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Dr. Bob is Robert Hsiung, MD,
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Posted by drylightning on June 3, 2009, at 16:11:49
In reply to Re: best/worst generic xanax » drylightning, posted by yxibow on June 3, 2009, at 15:24:52
> > > Not necessarily. Suggestion? How bought paying for a few days worth of the namebrand. Try it and see. Then compare to Greenstone and Sandoz?>
> >
> > Are pdocs willing to give away samples? I'd like to call my doctor and ask her to give me a sample of Sandoz when I see her in a week. (I don't know if that's enough time, though.) And, I may also ask her for some Greenstone, since I only took it a few isolated times, as well as namebrand.
> >
> > Is this reasonable to ask? Is a week enough lead time? Will she think I'm trying to hoard pills?
>
>
> No. And the number of "original" samples are coming down with tightening on drug representatives.
>
> Generics are not given away as samples, hawked on TV, and print ads, hence they are CHEAPER, that's why they're generics.
>
> I just don't see the issue with generic Xanax since it came out in 1981 -- I don't think you'd want samples from 1981.
>
> But to each their own.
>
> -- JayJay,
I presume that by "no" you mean I shouldn't expect my pdoc to give me samples, right?
Also, you're saying doctors do not give out samples of generics because they don't get them. That makes sense. And restrictions are reducing the number of name brand samples that the pharmaceutical companies give out to doctors. That also makes sense.
Finally, are you saying that you think generic = brand? I used to think that, and may think it again someday soon, but for now I'm obsessing. I just don't feel quite as good as I recall feeling last time I was on a dose this high. And I've read too much about Mylan (my generic now) being weak. The internet is a blessing and a curse...
Thanks,
dan
Posted by SLS on June 3, 2009, at 16:27:53
In reply to Re: best/worst generic xanax » yxibow, posted by drylightning on June 3, 2009, at 16:11:49
> Finally, are you saying that you think generic = brand? I used to think that, and may think it again someday soon, but for now I'm obsessing. I just don't feel quite as good as I recall feeling last time I was on a dose this high. And I've read too much about Mylan (my generic now) being weak. The internet is a blessing and a curse...
At the very least, the drug used in the generic preparation is exactly the same as that used in the name brand preparation. However, the rest of the recipe can be completely different. The delivery system - the binders, fillers, and other excipients - is different. The manufacturing process is necessarily different; different humidity, pressure, pH, etc. This doesn't even take into consideration the chemical reactions that might occur between the drug or the excipients with the rest of their chemical environment.
Different is different. This is as true of the pills as it is of the digestive systems of the people who take them.
- Scott
Posted by yxibow on June 3, 2009, at 17:31:03
In reply to Re: best/worst generic xanax » yxibow, posted by drylightning on June 3, 2009, at 16:11:49
> Jay,
>
> I presume that by "no" you mean I shouldn't expect my pdoc to give me samples, right?Yup... generics
> Also, you're saying doctors do not give out samples of generics because they don't get them. That makes sense. And restrictions are reducing the number of name brand samples that the pharmaceutical companies give out to doctors. That also makes sense.
Basically.... there's no incentive for feel-good programs for generics, since they're made on the cheap.
Yeah... there's been a reduction in that with our litigious society.
> Finally, are you saying that you think generic = brand? I used to think that, and may think it again someday soon, but for now I'm obsessing.I didn't say that generics are always 100% the same as the "original"... bindings, as Scott said digestion, etc....
But I really can't think that there are too many people out there not taking generic benzodiazepines or propranolol or TCAs as they are medications up to 50 years old and its just pure profit if Valium is even stamped out by the original makers. You're talking the difference on an average prescription of like $5-$20 and $50-100 for the "real".
I just don't feel quite as good as I recall feeling last time I was on a dose this high. And I've read too much about Mylan (my generic now) being weak. The internet is a blessing and a curse...Yes, if you read every drug side effect in a PI (prescribing information).... you'll get medical student syndrome. That doesn't mean you shouldn't have informed consent to take a medication.
Well... Mylan did get into hot water in California by buying up all the raw materials for benzodiazepines... but its been quite a while since that settlement.
Xanax at a high dose ... you can habituate quite easily because of the short half life (at least my unqualified opinion) so it isn't out of the question that you might not feel the same.
-- Jay
Posted by greywolf on June 3, 2009, at 18:25:37
In reply to Re: best/worst generic xanax » drylightning, posted by yxibow on June 3, 2009, at 17:31:03
The generics vs. brand name issue has always vexed me. I'd love to go brand name on everything (I do on some because there is no other choice), but even with generics I estimate my monthly co-pays for asthma and psychological medications at approximately $150.00. Then you add in the co-pays for the monthly doctors' and therapist's visits and you've got another $85.00. Finally, add in the co-pays for my 3 kids, two of whom have asthma and allergies, and one's in physical therapy and it's another about $200.00. So I end up paying about $400.00/month in co-pays (when you include the ex-wife's co-pays on my insurance) for a normal month (we won't add in the occasional hospital co-pay for lacrosse and football injuries).
Consequently, generics are essential for me. Wish that weren't the case because I think I'd be receiving more effective treatment with most brand names, but there's little I can do about it.
Greywolf
Posted by Phillipa on June 3, 2009, at 19:47:40
In reply to Re: best/worst generic xanax, posted by greywolf on June 3, 2009, at 18:25:37
The way I figure it if the difference between being well or not is brand vs generic I'd have to find a way to pay for it as in the long run would cost less. Less docs visits less meds possibly. And no I'd ask for name brand for a few days and decide for yourself as it's you're life you're dealing with. also a few days of namebrand to ask the pdoc for same amount of pills. I did this myseelf more than once. Phillipa
Posted by greywolf on June 3, 2009, at 20:10:40
In reply to Re: best/worst generic xanax, posted by Phillipa on June 3, 2009, at 19:47:40
> The way I figure it if the difference between being well or not is brand vs generic I'd have to find a way to pay for it as in the long run would cost less. Less docs visits less meds possibly. And no I'd ask for name brand for a few days and decide for yourself as it's you're life you're dealing with. also a few days of namebrand to ask the pdoc for same amount of pills. I did this myseelf more than once. Phillipa
The problem for me is that if I went brand name on Parnate, Cytomel, Xanax, and Omeraprazole in addition to already being on brand name Lunesta and Namenda, my costs were be sky-high. Hundreds of dollars per month more. It's not realistic for me and it wouldn't change the number of doctor appointments I have. I have a regular schedule of CBT twice a month along with a required monthly visit with my psychiatrist. My GP's only every 2 or 3 months, so that's no big deal, but the other stuff adds up quickly.
Greywolf
Posted by Phillipa on June 3, 2009, at 21:39:34
In reply to Re: best/worst generic xanax, posted by greywolf on June 3, 2009, at 20:10:40
Greywolf having a family does complicate things. Money is the root of all evil. Especially today. But this poster could see since it's only one med? Love Phillipa
Posted by drylightning on June 3, 2009, at 22:56:25
In reply to Re: best/worst generic xanax » greywolf, posted by Phillipa on June 3, 2009, at 21:39:34
> Greywolf having a family does complicate things. Money is the root of all evil. Especially today. But this poster could see since it's only one med? Love Phillipa
For me it would only be the one med. I do have a wife and two kids, but I'm the only one on regular medication. But we're talking at least $150/month, I think, since my insurance doesn't cover any of the cost of most brand name drugs. Something to consider, but probably out of the question because of the cost.
Posted by yxibow on June 4, 2009, at 1:00:08
In reply to Re: best/worst generic xanax, posted by Phillipa on June 3, 2009, at 19:47:40
> The way I figure it if the difference between being well or not is brand vs generic I'd have to find a way to pay for it as in the long run would cost less. Less docs visits less meds possibly. And no I'd ask for name brand for a few days and decide for yourself as it's you're life you're dealing with. also a few days of namebrand to ask the pdoc for same amount of pills. I did this myseelf more than once. Phillipa
If your life really depended upon it, I'm not going to just continue to kowtow the party line of the FDA.... but... its true that there are a few medications that have such close tolerance that deviation is not acceptable to bring to market.And speaking of medications that your life depends on it -- some HIV medications are now officially generic, others are grey market generic in countries where it is a desperate need, and thirdly through patient support programs.
-- Jay
Posted by Abby Cunningham on June 4, 2009, at 10:17:03
In reply to best/worst generic xanax, posted by drylightning on June 2, 2009, at 16:19:34
I have taken the Sandoz and Mylan brand of alprazolam (xanax) and when one time I felt withdrawal sx's on my regular dose, I was concerned about tolerance, so I asked my doctor to prescribe name brand and she did. It was fine, but then thanks to Phillipa I discovered "Greenstone" and BELIEVE ME, it is the REAL thing.
Greenstone is a subsidiary of Pfizer, I believe, who bought out Eli Lilly, the original makers of xanax and it is the same exact formula as far as I can tell. I love it (although hate taking benzo :( )
Posted by Phillipa on June 4, 2009, at 12:29:20
In reply to Re: best/worst generic xanax, posted by Abby Cunningham on June 4, 2009, at 10:17:03
Abby thanks for posting the buy outs of the companies as I didn't know them remembered you posting them. Yes Greenstone is the real deal. For some I guess it's acceptance that these meds are necessary for us. Love Phillipa
Posted by drylightning on June 4, 2009, at 12:45:33
In reply to Re: best/worst generic xanax, posted by Abby Cunningham on June 4, 2009, at 10:17:03
> I have taken the Sandoz and Mylan brand of alprazolam (xanax) and when one time I felt withdrawal sx's on my regular dose, I was concerned about tolerance, so I asked my doctor to prescribe name brand and she did. It was fine, but then thanks to Phillipa I discovered "Greenstone" and BELIEVE ME, it is the REAL thing.
>
> Greenstone is a subsidiary of Pfizer, I believe, who bought out Eli Lilly, the original makers of xanax and it is the same exact formula as far as I can tell. I love it (although hate taking benzo :( )
>I wonder why Greenstone didn't do much for me...
When I tried it, I only had a couple days worth to try, and I never took all Greenstone in one day. Do you think that could have something to do with it?
Posted by Phillipa on June 4, 2009, at 19:33:03
In reply to Re: best/worst generic xanax, posted by drylightning on June 4, 2009, at 12:45:33
Could have would take a few days to build up in your stystem. Phillipa
Posted by drylightning on June 4, 2009, at 20:03:58
In reply to Re: best/worst generic xanax » drylightning, posted by Phillipa on June 4, 2009, at 19:33:03
> Could have would take a few days to build up in your stystem. Phillipa
Thanks, Phillipa. Yes, that makes sense. So, I'm torn as to whether I should get Sandoz or Greenstone when I next fill my prescription. I would hate to try one or the other and then be stuck with a month of alprazolam that doesn't work well for me. I wish there was a way to get it filled with half of each.
Posted by Phillipa on June 4, 2009, at 21:41:55
In reply to Re: best/worst generic xanax » Phillipa, posted by drylightning on June 4, 2009, at 20:03:58
You can just ask the pharmacist to split the prescription between the two tell what you're doing. Big chains less likely to do this. We found a small pharmacy just starting out and I get my meds for half what paid at the C you know the rest of the initials that form the chain. Love Phillipa
Posted by drylightning on June 4, 2009, at 21:51:48
In reply to Re: best/worst generic xanax » drylightning, posted by Phillipa on June 4, 2009, at 21:41:55
> You can just ask the pharmacist to split the prescription between the two tell what you're doing. Big chains less likely to do this. We found a small pharmacy just starting out and I get my meds for half what paid at the C you know the rest of the initials that form the chain. Love Phillipa
The chain known as C...etc... wouldn't even order anything other than Mylan, so they're useless. Maybe I should try this. I know a small local pharmacy on my way to work... Thanks (again!)
Posted by drylightning on June 5, 2009, at 21:23:36
In reply to Re: best/worst generic xanax, posted by Abby Cunningham on June 4, 2009, at 10:17:03
I've decided to just try the name brand. I called my insurance company today and they said they'll only dispense name brand Xanax with a doctor's authorization. I called my doctor and left a message and will talk to her Monday. Hopefully she'll fill out the authorization form, the insurance company will accept her argument, and I'll be allowed to pay the higher co-pay for brand name Xanax.
I think I'm having some symptoms similar to what Abby wrote about. I just don't feel like the Mylan is working very well anymore. I'm on a high dose - 5mg/day. I don't want to increase that dose. In fact, I want to get to a good place again and then taper down. (I was down to 1.25mg/day until my recent relapse...and I'd like to get there, and further down, again.) But, I am a bit worried about tolerance, despite the fact that I've only been on this high dose for about a month.
Interesting little sidenote: I still have a bunch of .25 mg alprazolam (also Mylan) sitting around, and when I take four of those rather than one of the 1 mg, it works better. I wonder if it's a batch difference, or what.
Also, a question. When I talk to my pdoc on Monday, I will, of course, ask her to switch me to brand, and I'll get the authorization form to her to fill out and fax to the insurance company. It takes a couple days before we'll know whether it's authorized. Do you all think that I can ask my pdoc to get me like a week's prescription so I can start on the brand right away? I could pay for that amount of meds out of pocket. Or, do you think she'll say to wait until we hear back? I just have no idea if a weeklong script is even possible, but I'd like to stop taking this Mylan ASAP. I have some work-related travel next week which is causing some stress, and I don't want to have to bring Mylan....
Thanks to everyone for the feedback.
Dan
Posted by Phillipa on June 5, 2009, at 21:30:35
In reply to Re: best/worst generic xanax, posted by drylightning on June 5, 2009, at 21:23:36
Dan that's great. Yup ask for the name brand. And a favor please? Let me know if there is a difference. Thanks Phillipa
Posted by drylightning on June 5, 2009, at 23:38:26
In reply to Re: best/worst generic xanax, posted by Abby Cunningham on June 4, 2009, at 10:17:03
> I have taken the Sandoz and Mylan brand of alprazolam (xanax) and when one time I felt withdrawal sx's on my regular dose, I was concerned about tolerance, so I asked my doctor to prescribe name brand and she did. It was fine, but then thanks to Phillipa I discovered "Greenstone" and BELIEVE ME, it is the REAL thing. >
I'm praying that I haven't built up a tolerance. I guess we'll see when (IF??) I start taking the brand name.
Posted by drylightning on June 5, 2009, at 23:40:11
In reply to Re: best/worst generic xanax » drylightning, posted by Phillipa on June 5, 2009, at 21:30:35
> Dan that's great. Yup ask for the name brand. And a favor please? Let me know if there is a difference. Thanks Phillipa >>
I will let you know. Hopefully the insurance approves it and I'll be taking brand next week. And if it is a tolerance issue, well, I don't know what to do then. I took the same dose I'm on now from 1995-1999 and never had a problem with tolerance...
Posted by yxibow on June 6, 2009, at 0:23:25
In reply to Re: best/worst generic xanax » Phillipa, posted by drylightning on June 5, 2009, at 23:40:11
I still think these things are issues of tolerance and some degree of suggestability, for drugs that last came out in 1981, but if your insurance allows it (and they will charge you), go ahead and tell us.
-- tidings
Jay
Posted by garnet71 on June 6, 2009, at 8:09:57
In reply to best/worst generic xanax, posted by drylightning on June 2, 2009, at 16:19:34
I've used generic Xanax from Rite Aid, CVS, grocery store pharmacies, and others. There was never a difference for me. The only problem I have is when my level of anxiety goes thru the roof and I don't take one at the onset, I have to take more, 1 mg., before the anxiety shuts off.
But as far as the brand CVS uses, it works ok for me.
Posted by rskontos on June 11, 2009, at 1:56:03
In reply to Re: best/worst generic xanax, posted by garnet71 on June 6, 2009, at 8:09:57
I have been on the generic xanax since 12/07 and it has worked fairly well.
I never even thought to ask about the name brand. Mine is mylan.
I think I will now ask my p-doc. He did prescribe the brand name Wellbutrin when I asked about it. I did not notice a difference though unlike others.
rsk
Posted by drylightning on June 13, 2009, at 18:08:54
In reply to Re: best/worst generic xanax » drylightning, posted by Phillipa on June 5, 2009, at 21:30:35
> Dan that's great. Yup ask for the name brand. And a favor please? Let me know if there is a difference. Thanks Phillipa>
I finally got the brand name Wednesday evening, and really haven't noticed that much of a difference. Maybe I will over time. It does seem slightly "smoother" than Mylan, meaning I don't feel the ups and downs of the drug in my system as much. But it really doesn't seem any more effective.
Saw the pdoc on Thursday and she's sort of at a loss as to how to control these ongoing panic/GAD (mostly GAD at this point) symptoms. When I was first diagnosed, I feel like the Xanax and Zoloft totally wiped it out and I was better. Hindsight may make it seem like I was better sooner than I actually was, however. So, this "relapse" has been going on for about two and a half months. Maybe it took longer back in 1995 to feel better. I do know that my life is about 100 times more stressful now, with a job and kids. When first diagnosed, I was living with my parents and doing absolutely nothing but recovering.
So my pdoc considered raising my Xanax dose (I'm now on 5mg/day (1mg 5 times per day), which is the dose that worked back in 1995. I had gotten that down to .25 mg 5 times per day until recently. Pdoc seemed to be weighing the idea of increasing the Xanax further, but decided not to. I think she wants to try one more option first, so she gave me a new script: Guanfacine, which is a high blood pressure med. Since I have borderline hypertension, it can't hurt. She said that she thinks it will help with my general anxiety by calming my central nervous system and lessening the physical symptoms of anxiety. So far, it is mostly making me tired, but there have been times when I've felt it's working.
I forgot to mention it during the appointment, but my brother has anxiety issues, too (to a lesser extent than me, fortunately) and said that beta blockers helped him quite a bit. It was prescribed for high blood pressure, but he said it has had a positive effect on his anxiety. Now I'm wishing I'd asked my pdoc to try a beta blocker.
Does anyone have experience with either guanfacine or a beta blocker for anxiety?
I'm thinking I'll give the guanfacine about a week and if it doesn't seem to be helping, I'll call my pdoc and ask about a beta blocker. I know that when a drug helps someone you're related to, there's a good chance it'll help you.
Thanks everyone. I'm still feeling pretty crappy, but do have some much better days mixed in with the bad ones, so I'm hoping those better days begin to take over soon.
Dan
Posted by Phillipa on June 13, 2009, at 22:00:10
In reply to Re: best/worst generic xanax - Guanfacine???, posted by drylightning on June 13, 2009, at 18:08:54
Took 25mg of lopressor with xanax and yes it made me tired only reason not inderal was my thyroid disorder. Not familiar with the drug name you posted. Will have to google Phillipa
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