Newsletter: Switching Medication

The following newsletter comes from The Transplant Experience, a division of Astellas Pharmaceuticals. The newsletters are full of valuable information for individuals facing prospective organ transplants. The information is a free service of Astellas Pharmaceuticals.

"What You Need to Know about Medication Switching"

If you are on prescription medications, you may be asked if you'd like to switch from the brand name drug to its generic alternative. Before you make any decisions, though, you may consider why the medical community advocates for greater transparency about medication switching. Understanding Immunosuppressants Immunosuppressant regimens are customized specifically to your body's needs. Your doctor will monitor your drug levels regularly to make sure you have the proper amount in your body—preventing the rejection of your transplanted organ, while controlling for side effects.1 When it comes to selecting the formulations right for you, your doctor may want you to take a brand name drug for some medications and a generic drug for others. You should not make any switches without your doctor's guidance. Understanding Brand and Generic Formulations Generic medications have the same active ingredients as their brand counterparts, but may have differences in their inactive ingredients.2,3 Otherwise, both brand and generic medications have been determined by the FDA to demonstrate the same standards of strength, purity, effectiveness, and quality controls. How Could Switching Formulations Affect You? Any one brand name drug may have multiple generic alternatives, each with a different set of inactive ingredients. But since different generics for the same brand name medication can be freely substituted for one another, you may receive a generic from one manufacturer at one refill, and a different generic from another manufacturer at another refill. There is no guarantee, however, that these two different generics will behave the same way in your body. Your doctor may want you to take a brand name medication. Remaining on the brand name drug is the only way to make sure that you are receiving the same formulation at every refill. If this is your doctor's preference, your prescription will need to be protected with state-specific language, such as "do not substitute." Additionally you have the right to tell your doctor and pharmacist that you do not want your medication switched. In most cases, pharmacists or pharmacy personnel are not required to tell you if they decide to switch from one formulation to another.

Cost Savings as a Reason for Medication Switching It is often assumed that switching brand name medications for generic alternatives cuts costs.2,5 If your doctor wants you to stay on the brand name medication, most drug manufacturers offer prescription co-pay cards or other programs to help alleviate brand name medication costs. Be sure to discuss all your options with your doctor and transplant team.