What do you do when you have a headache or sore throat? You probably grab some medication from your medicine cabinet or head to the store to get something to help you get through the day. Over-the-Counter (OTC) medications – those you can get without a prescription – are often the first line of defense against illness. In the US, the average household spends around $338 a year on OTC products, which amounts to more than $34 billion in OTC sales a year.
However, you know from your trips to the store that it can overwhelming to choose among the numerous options available. For every brand name you recognize, there seems to be a similarly packaged generic option. At least half of the products on the shelves are generic. Which is the best? What do you need to know about generic versus brand name OTC medications before buying?
According to the US Food and Drug Administration (FDA), “generic medicines work the same as brand-name medicines.” Both types of drugs must have the same active ingredients and work in the same way, meaning generics must provide the same clinical benefit as name brand products. They must be identical in terms of strength, use indications and route of administration and be manufactured under the same strict standards.
There are some key differences, however:
Cost: Generic drugs are less expensive because the drug companies didn’t have to perform costly clinical trials to get the initial approval or make other significant investments to bring the product to market. If there are multiple generic versions of a drug, competition can help lower prices even further.
Variability: With any manufactured product, whether generic or name brand, there will be variations from batch to batch. These variations won’t affect the medical properties of the drug, but they are still measurable. One research study showed the on average, there’s a 3.5% difference in the levels of absorption between generics and brand names. This level is an acceptable and expected amount of variation.
Appearance: While generics contain the same active ingredients as brand names, they must look different according to trademark regulations. This is why the pills are different shapes or colors.
Inactive Ingredients: The FDA does not require generics to have the same inactive ingredients as the brand name. Inactive ingredients are the non-medicinal ingredients such as dyes, preservatives, binding materials or flavoring agents.
Time on Market: Generics can only come on the market once the brand name drug has come off patent. Just because a drug has been for sale longer doesn’t mean it’s better, it just explains why people might ask for Tylenol when they need acetaminophen.
Even though the differences between generic and brand name OTC medications are minimal at the clinical level, and generics can save you money, there are a few steps you should take as you decide which product to buy.
1. Check and Compare the Labels: All drugs are required to have a label which clearly states the active and inactive ingredients. Be sure to read the labels for both the brand name and generic versions. If you’re allergic to any of the inactive ingredients in the generic version, then you should go with the brand name product.
Similarly, if you try the generic version and have an allergic reaction, cease taking it immediately and switch to the brand name version. If you don’t have an allergic reaction to the brand name product, then the cause is likely one of the inactive ingredients. As with any allergic reactions, be sure to notify your doctor so she or he can update your chart and future treatment plans.
2. Listen to Your Body: Everyone’s body is different. Your body metabolizes drugs differently than your friend’s. It’s important to listen to your body and how you feel after you take a generic or brand name drug. In addition to potential allergies, you may also notice differences in effectiveness. Research that determines if the active ingredients are the same are based on average blood concentrations. It’s just how averages work that some people will be more or less affected by a drug.
Also, it’s okay if you just like one version over the other. Especially when flavoring agents are involved or different kinds of packaging, it’s understandable if you develop a preference for brand name over generic. You’ve probably battled with a generic blister pack that was near impossible to open and vowed to buy brand name next time.
3. Ask a Pharmacist: If you are confused by the labels or if you have a very specific allergy, don’t hesitate to ask a pharmacist. They know how OTC drugs work as well as prescription drugs. They can probably give you insight on different generics as well. A study done at the University of Chicago showed that most doctors and pharmacists choose generics. If they’re good enough for the professionals, they’ll probably be okay for you and your family.
The above differences and steps to deciding which medication to take only apply to OTC drugs. When it comes to prescription medications, it’s best to defer to your doctor’s advice. While most doctors will prescribe the generic if it is available, there are some meds where the brand name is probably preferred. For example, some drugs known as Narrow Therapeutic Index (NTI) drugs are more sensitive to differences in blood concentration and dose. With these drugs, it’s rare that the doctors will prescribe a generic.
However, when it comes to OTC drugs, there aren’t such grave risks. Switching to generic OTC medications can save you money. Even knowing this, you should never sacrifice your health for a few dollars. If you are allergic to one of the inactive ingredients in the generic version, or if the generic version doesn’t work as well for you, then definitely continue using the brand name version. If you aren’t sure, don’t hesitate to ask a pharmacist or your doctor for additional guidance.