Tuesday, January 3, 2012

PD Drugs (brand name vs generics) and PD vs Weather

The other day one of Mario's Twitter friends asked him if the change in weather bothered my Parkinson's Disease.    I then did some research both thru "The Parkinson's Disease Treatment Book" by J. Eric Ahlskog, M.D. Mayo Clinic Parkinson Specialist, and thru http://www.parkinson.org/.   I could not find any reference to weather playing a role in Parkinson's Disease.  It doesn't seem to affect me either - but read on......

However, i do have arthritis in many of my joints and spine.   I can tell you without a doubt that weather does impact my arthritis.   The past couple of mornings I have awaken to a very sore, stiff body and it has been difficult to get moving.   So, thank heavens for the Tramadol and Tylenol combination my family doctor prescribed.   

While doing the research on Weather/Parkinson's, I happened on an article published in http://www.parkinson.org/.  In an article (half way down the page on the left hand side) - click on:
  • Generic vs. Branded Drugs for Parkinson’s Disease
The following paragraphs were copied from that article:

"Currently, there are multiple pharmaceutical companies that manufacture a generic formulation of carbidopa/levodopa, dopamine agonists, monoamine oxidase inhibitors and anticholinergics. If you have Parkinson’s, are taking brand name medication and then are offered a generic substitution for one of your Parkinson’s medications, you should know that the FDA requires that generic drugs must show an “essential similarity” to the branded drug prior to market approval, but that in some cases, this standard is not high enough. A review supported by NPF chronicles compelling evidence that if you are in more advanced stages of the disease, switching from branded drugs to generic, or from one generic to another, may have adverse effects. The authors, including NPF National Medical Director Dr. Michael S. Okun, believe that the standards for approving generic drugs for Parkinson's may not be strict enough to demonstrate that the generic alternatives are equally effective."

"Work with your physician to develop a tailored treatment plan. Using generic drugs may provide a cost savings, but they may not be appropriate for you, especially if you already tolerate the branded drug.
If you make the switch, be sure to follow these tips:
  • Report to your physician how effective the drug is
  • Carefully keep a diary of any side effects
  • Record dose adjustments that your physicians make (higher or lower)
  • In general, try to stay with a single drug manufacturer for your generic medications (You may need to ask your pharmacist to special order for you)
When attempts to tailor drug therapy with a generic drug have been unsuccessful, have your doctor appeal to the insurance company for a branded drug. It is important to include meticulous details of the various adverse side effects with the generic medication in your appeal letter."

So this article supports the problems I experienced when the doctor switched me from the Brand name Mirapex to the generic one.  My system couldn't tolerate it and it wasn't my imagination.   Many of my readers also confirmed they many times they have had problems with generics.  This is not to say that generics are bad.  They are not, but if they don't work for you, then they don't work for you.  Tell your doctor.   This may be why I had problems with the generic levodopa/carbidopa drug that the doctor tried me on, which was also a generic.   I will be talking to him about that and am printing off a copy of this article to take with me.

In my opinion, doctor's are beginning to prescribe more and more generics because

1.  It does save the patient money. but, more importantly......
2.  The Insurance Companies prefer the use of generics to save money.  If a brand name is prescribed, the doctor has to jump through hoops to request the brand name.  They are already over booked with patients and just don't have time for the added paper work.   Strictly my opinion, not based on fact but seems to be what happens in my case.  

Thanks for reading about this subject again.  But I had to document what I found to back up my comments on the problems I was having.  



  1. Hi Mary,

    You are absolutely correct about how generics are being prescribed. Some generics work well for some people but not for everyone! I am fortunate to have a doc who will pester my insurance company if a generic does not work for me. However, this should be the norm not the exception!

    It must be difficult to sort out PD stiffness from arthritis but I and glad you are getting symptom relief.

    Hugs from North Carolina and Happy New Year to you and Mario!

  2. Hi Mary..
    I don't know where the comment box disappeared to on my computer...but today (1/3/12) is the first time I've seen it in weeks. Now you know for sure that I am challenged by this computer!!
    I hope that you are feeling better and all medicines are working "together".
    Happy New Year!

  3. It's always worth the time to do the research, and you have just proven it. I know you have a terrible time with generics, now you can show your doctor proof that it's not your imagination. Maybe now he will prescribe the Sinemet which is the brand name drug for the generic Carbodopa/Levadopa which you had so many problems. It is an effective drug for PD and I hope you find out the Sinemet works for you.
    Kathy Hudak

  4. Mary
    That is really interesting.
    I do agree with you about generics and why they are dispensed over the name brand.
    All you have to say is :insurance.
    I hope you are feeling better.

  5. It's great that you spend so much time researching prescriptions and don't just swallow whatever the doctor gives you. Some generics aren't as potent as the name brands, so it's a lot of trial and error. Feel better and I hope that your husband is doing well. Julie

  6. Thanks for the info! I know my Insurance company won't cover name brands if a generic is available. (Same thing if an OTC version is available.) I had no idea there could be differences or that my Doc could work with Insurance to convince them. Thanks for the research and hoping you're doing better with the weather and discomfort!

  7. hi Mary Very interesting article you certainly have done good research. Hope the doctors listen to you. anyway Happy New Year. Hope to see you this Sunday.

  8. Hi Mary,
    Thank you for all the great information! The health care system shouldn't be the obstacle course it seems to be. Prudence has chosen your blog for the Liebster Award! Because of your kindness! Coonhound {{hugs}}!

  9. I am amazed at the work and time you put into this excellent informative blog. This will be and already is a resource for folks who need the info. Especially about the conflicting drug effects and I would venture to say no one has posted better informatin that you. I also mean by that, that not many have kept a log of stymptoms/side effects and shared this information with others who need it.

    This blog, to me, is a public service.

    Blessings to you xoxo

  10. Hi Mary,
    In Australia, providing a drug is approved by our PBS (Pharmaceutical Benefits Scheme) under our public health system we only have to pay $5.80 for consession card holders (i.e. those on some form of pension - be it age or sickness). Our Doctors ask if we'd prefer the generic substitution but rarely recommend it. If you do not have a concession card then you will have to pay $35.40 which can be claimed back if you hold private health insurance. If the drug is not PBS approve then you are in deep doodoo. It is RARE for a famous drug like your Maripex (called Sifrol here) not to be PBS approved. This is one of the major benefits of a public health system for which I'm eternally grateful.
    Good luck with meds!
    PS For the time being, our dollar and the US dollar are on a par.

  11. Excellent blog very nice and unique information related to brand name vs generics. Thanks for sharing this information.
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