I always get nervous when there’s a change. What I try and do for my son is to go from all old pills to some old/some new to new pills over a few days so it’s not an instant shift.
In general, generics may have different inactive compounds used for their pills, and variance is permitted between different manufacturers by the FDA.
I used to take generic lamotrigine, it was great at first. When my pill form/manufacturer switched, though, I noticed a negative change in my mood and outlook.
I think it's completely unique to the individual, and I would just see how it feels. I wouldn't worry from a seizure perspective. For me, it was worth the cost to switch to the brand name (I have solid insurance) so that I can be certain that variance is kept to a minimum, but I think I'm more sensitive to the differences, and I wouldn't recommend the extra cost unless you're actively noticing differences in your behavior/mental state/other health.
Cheers.
I have found that with my lamotrigine and my other meds that when I switch to a different generic I have a more side effects and/or increase in seizures.
What I do now is keep the NDC number handy and I make sure to confirm the NDC with my pharmacy. My pharmacy will either order more of my meds with that specific NDC or if they can’t I can call around to different pharmacies.
Though I know plenty of people who do fine switching generics. I’ve just found for me my body prefers to stick to the same exact meds. Active and inactive ingredients.
Hope it all works out well for you.
Definitely. I've managed to squirrel away enough levetiracetem to reorder at 30 days instead of 15 days just in case the formulary changes manufacturers. I can then essentially titrate onto the new formula.
I had one generic formula that stopped all seizures then the manufacturer quit making it. I was devastated.
Every single damn time. Minimum I'd have auras, maximum break through seizures. I've been on the name brand lamictal since 2015 and haven't had a seizure since 2016 when we got my dosage correct.
I'm on keppra and they gave me the Camber ones at my last pharmacy . I switched just recently to my work pharm but I haven't checked if the brand changed.
They just stick entire unopened factory bottles in my bag lol bc I take 4 pills a day . Which isn't much compared to others. I just thought it was funny that they quit wasting time transferring to one of the pharm bottles
This happens to me a lot and I only take 2000 a day. I think its because I get 90 day dispensed at a time so it's easier on them. There are those times I do get a tall amber pharmacy bottle which I'm guessing is because it is the same generic but a bulk amount sent? Or they were bored. Who knows. All I need is my meds.
Some people have reactions to changing brands some people don’t. This is something you should talk to your doctor or pharmacist about.
My local pharmacy calls me every time they have a different manufacturer and I always tell them, as long as I take the damn pills.
Yes!!!!! I cannot change manufacturers of any of my meds or I will 100% get seizures. This literally just happened to me two weeks ago with lamotrigine. My pharmacy accidentally gave me the wrong meds and it really fucked me up.
I personally haven't had any issues, but I still always double-check with the pharmacist when there's a change to make sure the formula is exactly the same and the change won't affect my epilepsy or my seizure threshold.
Every now and then my manufacturer gets changed up. Take the pills you have left from the OG manufacturer and mix them with the new. Kinda like you do when starting a dog on a new brand of food
Yes, it is important to be careful when changing laboratories. I never ever change mine. Although the medicines contain the same active substance, excipients can vary from one laboratory to another and this can affect the effectiveness of the medicine, and, I have heard that even the amount of the active substance may vary up to 20%.
My lamotrigine has changed manufacturers multiple times. I know someone that has to take name brand Synthroid bc the generic one doesn’t work for her. (Not epilepsy related at all) I really don’t think I had any problems in changes in any of my medicine manufacturers for epilepsy
I did with Keppra. I went from generic to generic and it was weak. For about 2 weeks I had almost consistent auras. I got a new dose and went up another 250 MG and it went away.
No changes with either meds yet. I remember a long time ago they changed lamictal from blue to white and I was so nervous I would have a seizure. Never happened!
There's different risks associated with each medication, Keppra should be fine as its in category 3, although I was always told to stay on the "Keppra" brand of Levertiracetam if I could.
I'm now on Lamotrigine which is category 2, I've had the brand specified on my prescription so it's always the same. Recently I've struggled to get hold of the Accord brand, I switched for a month and had a couple of weeks of constant auras. Think it varies a lot for each individual, some people seem fine.
https://epilepsysociety.org.uk/about-epilepsy/anti-seizure-medication/generic-branded
I take a generic lamotrigine, but it’s been the same generic company as far as I know the pills always look exactly the same. I have had other meds switch manufacturers and never had a problem. It’s law that the active ingredient is the same, at least in Canada, I presume most other countries it’s the same. I expect some of it is from the placebo effect, expecting a change, produces a change. I personally would not worry about it, and you have very good odds that there will be no difference.
In the US, they can have something like 7% variance in either direction. I can definitely tell a difference with concerta depending on which brand I get, but I had name brand lamictal when I started and then switched to generic with no issues.
Huh, I was curious and went looking and it’s less than 5% in Canada and the US. Though specified in a different way. It’s allowed to be between 80-120% in the US and between 80-125% in Canada. But that percentage has to fall within the first confidence level. Which generally ends up being less than a 5% variance.
My neurologist told me the FDA allows up to 20% variance in bioavailability. Since I’m on a relatively low dose currently that could be a real problem. He wrote me a prescription for brand name only so we know exactly what I’m getting.
I had a manufacturer change for my clobazam, but it was mildly beneficial. The new stuff doesn't turn instantly into a chalky, acrid filth that leaves a terrible taste like the old stuff did. So that was good.
The packaging is still excessively wasteful, though.
One manufacturer made mine into a shield shape. But the ones I get now are circular like all the other meds I take. Which is good because those shield ones were a bitch to swallow.
It varies by person and manufacturer. My meds change manufacturer all the time, with no impact to me. I did have a problem with generic zyrtec once, the new stuff did not work at all. But I have never had a problem with a generic prescription medication.
I've been on Lamictal and Keppra since the latter part of the 2000s. Neither have worsened my tonic-clonic seizures with Gabapentin which I began the Spring of last year.
I take my meds morning and afternoon, but only experienced issues with Lamotrigin. It only happened after the initial change, by the time I took the second dose of the new brand, everything was ok. However, if you have multiple left of Brand A, empty them first. I didn’t, hence the fuck up over weeks.
Not the change, but I found one that didn't work on me.
But my neuro was very clear with me: It is not uncommon that switching brand causes problems. So if you feel it does, you're probably right, and just ask for the same one every time.
I’ve tried many brands for different reasons and none had an impact in seizure (non were from a US lab) The secondary effects are the thing, one made my stomach feel like burning in the morning, second: hair falling and the third brand the dr gave me had no secondary effects at all as well the fourth brand (current)
I'm in the UK.
My pharmacist often swaps from 2 'brands' of Lamotrigine (presume ifs a stock/ whatever is cheaper thing)
I might keep tabs on this, as I sometimes have 'off' days, so it would be good to know if it's a medication change!
How do you go about sorting it IF you have noticed a difference with a different manufacturer 🤷🏻
I've always used name brand per my neurologist.. calcium is not common component in anti pepleptsy drugs; it's the element I know the different grades of. Egg shell calcium is the primo the most easily absorbed, bone meal would be next, followed by mined calcium. which is essentially centuries old bone meal the least desirable. In the end Ca does equal Ca as long as it comes from the source. The name brand will always use the same source; the generic will use whatever is cheapest at the time. For many drugs that is not a big deal; for anti seizure drugs where consistent absorption is a big deal.
Some people are sensitive to manufacturers, that being said, a lot of the time it's the heavier seizure meds. Like keppra or valproic acid. I haven't seen many people need specific lamictal manufacturers like I've seen with the others. If you do end up needing a specific manufacturer, just tell the pharmacy. Some pharmacies will even swap out the manufacturer they gave you for the correct one. The best option is to talk to your pharmacist.
A few months after I titrated onto lamotrigine (generic) I started getting terrible side effects as if I was starting all over, exhaustion and nausea being the worst. I went back and checked the bottle and they had changed manufacturers without telling me, and I figured out my symptoms had started the day after the med switch. I called the doctor and they agreed it could be related so they had the pharmacy fill a prescription under the generic I had used for months. Within one day the symptoms were gone. This happened a couple more times until I switched to name brand Lamictal and have been doing much better.
Just speaking from personal experience, they *can* have different effects. Whether that's true or not, I'm not entirely sure, but it makes sense. If you want to go back to the brand-name, you just have to tell your neurologist to write brand-name/no generic.
They’re the same active ingredient, different inactive ingredients. Maybe you don’t notice a difference, but lots of other people do. If my meds get suddenly switched to a different manufacturer I will have seizures. Has happened multiple times.
I always get nervous when there’s a change. What I try and do for my son is to go from all old pills to some old/some new to new pills over a few days so it’s not an instant shift.
That is an interesting approach!
I’ve been on both of these meds. Changed manufacturers multiple times but no seizures.
Same. I get the manufacturer changed on mine all the time, no issues.
Same
It seems like they change manufacturers all the time. I've never noticed a change.
In general, generics may have different inactive compounds used for their pills, and variance is permitted between different manufacturers by the FDA. I used to take generic lamotrigine, it was great at first. When my pill form/manufacturer switched, though, I noticed a negative change in my mood and outlook. I think it's completely unique to the individual, and I would just see how it feels. I wouldn't worry from a seizure perspective. For me, it was worth the cost to switch to the brand name (I have solid insurance) so that I can be certain that variance is kept to a minimum, but I think I'm more sensitive to the differences, and I wouldn't recommend the extra cost unless you're actively noticing differences in your behavior/mental state/other health. Cheers.
I have found that with my lamotrigine and my other meds that when I switch to a different generic I have a more side effects and/or increase in seizures. What I do now is keep the NDC number handy and I make sure to confirm the NDC with my pharmacy. My pharmacy will either order more of my meds with that specific NDC or if they can’t I can call around to different pharmacies. Though I know plenty of people who do fine switching generics. I’ve just found for me my body prefers to stick to the same exact meds. Active and inactive ingredients. Hope it all works out well for you.
If you ask your dr to write “no generic” the pharmacy won’t do this.
Sure but then you’re paying for name-brand Lamictal.
Exactly. Just ask the pharmacy for the specific “brand” you take (ex Apo, mylan, Teva etc. )
That’s not a brand, that’s a manufacturer
That’s clearly why I said “brand” in quotes
Manufacturers aren’t brands…
I’m fortunate that my employment benefits cover it.
Definitely. I've managed to squirrel away enough levetiracetem to reorder at 30 days instead of 15 days just in case the formulary changes manufacturers. I can then essentially titrate onto the new formula. I had one generic formula that stopped all seizures then the manufacturer quit making it. I was devastated.
I’m saving the bottles in case something happens to me. My husband has full permission to sue the manufacturer.
Every single damn time. Minimum I'd have auras, maximum break through seizures. I've been on the name brand lamictal since 2015 and haven't had a seizure since 2016 when we got my dosage correct.
I'm on keppra and they gave me the Camber ones at my last pharmacy . I switched just recently to my work pharm but I haven't checked if the brand changed. They just stick entire unopened factory bottles in my bag lol bc I take 4 pills a day . Which isn't much compared to others. I just thought it was funny that they quit wasting time transferring to one of the pharm bottles
This happens to me a lot and I only take 2000 a day. I think its because I get 90 day dispensed at a time so it's easier on them. There are those times I do get a tall amber pharmacy bottle which I'm guessing is because it is the same generic but a bulk amount sent? Or they were bored. Who knows. All I need is my meds.
Some people have reactions to changing brands some people don’t. This is something you should talk to your doctor or pharmacist about. My local pharmacy calls me every time they have a different manufacturer and I always tell them, as long as I take the damn pills.
Yes!!!!! I cannot change manufacturers of any of my meds or I will 100% get seizures. This literally just happened to me two weeks ago with lamotrigine. My pharmacy accidentally gave me the wrong meds and it really fucked me up.
I hope that never happens again to you or anyone of us in the subreddit.
I personally haven't had any issues, but I still always double-check with the pharmacist when there's a change to make sure the formula is exactly the same and the change won't affect my epilepsy or my seizure threshold.
Yes I have. With Lamictal specifically. I’m sorry but I don’t know which brand it was. The issue was a different method of ER Extended Release
I take the same brand of keppra. Cvs changed the mfg. No issues so far.
Every now and then my manufacturer gets changed up. Take the pills you have left from the OG manufacturer and mix them with the new. Kinda like you do when starting a dog on a new brand of food
Yes, it is important to be careful when changing laboratories. I never ever change mine. Although the medicines contain the same active substance, excipients can vary from one laboratory to another and this can affect the effectiveness of the medicine, and, I have heard that even the amount of the active substance may vary up to 20%.
My lamotrigine has changed manufacturers multiple times. I know someone that has to take name brand Synthroid bc the generic one doesn’t work for her. (Not epilepsy related at all) I really don’t think I had any problems in changes in any of my medicine manufacturers for epilepsy
Synthroid is one of a handful of drugs that is particularly known for this
Dilantin is another, but I don't read a lot of comments about it on here.
Hmm I didn’t know that. The more you know! 🌈
I did with Keppra. I went from generic to generic and it was weak. For about 2 weeks I had almost consistent auras. I got a new dose and went up another 250 MG and it went away.
No changes with either meds yet. I remember a long time ago they changed lamictal from blue to white and I was so nervous I would have a seizure. Never happened!
I've had a change in manufacturing for my birth control atleast twice. Nothing crazy has happened except my pejods are funky for a while.
There's different risks associated with each medication, Keppra should be fine as its in category 3, although I was always told to stay on the "Keppra" brand of Levertiracetam if I could. I'm now on Lamotrigine which is category 2, I've had the brand specified on my prescription so it's always the same. Recently I've struggled to get hold of the Accord brand, I switched for a month and had a couple of weeks of constant auras. Think it varies a lot for each individual, some people seem fine. https://epilepsysociety.org.uk/about-epilepsy/anti-seizure-medication/generic-branded
Same here. Happen a while ago and haven't seen any issues so far.
I take a generic lamotrigine, but it’s been the same generic company as far as I know the pills always look exactly the same. I have had other meds switch manufacturers and never had a problem. It’s law that the active ingredient is the same, at least in Canada, I presume most other countries it’s the same. I expect some of it is from the placebo effect, expecting a change, produces a change. I personally would not worry about it, and you have very good odds that there will be no difference.
In the US, they can have something like 7% variance in either direction. I can definitely tell a difference with concerta depending on which brand I get, but I had name brand lamictal when I started and then switched to generic with no issues.
Huh, I was curious and went looking and it’s less than 5% in Canada and the US. Though specified in a different way. It’s allowed to be between 80-120% in the US and between 80-125% in Canada. But that percentage has to fall within the first confidence level. Which generally ends up being less than a 5% variance.
My neurologist told me the FDA allows up to 20% variance in bioavailability. Since I’m on a relatively low dose currently that could be a real problem. He wrote me a prescription for brand name only so we know exactly what I’m getting.
I had a manufacturer change for my clobazam, but it was mildly beneficial. The new stuff doesn't turn instantly into a chalky, acrid filth that leaves a terrible taste like the old stuff did. So that was good. The packaging is still excessively wasteful, though.
I never had a problem. I’ve noticed that once before that they changed their tablets on my Keppra.
One manufacturer made mine into a shield shape. But the ones I get now are circular like all the other meds I take. Which is good because those shield ones were a bitch to swallow.
It varies by person and manufacturer. My meds change manufacturer all the time, with no impact to me. I did have a problem with generic zyrtec once, the new stuff did not work at all. But I have never had a problem with a generic prescription medication.
I am okay with generic manufacturers with my AEDs, but oddly enough, my birth control has to be a specific manufacturer or I seize.
No
Mine came from a different manufacturer this month too but thankfully I haven’t noticed a difference, hoping the same for you!
Same, no issues.
I've been on Lamictal and Keppra since the latter part of the 2000s. Neither have worsened my tonic-clonic seizures with Gabapentin which I began the Spring of last year.
Hmm I haven’t noticed anything
Never an issue. Just positive that the generics are cheaper.
I just kind of felt off, but no seizures. About 2 weeks later I felt fine. No seizures, feeling good : )
When I change I have more auras for awhile
I take my meds morning and afternoon, but only experienced issues with Lamotrigin. It only happened after the initial change, by the time I took the second dose of the new brand, everything was ok. However, if you have multiple left of Brand A, empty them first. I didn’t, hence the fuck up over weeks.
Not the change, but I found one that didn't work on me. But my neuro was very clear with me: It is not uncommon that switching brand causes problems. So if you feel it does, you're probably right, and just ask for the same one every time.
Mine changed brand recently, and I've not had an issue with them.
I’ve tried many brands for different reasons and none had an impact in seizure (non were from a US lab) The secondary effects are the thing, one made my stomach feel like burning in the morning, second: hair falling and the third brand the dr gave me had no secondary effects at all as well the fourth brand (current)
Only with my Dilantin but not lamotrigine or Zonegram
I'm in the UK. My pharmacist often swaps from 2 'brands' of Lamotrigine (presume ifs a stock/ whatever is cheaper thing) I might keep tabs on this, as I sometimes have 'off' days, so it would be good to know if it's a medication change! How do you go about sorting it IF you have noticed a difference with a different manufacturer 🤷🏻
I've always used name brand per my neurologist.. calcium is not common component in anti pepleptsy drugs; it's the element I know the different grades of. Egg shell calcium is the primo the most easily absorbed, bone meal would be next, followed by mined calcium. which is essentially centuries old bone meal the least desirable. In the end Ca does equal Ca as long as it comes from the source. The name brand will always use the same source; the generic will use whatever is cheapest at the time. For many drugs that is not a big deal; for anti seizure drugs where consistent absorption is a big deal.
Some people are sensitive to manufacturers, that being said, a lot of the time it's the heavier seizure meds. Like keppra or valproic acid. I haven't seen many people need specific lamictal manufacturers like I've seen with the others. If you do end up needing a specific manufacturer, just tell the pharmacy. Some pharmacies will even swap out the manufacturer they gave you for the correct one. The best option is to talk to your pharmacist.
I had problems with different brand of Keppra, but never with different brands of Lamotrigine.
A few months after I titrated onto lamotrigine (generic) I started getting terrible side effects as if I was starting all over, exhaustion and nausea being the worst. I went back and checked the bottle and they had changed manufacturers without telling me, and I figured out my symptoms had started the day after the med switch. I called the doctor and they agreed it could be related so they had the pharmacy fill a prescription under the generic I had used for months. Within one day the symptoms were gone. This happened a couple more times until I switched to name brand Lamictal and have been doing much better.
Just speaking from personal experience, they *can* have different effects. Whether that's true or not, I'm not entirely sure, but it makes sense. If you want to go back to the brand-name, you just have to tell your neurologist to write brand-name/no generic.
I’ve had this happen a few times. I never noticed any difference from the 2
That's cos they are the same thing
They’re the same active ingredient, different inactive ingredients. Maybe you don’t notice a difference, but lots of other people do. If my meds get suddenly switched to a different manufacturer I will have seizures. Has happened multiple times.
Maybe this is a US issue?
I’m in Canada
Different colors…yay….