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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by morganator on March 8, 2010, at 20:23:39
Has anyone experienced a major difference between Fluoxetine generic and brand name Prozac? I just switched from Symbyax 6/50 to Zyprexa 5 and generic Fluoxetine 40 and I haven't been feeling so hot. It's not like I really felt that great before but I have had some pretty awful bouts of anxiety and fatigue since the switch. I just emailed my pdoc and we both agreed that I should go back to the Symbyax until I see him next. He also said that sometimes when people switch to the generic and do not respond well, bumping up the dose considerably helps to get them back to how they were feeling on the brand. Any thoughts on this as well?
Posted by conundrum on March 8, 2010, at 20:36:52
In reply to Generic Fluoxetine Vs. Prozac, posted by morganator on March 8, 2010, at 20:23:39
I guess anything is possible. Are the doses of both drugs you are taking now the same as in the dose of symbax? Usually generics are a problem when they release the drug to quickly, but prozac has such a long half life it shoudln't really make a difference.
Posted by Phillipa on March 8, 2010, at 23:59:25
In reply to Re: Generic Fluoxetine Vs. Prozac » morganator, posted by conundrum on March 8, 2010, at 20:36:52
If you were doing well on the symbax I'd go back on it. I know some thing having both meds allows you to adjust the two doseages which is true. So if you afford both namebrand I get both. But if doing well on above continue on. Love Phillipa
Posted by morganator on March 9, 2010, at 0:30:57
In reply to Re: Generic Fluoxetine Vs. Prozac, posted by Phillipa on March 8, 2010, at 23:59:25
I wasn't doing all that great on Symbyax. I'm functioning at a higher level but I am nowhere near where I should be. So yeah I have to figure things out with my doc.
Posted by manic666 on March 9, 2010, at 4:14:09
In reply to Re: Generic Fluoxetine Vs. Prozac » morganator, posted by conundrum on March 8, 2010, at 20:36:52
i noticed a big difference between prozac an fluoxetine /// but you will only notice if you have been or the reel prozac for a while. //if you have never had the real prozac you wont notice,/// it just prozac is made by one company//an fluoxetine by many , so they vary in quality// an thats no good to you, //if you find a geniric brand thats cool ,stick to it an dont use another.// im on generic citalopram//came of genreic zoloft/on weighing up the two to the same mg ie sertraline 100mg ctalopram 40mg// that is a simular dose for the two drugs ///sertraline is much mor sedateing/to me /yet the meds are near on the same/// i would need a higher dose of citalopram to match the sertraline. thats how it goes with generic,s// unless i trawl all the chemist an try all the different generics of citalopram
Posted by Roslynn on March 9, 2010, at 16:28:05
In reply to Generic Fluoxetine Vs. Prozac, posted by morganator on March 8, 2010, at 20:23:39
Hi, yes, I am much more tired when I take the generic and it doesn't seem to work as well as brand. So for now I am shelling out $$ for brand Prozac.
> Has anyone experienced a major difference between Fluoxetine generic and brand name Prozac? I just switched from Symbyax 6/50 to Zyprexa 5 and generic Fluoxetine 40 and I haven't been feeling so hot. It's not like I really felt that great before but I have had some pretty awful bouts of anxiety and fatigue since the switch. I just emailed my pdoc and we both agreed that I should go back to the Symbyax until I see him next. He also said that sometimes when people switch to the generic and do not respond well, bumping up the dose considerably helps to get them back to how they were feeling on the brand. Any thoughts on this as well?
Posted by bleauberry on March 9, 2010, at 16:49:27
In reply to Generic Fluoxetine Vs. Prozac, posted by morganator on March 8, 2010, at 20:23:39
If I got a dollar for every report I've heard about a problem with a generic I would have a pretty darn good savings account. Fluoxetine happens to be one of the more commonly mentioned ones.
I've read some rather intricate reports explaining why generics can be sub-therapeutic compared to brand, despite that they are supposedly the same active ingredient. Pretty fascinating stuff most of us don't think about and are not aware of.
One of my doctors had so many patients relapse on generics and then bounce back on brand that he won't even prescribe generics.
To be fair, some people do fine on generic. Some people do better on generic than brand. It happens. Not as much, but it happens. Generics themselves can vary a lot from one manufacturer to another.
Is your dose the same as it was on Symbyax? If I recall correctly, the prozac dose in symbyax is 25mg? To get that extra odd 5mg you would have to do the orange juice trick. Or maybe your dose is different? Not sure. Just a thought.
There is one way to challenge it and see for sure. Call your doctor and ask him to call in a prescription for brand prozac.
Naysayers will claim it is your imagination or placebo effect. I would guess maybe in a very small percentage of people that is true, but in the majority it is false. There is more to this issue than we know.
When I was switched from brand prozac to generic fluoxetine, I was stable. I did not know I had been switched. I thought the capsules looked a little different, but didn't give it any thought. Immediately I noticed that the "buzz" I got from prozac in the 6 hour period following a dose was gone. And while brand prozac gave me some sleep problems, I no longer had those problems on generic. So something was different. At my next appointment I talked about my deterioration with my doctor. He said maybe it was because of the switch to generic. I said, "huh?" I didn't even know I had been switched. An increase in dose of the generic only brought on agitation and feeling worse. A return to brand prozac pretty much fixed the whole issue back to normal within a couple days. I knew it was the real stuff because I had that 6 hour warm buzz again.
I estimate it will be another 5 tyo 10 years before this topic gets the attention it deserves. Just know, you aren't alone in your experience.
Bioequivalence does not equal therapeutic equivalence. Simple as that. Brands had to go through lengthy trials. Generics did not. You and me are the realworld live guinea pigs.
Posted by morganator on March 9, 2010, at 22:51:37
In reply to Re: Generic Fluoxetine Vs. Prozac, posted by bleauberry on March 9, 2010, at 16:49:27
Yeah I'm back on Symbyax but not quite feeling better yet. I just stopped Zoloft 2 weeks ago and have been on Symbyax for about 6 weeks-4 weeks at 3/25 and 2 at 6/50. So, I think I may need more time and dosage adjustment before I hopefully feel considerably better as a result of Prozac. When or if this happens, I may go down to 2.5 mgs Zyprexa and eventually off.
Yeah I hate generics. It's unfortunate since the generic fluoxetine was 17 dollars without insurance coverage and Prozac was about 340 dollars at the CostCo pharmacy.
Posted by Phillipa on March 10, 2010, at 20:04:36
In reply to Re: Generic Fluoxetine Vs. Prozac, posted by morganator on March 9, 2010, at 22:51:37
You have got to be kidding!!!! And it's old!!!! Phillipa
Posted by ed_uk2010 on March 11, 2010, at 15:26:17
In reply to Re: Generic Fluoxetine Vs. Prozac, posted by morganator on March 9, 2010, at 22:51:37
What a rip off. You would scream if I told you how much the Prozac brand costs in the UK!
Posted by ed_uk2010 on March 11, 2010, at 15:33:31
In reply to Re: Generic Fluoxetine Vs. Prozac, posted by ed_uk2010 on March 11, 2010, at 15:26:17
Well put it this way, it's cheaper than your generic.
Posted by morganator on March 12, 2010, at 2:02:08
In reply to Re: Generic Fluoxetine Vs. Prozac, posted by ed_uk2010 on March 11, 2010, at 15:33:31
What?!! Brand Prozac costs less than seventeen bucks? That's with insurance I presume. If it's without insurance that is ridiculously cheap. Why would GSK sell it for so much cheaper in the U.K.? It has to be the price your getting for it after insurance covers it.
Posted by manic666 on March 12, 2010, at 5:10:35
In reply to Re: Generic Fluoxetine Vs. Prozac, posted by ed_uk2010 on March 11, 2010, at 15:33:31
well i live in the uk so tell me how much prozac costs , an were do you get it///all gps give you genric thats the rules of cost cutting.//.so you arnt getting on a script at £8 so you must be private,so tell us you price an were you buy it //i find your claim hard to believe//so spill the beans .no gp it going to give a months supply of prozac £25 when fluoxetine costs £3 ///so back up your claim instead of holding back
Posted by ed_uk2010 on March 12, 2010, at 14:03:35
In reply to Re: Generic Fluoxetine Vs. Prozac, posted by morganator on March 12, 2010, at 2:02:08
> What?!! Brand Prozac costs less than seventeen bucks? That's with insurance I presume. If it's without insurance that is ridiculously cheap. Why would GSK sell it for so much cheaper in the U.K.? It has to be the price your getting for it after insurance covers it.
The US and UK have *completely* different health systems. Drug prices in the UK are among the lowest in the world. Drug prices in the US are among the highest in the world.
In the UK, very few people have health insurance. As is the case in most European countries, taxes are quite high in the UK eg. to pay for our National Health Service (NHS).
In Europe, governments also exert many price controls on branded drugs, as well as on generics. Manufacturers cannot just charge whatever they want.
In the UK, there are two types of prescription: private prescriptions and NHS prescriptions. If you see an NHS doctor (which is free), you will get an NHS prescription. If you have an exemption from charges (eg. diabetes), your prescription will be completely free. Otherwise, there is a fixed charge of £7.20 per item (about $10.90), the government pays the rest. NHS prescriptions cost £7.20 regardless of the actual cost of the med.
If you see a doctor privately (ie. you pay to see a doctor because you do not want to go to an NHS doctor), you will get a private prescription. This is rather like the USA system ie. you pay the full cost of the med plus the pharmacy's mark-up.
Currently, the wholesale price of branded Prozac in the UK is £4.25 for a box of 30 caps. This is about $6.42.
If you had a private prescription for branded Prozac, you would have to pay the wholesale price plus the phamacists fees. On average, you would pay about £8 or £9 for a box of 30 capsules. This is about $12.00 to £13.50.
So yes, branded Prozac in the UK is much less expensive than your USA generic.
If you had a private prescription for 30 caps of generic fluoxetine, you would be charged about £3.50 to £5.00 ie. about $5.30 to $7.50.
I hope this information is of interest to you! It certainly shows the difference between US drug prices and European drug prices.
Posted by ed_uk2010 on March 12, 2010, at 14:17:32
In reply to Re: Generic Fluoxetine Vs. Prozac, posted by manic666 on March 12, 2010, at 5:10:35
> well i live in the uk so tell me how much prozac costs , an were do you get it///all gps give you genric thats the rules of cost cutting.//.so you arnt getting on a script at £8 so you must be private,so tell us you price an were you buy it //i find your claim hard to believe//so spill the beans .no gp it going to give a months supply of prozac £25 when fluoxetine costs £3 ///so back up your claim instead of holding back
Prozac does not cost the NHS £25 per box. Currently, it costs the NHS less than £5 per box. The price was reduced substantially in January 2009 to £1.53 per box, but was increased up to £5.00 (£4.25 after discount) in October 2009 due to a shortage. Generic fluoxetine currently costs the NHS less than £1.50 per box.
As you are aware, generic fluoxetine is very widely prescribed in the UK. Brand-name Prozac is not commonly prescribed. GPs are well within their rights to prescribe Prozac if they believe that the brand is necessary, and indeed some GPs do.
Posted by manic666 on March 13, 2010, at 3:49:56
In reply to Re: Generic Fluoxetine Vs. Prozac, posted by ed_uk2010 on March 12, 2010, at 14:17:32
yes i was looking on a private uk site for prozac in england ,not what it cost,s the nhs.// this if my story 10 years ago.// i was on prozac ,mabye longer anyway when generic came out./// my doc still scripted me the real prozac,// the chemist gave me fluoxetine/// i said i dont want this how come you cave it me //an he said all those years ago,, prozac was £12 more than fluoxtine
Posted by ed_uk2010 on March 13, 2010, at 8:56:08
In reply to Re: Generic Fluoxetine Vs. Prozac, posted by manic666 on March 13, 2010, at 3:49:56
> yes i was looking on a private uk site for prozac in england ,not what it cost,s the nhs.// this if my story 10 years ago.// i was on prozac ,mabye longer anyway when generic came out./// my doc still scripted me the real prozac,// the chemist gave me fluoxetine/// i said i dont want this how come you cave it me //an he said all those years ago,, prozac was £12 more than fluoxtine
Hi there,
You are quite right that there used to be a large price difference between generic floxetine and Prozac, but even back then, our Prozac would have been cheap by USA standards :)
Posted by Phillipa on March 13, 2010, at 19:20:06
In reply to Re: Generic Fluoxetine Vs. Prozac, posted by ed_uk2010 on March 13, 2010, at 8:56:08
Yes for sure as ad's here cost in the hundred's unless great insurance. Love Phillipa
Posted by alicew on March 28, 2010, at 10:46:21
In reply to Re: Generic Fluoxetine Vs. Prozac, posted by ed_uk2010 on March 11, 2010, at 15:33:31
Wow... After reading these posts I decided to find out which drug company makes the generic Fluoxetine I've been taking for 5 weeks.
It's made by Par, whom I've never heard of.
I am still very depressed after 5 weeks (very tired, unmotivated, want to sleep all the time, cry a lot, have obsessive thoughts, feel hopeless/powerless/despaired, etc.) My doc switched me from 20mg to 40mg Fluoxetine 2 weeks ago, but it's still generic, bought at the same pharmacy where they sell generic meds for only $4.00. A huge difference in cost, to be sure. But if the drug is not as effective, it's worthless to me and I'd shell out the extra $ to get Prozac.Given what I consider very little relief from my generic after 5 weeks, combined with all the posts here that state there really CAN be a difference between brand-name Prozac and some generic versions, I wonder if that's why I'm not feeling that much better.
Is anyone else on this particular brand???
They are blue-and-white capsules and stamped with "R149" on the white half.It would be really helpful to compare our "generics" to see if there's a pattern as far as the effectiveness of each.
I'm very very curious...Thanks,
Alice
Posted by manic666 on March 28, 2010, at 11:06:24
In reply to Re: Generic Fluoxetine Vs. Prozac, posted by alicew on March 28, 2010, at 10:46:21
not heard of that one// but 5 weeks on prozac you may still have a way to go//i told you it took me 12 weeks. //i didnt move from the 20mg //to be honest 40 mg dont seem to do anymore than 20mg only mabye stronger side effects
Posted by munembo on May 23, 2011, at 21:04:26
In reply to Re: Generic Fluoxetine Vs. Prozac, posted by ed_uk2010 on March 11, 2010, at 15:33:31
Alice,
I read your post and wanted to let you know I too was taking Fluoxetine blue and white with the words PAR on it. I didn't realize that generic didn't work as well as brand names and was on it for six months before I realized I was in a deep depression, but couldn't figure it out since I was taking my 40mg of Fluoxetine every day. Prior to this I was on the Brand name and had no issues but it took me six months to make the connection that the reason I was depressed was because the generic wasn't working. I have since went back to the generic brand and I have done a 180. Thank goodness I found this out before I slit my wrists!
This is the end of the thread.
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