Currently, there are multiple pharmaceutical companies that manufacture a generic formulation of carbidopa/levodopa, dopamine agonists, monoamine oxidase inhibitors and anticholinergics. If you are taking brand-name Parkinson's medication and are offered a generic substitute, be cautious. The FDA requires that generic drugs show an “essential similarity” to the branded drug prior to market approval, but in some cases this standard is not high enough. A review supported by NPF chronicles compelling evidence that if you are in the more advanced stages of the disease, switching from branded drugs to generic, or from one generic to another, may have adverse effects.
The authors, including NPF National Medical Director Dr. Michael S. Okun, believe that the standards for approving generic drugs for Parkinson's may not be strict enough to demonstrate that the generic alternatives are equally effective.
Work with your physician to develop a tailored treatment plan. Using generic drugs may provide a cost savings, but they may not be appropriate for you, especially if you already tolerate the branded drug.
If you make the switch, be sure to follow these tips:
- Report to your physician how effective the drug is.
- Carefully keep a diary of any side effects.
- Record dose adjustments that your physicians make (higher or lower).
- In general, try to stay with a single drug manufacturer for your generic medications. You may need to ask your pharmacist to special order for you.
When attempts to tailor drug therapy with a generic drug have been unsuccessful, have your doctor appeal to the insurance company for a branded drug. It is important to include meticulous details of the various adverse side effects with the generic medication in your appeal letter.
If you have questions about this information, please call NPF’s Helpline at 1-800-4PD-INFO (473-4636).
Ask the Pharmacist about your medications in NPF’s online forum.
Page reviewed by Dr. Joash Lazarus, NPF Movement Disorders Fellow, Department of Neurology at Emory University School of Medicine.