Health knowledge and news provided by doctors.

What patients and pharmacists need to know about generic medication

Kathleen Blanchard's picture
Generic medication comes in all colors, leading to prescription non-adherence.

New research published in the Archives of Internal Medicine identifies a potential problem linked to generic prescriptions drugs. How can a patient know if they’re taking the right medication, given the variety of pill shapes, sizes and manufacturers?

The simple answer is that you don’t know, unless your pharmacist or doctor tells you that generic medicines can look entirely different.

According to the study, not knowing if your generic meds are the right prescription might mean you won’t take them.

Needless to say, that’s a bad idea. Instead of wondering, take the medication to your pharmacist for a check.

But if you’re one of those patients who stopped taking their medication because of uncertainty, you’re not alone.

The study, conducted by researchers from Brigham and Women's Hospital (BWH), found 50% of patients stop their generic medicines when they don’t look the same as their previous prescription.

First analysis links pill appearance to drug adherence

"Pill appearance has long been suspected to be linked to medication adherence, yet this is the first empirical analysis that we know of that directly links pills' physical characteristics to patients' adherence behavior," explained Aaron S. Kesselheim MD, JD, MPH, assistant professor of medicine in the Division of Pharmacoepidemiology and Pharmacoeconomics at BWH, and principal investigator of this study in a press release.

For their study, researchers looked at patients taking medications to control seizures. They discovered interruptions in filling prescriptions were more likely when generic pills were a different color from previous refills.

Follow eMaxHealth on YouTube, Twitter and Facebook.
Please, click to subscribe to our Youtube Channel to be notified about upcoming health and food tips.

Ask questions if in doubt

The researchers note the finding is important. Interrupting anti-epileptic medicines for even a short period of time can have negative health consequences.

Kesselheim advises: “Patients should be aware that their pills may change color and shape, but that even differently-appearing generic drugs are approved by the FDA as being bioequivalent to their brand-name counterparts and are safe to take. Physicians should be aware that changes in pill appearance might explain their patients' non-adherence.

Finally, pharmacists should make a point to tell patients about the change in color and shape when they change generic suppliers”, which is a fairly common practice.

The take home message is that you can know you’re taking the right generic medication when your refill looks different by taking advantage of your pharmacist’s expertise and counseling.

Often, we’re in a hurry and decline a one on one medication discussion with our local pharmacist. If you get your medications through the mail for cost savings, pick up the phone and contact your pharmacy. It’s also a great idea to take advantage of a yearly medication review that is offered through several Medicare Advantage plans.

Generic drugs come in all shapes, sizes and colors. The new finding highlights one factor that could contribute to hospitalization from medication non-adherence.

Other factors that keep patients from taking their medication include cost and adverse side effects. Never stop your meds without speaking to your physician.

Taking generic medication whenever they’re available cuts down on health care costs – but it can also make it difficult to know if you’re taking the right pill, identified in the new study. The finding is important for patients and pharmacists.

Archives of Internal Medicine
December 31, 2012

Image: Morguefile



We find clients on Thyroxine handle it well, but many show allergic reactions to the synthetic thyroid hormone called levothyroxine. This drug is a synthetic derivative of T4 (thyroxine), and it normalizes blood levels of TSH, T4, and T3. In the past, manufacturers of levothyroxine did not need to meet as strict standards as in the production of other drugs. This resulted in thyroid products with varying quality. The FDA has issued stronger requirements that have largely(?) corrected this problem.
I wonder. I hear from patients that they can't take generics forms of certain meds and I can't pinpoint why.
It reinforces the need for MD's to test their patients for allergies to the very drugs the are prescribed to get better rather than prescribing another drug to counteract the allergic response of the first one. This is often the case, in particular with the elderly, who are quite defenseless and see the MD's as God(s) I have seen them at night sitting on the edge of their bed counting out the tablets the need(?) to take the next morning. ( One red one, two of the little blue ones, one pink one, one big white one, one small white one for me. And for you dear, one, no, two blue........ ......... ........ ..... My ex father in law would say, with some pride, and an increase in volume, 'And the doctor says if I miss one of those I will die!'
Right! I think it might even been different coatings and other ingredients (dyes?) versus the actual medication itself that might cause allergy or other adverse effects. Much like food additives.
Very possible! Thank you for pointing that out! A lot of pills are lactose based, even the so-called healthy ones like Dr Schuessler tissue salts, and many vitamin and mineral supplements, even though the knowledge that less than 50% of adults are lactase persistent. Lactase persistence is fairly common in people of European ancestry as well as some African, Middle Eastern and Southern Asian groups, but is rare or virtually absent elsewhere in the world. Many dyes have been banned by the FDA, the same company who approved them in the first place. Many people have adverse reactions to those dyes. Plus the actual synthetic drugs itself! And the chemicals, which are alien to the human system and instigate immune responses which will affect the efficacy of the drug and depletes the immune system, which is the last thing sick people need.
Then the message becomes to be an aware consumer and pay attention to your body. Discuss these things with your health care provider. And don't just stop your meds - We need them until we get things under control, which of course, should be the ultimate goal - not more meds, but fewer.