Generic Epilepsy Drugs Not the Same
Patients Warned Switching Between Dilantin and Generic Brands Can Cause Relapses
Generic Not Bad, Just Different
Leppik says that for 15 years, one of his patients kept her epilepsy seizures under control with Dilantin. That suddenly changed.
"This year, she shows up in my clinic with two seizures," he says. "She lost her driver's license, and her blood levels of Dilantin were low. She said she'd been taking her medicine same as always. So I asked her, 'Do your pills look different?' She said, 'Yes, but my pharmacist said it was the same thing, so don't worry.' We got her back on brand-name Dilantin, and now she is doing fine."
Leppik and Barkley stress that brand-name Dilantin isn't necessarily better than generic versions of the drug. It's just different -- and this difference may be important.
"My recommendation is if you're on Dilantin, don't' switch. And if you're on generic phenytoin don't switch," Leppik says. "Either way you can get into trouble. The worst is switching back and forth."
Barkley says that while the cost of Dilantin is only a few cents a pill more than generic versions, most of his patients taking phenytoin are on generic versions of the drug.
"In most cases, generic drugs are a good deal for the consumer," he notes. "It is the best thing for keeping drug costs low."
In the case of switching patients from Dilantin to generic phenytoin, however, any savings could be wiped out by a single trip to the emergency room.
"Switching from Dilantin to a generic version may be penny wise and pound foolish," Barkley says.
Leppik advises people taking either Dilantin or generic phenytoin to pay attention when they're at the drug store.
"The message here is to look carefully at your pills when you go to the pharmacy," he says. "If you are taking Dilantin brand, be sure to continue. If you're getting a generic brand of phenytoin, be sure to get same-looking generics."
Meanwhile, Leppik and colleagues took their findings to the Minnesota state health authorities. They changed the rule requiring a switch to generic Dilantin.