.

    If, in fact, you were given Methylphenidate ER in the same strength and dosage as the Methylin ER, you could still be experiencing an intolerance to the generic (usually it's one of the inert ingredients that causes the problem, and not the active drug itself.) From now on, you might want to ask your doctor to write your Methylin ER prescriptions for the brand only - no generic substitution permitted.

    Hope you get the situation straightened out!

  4. #4
    tbiuser is offline New Member
    Join Date
    Nov 2010
    Posts
    1

    Default

    As a reference point, I've noticed a difference between Methylin ER 20 and metadate er 20, though it's the reverse in my case. I get migraines from the Methylin a few hours after taking it, whereas I'm fine with the Metadate. This just confirms that there can be differences in different formulations--though it might be the fillers or a different time release profile.

    Quote Originally Posted by drcassie8 View Post
    Dear kind and knowledgeable rph480 !!

    Thank you so much for taking the time to help me with this--really. And I have a more recent development if you have time to weigh in on that one!

    First, I did check the pill identifier on this site just now for the 'bad' (for me) medication. The bottle says methylphenidate SA, 20 mg. "Tasan." Checking the actual markings on the Web site confirms contents are in line with the label, except that the site indicates the manufacturer is Sandoz; I don't see any mention of Sandoz on the bottle and thought Tasan was the manuf. Oh well.

    Here is my newer quandry: Since writing to the forum, my insurance carrier and hence mail order pharmacy changed and ah ha, another mystery entered my life.

    This time, my doc wrote 'methylin er' for reasons already mentioned, but did not specify 'as dispensed.' New pharmacy sent 'methylphenidate er' tabs with note on the label that this was a generic substitute for methylin er. This time I checked the markings, which are identical, and saw the manuf is the same, Mallinckrodt.

    Assumed and hoped they would of course be identical. Was surprised, when I switched to the new bottle (leaving some of the 'old' just in case any more surprises) to find that after taking about these for a couple of days I was getting kind of dizzy/woozy at day's end (felt like I was a few seconds away from blacking out). Went back to the 'old' ones because I had some important meetings at work so really needed to be alert.

    Recently, called my mail order pharmacy. First person on the line insisted only one generic is available for any drug but moved me to a pharmacist when I differed on that point. New pharmacist agreed the 2 versions should be essentially the same, but also agreed it was puzzling that the manufacturer would go to the trouble of calling the exact same medication by 2 names, changing the label, etc.

    I remember reading that generics are deemed essentially identical if the active and inactive ingredients are within a certain percentage of what they are in the related brand name; since I have had some odd reactions to fillers etc., she agreed there might be some very slight difference between these 2 generics that for some reason I react to. Or she was just humoring me, though I appreciate it?!

    She suggested as you did, that my doctor specify as dispensed, though she added that the company might be leery if they get a new prescription this soon given it's a controlled substance, my fear as well. I told her I would give the new version another trial and I have, for about the last 2, 3 weeks. Wooziness got better, but after a couple of weeks, what I have realized is that there is a brief welcome period after I take it, during which pistons usually start clicking mentally--but all the time, a lingering effect of feeling emotionally distant--per my earlier training as a therapist, almost dissociated/floaty.

    And honest, this doesn't happen with the methylin er?! There, the only problem (as with any of these variations) is that the 'wakening' effects are inconsistent over the week, I guess related to the dose. My original prescribing physician is a gastroenterologist and very supportive about trying to help w/ the fatigue but not an expert on this medication beyond having had some of his patients who benefitted from it. Otherwise, given the other AI stuff going on, I haven't been able to find a specialist to help me figure out optimal dosing for me as an adult using this for the off-label purpose of fending off intractible fatigue (or finding me another medication espec one that isn't controlled?!). Gosh knows I also try the saner non-medical approaches that do not require a guru.

    Anyway, I responded mostly to say 'thank you' and instead throw another conundrum out: "No good deed goes unpunished"? But if you don't have time to respond to this one, I still thank you very much for your kindness to a stranger--Cassie

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