From: dyer@spdcc.com (Steve Dyer)
Subject: Re: Generic drug store brands.
Organization: S.P. Dyer Computer Consulting, Cambridge MA
Date: Thu, 31 Dec 1992 09:31:59 GMT

In article <4zqr==b@dixie.com> jgd@dixie.com (John De Armond) writes:
>No we weren't.  "Drugs" is plural above.  I interpret his question to
>be generic.

Yeah, like should I buy the generic little red pills or Sudafed.
He was talking about OTC medications.  But it really doesn't matter
all that much; I'd have said roughly the same.

>>I'm am sure the knowledge that the manufacturer was A.H. Robins had a much
>>greater effect on your back pain than any pharmacological effect of either
>>form of the drug.  
>Actually I had no idea who makes the drug and could care less.

You ultimately knew one was Robaxin and the other was generic methocarbamol.

>Obviously Dyer is capable of diagnosing problems and judging drug effects
>over the net.  What a skill.  

I know about drugs; that was the question, after all.

>In my case, I did
>not know I had a generic until I went to see why the damn stuff was not
>working.  Secondly, my wife has suffered from soft tissue back pain
>for years.  She and her docs have experimented with numerous drugs 
>in an effort to relieve the pain.  Valium has little effect other 
>than making her feel bad.  Elevil (sp) worked but made her sleep all
>the time.  Robaxin is the ONLY drug tried to date that relieves the 
>pain AND does not cause any side effects.  Since she's been using the drug
>since before my problem, it's effects cannot be attributed to my 
>saying it worked with me.

It is indeed likely to have few side effects, or main effects for that matter.
Maybe it worked just fine.  What we do know is that Robaxin and placebo
both seem to work equally well against back pain in controlled studies,
making the measurement of any drug effect virtually impossible.

>Now either or both of our cases might by some stretch of the imagination
>involve placebo effects but I doubt it.  Regardless of the mechanism,
>the drug gave both of us relief and that's all that really matters.

Glad to hear it.

>My attitude with generics is this.  Regardless of the reason I have
>been prescribed the drug, be it because it is the best available,
>because the doc read about it in a journal, because the mfr will give
>him a Benz on the frequent prescriber program or whatever, I have 
>at least a bit of confidence that by the time branded drug is approved
>by FDA for use, its safety and effectivness has been proven.  I have
>no such assurances regarding some nameless generic.

You most certainly do.  All drug manufacturers have to have their drugs FDA
approved before marketing, regardless of whether the drug has a brand name
or simply a generic name.  Plus, many generic drugs are manufactured and
sold by first line drug companies, which, having failed to stem the tide
of low cost generics by scare tactics, decided to cash in on the trend
themselves.

The Reagan FDA drastically reduced its oversight over drug firms, allowing
a number of notable cases of fraud to flourish in a few generic drug firms
(misrepresentation of bioequivalency data for Bolar's Dyazide-clone being
the most notorious.)  Before this, generics had a pretty good track record,
scare stories by the Pharmaceutical Manufacturers' Association not with-
standing.  There are a few generic drugs which are not interchangable across
brands because each manufacturer's preparation has different absorption
characteristics or which may have a low therapeutic index (meaning that small
variations in dose can lead to too great or too little an effect.)  Digoxin
is the best known of these.  "Dyazide" clones (triamterene/hydrochlorothiazide)
have had a problem with bioequivalence.  It doesn't seem to matter much with
most drugs.

>Everyone is entitled
>to an opinion on this topic.  You now have mine.  It's worth what you
>paid for it.

Not all opinions are worth the same, of course.  You get to tell us
your back pain is gone.  I get to tell you that it might not have been
due to any drug effect, generic or not.

-- 
Steve Dyer
dyer@ursa-major.spdcc.com aka {ima,harvard,rayssd,linus,m2c}!spdcc!dyer
Newsgroups: sci.med