Is It Safe to Switch to Generic Epilepsy Medications?
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Newer research about other epilepsy drugs is a little more reassuring. One study published late in 2015, the Bioequivalence in Epilepsy Patients (BEEP) study, looked at the differences between the generic drug lamotrigine and its brand name form, Lamictal. The study compared how the medications were absorbed and processed in the bodies of 34 people in three different ways:
- Brand name to generic
- Brand name to brand name (different versions of Lamictal)
- Generic to generic
The patients had frequent tests to see how much medication was in their blood. The researchers saw that while a few people had trouble going back and forth between drugs, only one patient had major problems with seizures.
The question was whether their bodies processed the drugs in the same way. They did, says Barry E. Gidal, PharmD, division chair and professor of pharmacy and neurology at the University of Wisconsin-Madison School of Pharmacy.
Gidal says there was one surprising result. “They also showed that taking the brand-name drug showed a fair amount of variability.”
In other words, there are no guarantees the medication will be exactly the same every time you get a refill, even for the brand name. If your epilepsy is brittle, you could react to the difference and have a breakthrough seizure.
“The reassuring part is that they found the risks [of switching to generics] to be pretty small, [although] it’s not entirely clear how we can make predictions for individual patients,” Selwa says.
Another study, the Equivalence among Generic Antiepileptic Drugs (EQUIGEN) study, on which Gidal is a researcher, compared different generics to each other. The results were similar: Patients didn’t have any major changes in how often they had seizures or side effects.
If you can stay with what works for you, you should, Selwa says. “The best advice seems to be to stick with a single formulation, whether it’s generic or brand.”
Working With Insurance
If you’re taking a brand-name medication, one day your insurance company might decide it doesn’t want to pay for it anymore. What then?