Are There Situations That Require Special Consideration Before Choosing a Generic?
Some drugs -- known as NTI (narrow therapeutic index) drugs -- may need special consideration if you are thinking of using the generic version. NTI drugs have a narrow margin between the amount that is safe and effective and the amount that is toxic.
These generic drugs include:
- warfarin (a blood thinner)
- digoxin (treats certain heart conditions)
- theophylline (treats asthma, COPD, and other lung diseases)
While the FDA has not had a policy restricting the use of NTI generics, some states have laws that do. In those states, if generics are used, precautions and additional monitoring are required.
The list of restricted NTI drugs varies from state to state. The FDA does not have a list of recognized NTI drugs. The FDA is revising its policy to identify drugs that should be included on such a list and to specify whether additional precautions are needed when generics are substituted for such drugs.
Your doctor should tell you if you are taking an NTI drug and what type of monitoring you need.
Should You Be Taking Generic Medication?
Generics are not available for all medications. The best way to find out if a generic is available for a medication you are taking -- and whether or not you should take it -- is to ask your doctor and pharmacist.
Some health insurance companies require that you use a generic drug, if available. If you chose to purchase the brand-name product, you may end up paying on your own or be required to pay a larger co-pay.
Generally, your pharmacist can substitute a generic drug for a brand-name drug. If there is a generic available but for some reason your doctor thinks you should still take the brand-name drug, the doctor will indicate that on the prescription by writing "Do Not Substitute."
If your pharmacist for some reason does not substitute a generic for a brand-name drug, you can ask your doctor to indicate on the prescription that substitutions are acceptable. That way, you can get the same drug for considerably less expense.