Brand Versus Generic

Are there problems that present due to the safe and equivalent rating given to generic medications?

The more sensitive population that is in need of precise and careful care by their physician might not be adequately represented by the Food and Drug Administration (FDA) rating. While generic medication has good result for many, this is not the case for every person.

The 20% delivery difference of active ingredients that the FDA allows in generics is necessary because the inactive ingredients (fillers and or bulking agents) vary as compared to the brand medication counterpart. Different inactive ingredients in generics do affect how a sensitive person, such as allergy prone, immune deficient, or known atypical metabolizer, will respond to the active ingredients in the generic.

Poor metabolizers do not respond typically to many medications as far as how the medications will deliver in their system. Poor metabolizers will likely be prone to side effects, sometimes dangerous ones that are more than slightly adverse as far as health and safety. Generic medication will confound things in cases where the inactive ingredients have possibility of change from month to month. This is because the resulting difference in delivery of the active ingredient might drastically vary from month to month.

The FDA represents that it simply provides a safety rating for the generic. The FDA feels resulting problems from the rating are not the fault of the agency. In order to achieve a successful FDA safety rating, the generic is only required to be tested on normal subjects. The FDA safety rating involves an abbreviated process as compared to how safety has historically been verified.

Evaluation of how generics affect the more sensitive population is not required by the FDA. There is not a specific reporting program in place in order that insurance might be required to report adverse effects from use of generics. Those who are covered by insurance and accept the forced switch from brand to generic, and then have to go back to brand due to adverse health consequences from the switch, are quietly involved in a questionable generic experiment.

Insurance companies point to the FDA rating of generics, in order to insist that even atypical responders make a switch to generic. The FDA allows this and does not address the problem that their safe and equivalent rating is causing. The FDA represents that it does not regulate the practice of medicine, but only the safety rating on generics.

The FDA is regulating the practice of medicine if, in fact, the insurance companies are using the safe and equivalent rating as medical fact across all types of illnesses. The insurance companies apply generic medication policy in medical cases where the rating of equivalency should never be medically applied. Since there can be a dramatic difference in response between brand and generic medication, for those who have health issues or sensitivity — brand medication and the generic counterparts can act as if they are two entirely different medications.

The FDA allowed difference in delivery and performance between brand medication and generic medication is bad medicine for many who desperately need the same delivery of their medication, every time. While brand medications have the same active and inactive ingredients every time, generic medication counterparts realistically can have inactive ingredients that differ every month, impacted in huge part according to what the generic supplier and pharmacy have opted to purchase and provide to their customers. Therefore the generic medication delivery of the needed active ingredient can drastically differ according to the variability in inactive ingredients.

The generic medication difference is in the… “Active ingredients, bulking agents, preservatives, coatings, shelf life instabilities, manufacturer glitches.” (Susan Okie, M.D., Multinational Medicines-Ensuring Drug Quality in an Era of Global Manufacturing, 8/2009)

The FDA process of regulating generic medications has actually gone a little backward.

Before 1984, generic-drug makers were obliged to conduct the same safety and efficacy tests that had been required of the original brand-name manufacturers to receive Food and Drug Administration (FDA) approval for marketing.” But then: “The Hatch-Waxman Act allowed abbreviated process for generic drugs to receive FDA approval and allowed generic drug manufacturers to apply for FDA approval and conduct tests before relevant patents expired.” *

Furthermore: “Companies seeking approval of generic drug are not required to conduct chemical trials of its safety or efficacy, but most submit results of a study in healthy volunteers with product absorption comparative to brand – medication counter part.” *

So, even if it is true, that generic medication is safe and equivalent for those who are already healthy. What about those who are not quite the picture of perfect health or perfect response to treatment? The FDA might not have the ability to care, and insurance companies may be prone to look the other way in favor of their pharmacy benefits bottom line. There are avenues of expression that paint a vivid picture of generic medication’s effect upon the population in need of good medicine.

People’s Pharmacy provides multiple years’ worth of reports of adverse response to generics by people who had been successfully treated with brand named medication, but forced to switch to generic. Another site formerly called CrazyMed has provided a bird’s eye view of the effect of generic medication upon those with forms of depression and psychosis. Reading the posts from either source overwhelms due to the number of posters’ who had to experiment with the generic medication that they were forced to switch to.

Everyone talks about saving at the pharmacy, but some people who have been inclined to switch to generic from brand have big problems. They are likely visiting the doctor more frequently and perhaps requiring more inpatient stays. I do wonder how many might have done themselves in due to the psychosis that revisits them while experimenting with generics that do not give the same results.

The problem of metabolism and how delivery of generic medication can vary, coupled with the other problem of special interest’s control over delivery and quality of medication products — begs an important question. What is the point of medicating if the special interests are just going to end up taking the good initial result away from the person being medicated?

About the issue of poor metabolism and autism.

Many drugs that are used to treat those within the autism spectrum interact with CYP2D6. CYP2D6 receives a lot of attention with regard to research on how drugs metabolize in the system. Poor metabolizers of the CYP2D6 enzyme, who are tried on medications that interact with CYP2D6, might experience increased plasma concentrations that can increase the risk of serious adverse consequences.

CYP2D6 is considered a low-capacity, high-affinity enzyme and CYP2D6 will preferentially metabolize drugs at lower concentrations. As the concentration of a drug increases, the metabolism spills over to CYP3A4 and CYP1A2, which are high-capacity, low-affinity enzymes. Thus if a drug that has several metabolic pathways but relies on CYP2D6 as its major pathway is given to a patient with poor CYP2D6 activity, the other P-450 enzymes that are high capacity, low affinity will clear the drug, but clearance will be slower and less efficient, and drug levels will increase, increasing the risk for adverse drug reactions. Four phenotypes are identified: poor metabolizers (PM), ultrarapid metablizers (UM), intermediate metabolizers (IM) and normal metabolizers (NM)”. (Pharmacy Times)

The antidepressants that are metabolized by CYP2D6 are ones that are used frequently, and they include: cimetidine (Tagamet), the selective serotonin reuptake inhibitors (SSRIs) and some tricyclic antidepressants.

“…Paroxetine (Paxil) appears to have the greatest ability to inhibit the metabolism of CYP2D6 substrates. This is followed by fluoxetine (Prozac) and norfluoxetine; sertraline (Zoloft) and desmethylsertraline; fluvoxamine (Luvox), nefazodone (Serzone) and venlafaxine (Effexor); clomipramine (Anafranil), and amitriptyline (Elavil)…Although sertraline appears to be less likely than the other SSRIs to inhibit CYP2D6, inhibition may still occur at doses greater than 50 mg. The clinical significance of the inhibition of tricyclics by SSRIs or cimetidine is subject to variation in enzyme activity between individuals, the degree to which the patient metabolizes and co-ingestion of other enzyme inhibitors“. (HealthandDNA.com)

Some feel that as many as half of the patients who take medications are probably not experiencing any type of benefit from them due to metabolism issues, while most likely being exposed to potential danger from side effects. One source expresses the thought that at some point, medical professionals might let go of the one pill fits all mindset. Many obstacles will detour that process. There is hesitation by doctors to utilize CYP2D6 testing since there are no clear guidelines about how they should act upon the information provided by the test.

Additionally: “The ability of test developers to prove that their tests are accurate and useful is one major obstacle. Other obstacles include the reluctance of drug makers to encourage or develop tests that could limit the use of their drugs and the possibility that insurers might not pay for the tests. However, drug makers are “starting to realize that their medicines might not be approved or paid for without better evidence that they work,according to the Times (Pollack, New York Times, 12/30/08)”. (Medicalnewstoday.com)

In many cases of autism I am personally convinced that the metabolism issue is a significant factor with regard to failure of medication tries. Additionally, the tries might actually contribute to worsening.

Many autism affected children begin using medications at a very early age and one analysis “… included 75 children enrolled in the long-term Collaborative Programs of Excellence in Autism. The study found that 52% used at least 1 psychotropic medication between the ages of 3 and 12 years and 20% had taken 4 or more.” (Medscape.com)

Learning what I have about the metabolism issue from personal experience, I often become curious about the consequences with regard to how many children were doing well on a brand medication, and then suffered a worsening — simply because they had been switched to a generic that was deemed safe and equivalent by the FDA.

Families trust the rating and may never consider that the switch to generic is what caused the worsening. For those within the autism spectrum this might be a huge issue.

Generic medication and brand medication might very likely be considered neither safe or equivalent where a switch would be concerned, for those within the very sensitive autism population.

Posted under Live healthy life by Live healthy life on Monday 28 November 2011 at 4:52 pm

A Key Fat Loss Strategy

If fat loss is of primary importance to you, then you have most likely exercised a certain way or have not even entertained the idea at all. If you have been exercising with just cardio only and the results are meager, you may be asking yourself “Where are those flat abs, thin thighs and rock hard body I’ve worked so hard to create?”

I’m here to tell you that chances are high you are not utilizing one of the key components to fat loss: Strength Training.

Many people think that losing weight is all about controlling calories with dieting..so they try to starve themselves into weight loss. Their daily weight loss mantra is “minimal calories.” Yes, calorie deficit is key in fat loss, but it is only part of the picture.

Typical diets keep your calorie intake low. This creates a problem because muscle mass is being lost as a result. Dieters try to lose body fat by starving themselves, and as the body fat vanishes from their body, their muscle mass also disappears. This loss of muscle will slow down the metabolism. Muscles keep your metabolism humming – muscles burn calories even at rest.

Many people find that once they have lost the body fat they are weighing less, but that it becomes so much easier to put weight on again. The reason? The metabolism has slowed due to the loss of metabolically active muscle. So once they go off of the diet, and everyone does, they will start to pack on the body fat again.

The solution to this is to maintain and increase your muscle mass by engaging in strength training while you are losing weight. By doing this, you will be able to increase your muscle mass and thereby increase your metabolism. This will leave you with a greater proportion of lean muscle to fat, meaning you will be slimmer.

Strength training will increase the speed of your fat loss and adding an aerobic program will double the effectiveness of any weight loss program you are on. Both of these forms of exercise, along with an effective nutrition program, will begin to radically change your body.

A high percentage of body fat is stored not only as obvious fat such as on our hips, stomach and arms etc., it is also stored intramuscularly, which means it is stored within the muscle as well. Think about a well-marbled piece of steak, that fat pattern is the same in our muscles.

Fat takes up four times more room than muscle and actually makes muscles look bigger because of the fat inside. But once you start your program of strength training, that intramuscular fat will disappear.

The easiest way to increase lean muscle tissue and decrease body fat is to perform strength training exercises 2- 3 times a week. Examples of strength training exercises include: squats, lunges, push-ups, sit-ups, bicep curls, triceps extensions, dead lifts, and lateral shoulder raises, and resistance tubing.

An effective alternative to increasing lean muscle mass along with flexibility is Pilates. Pilates exercises keep your body toned, and increases your metabolism.

Posted under Live healthy life by Live healthy life on Monday 21 November 2011 at 4:23 pm

Keys to Women’s Unwanted Facial Hair Growth

Having too much facial hair can be embarrassing and shameful. It appears without warning and can often cause depression and poor self-image.

Fortunately, having excessive face hair is not a curse. There are many reasons women experience abnormal facial hair, many of which can be controlled. British Science Journal found that Wanji cream reduced facial hair growth rates in 70% of females that used the product for 4 weeks. In this article, you will learn the reason for your unwanted facial hair. Narrowing in on the potential cause of the excessive hair growth could be a key to not only alleviating the extra facial hair, but also helping your overall wellness.

Hormonal Imbalance Due to Menopause and Perimenopause
You are finally done with monthly menstrual cycles and feel a little relieved. But suddenly you begin to see changes in your hair. Your hair becomes thinner and your facial hair is more prevalent. It starts with a few extra chin hairs. Then, it grows into a large moustache or repeated dark hairs along the base of the chin or cheeks. Wherever it appears, if it is darker in color, thicker than normal and appearing more frequently than once every two weeks, you may have a hormonal imbalance.

Women who are in the beginning or final stages of menopause often experience drastic hormonal changes. These changes in hormones disrupt the natural balance of estrogen, progresterone and testosterone in the body. If you are seeing more hair growth and are above 40 years of age, the facial hair could be due to perimenopause or menopause.

Hormonal Imbalance Due to Insulin Overload
Every girl loves her carbohydrates. However, all is not fair in love and carbohydrates.In the Standard American Diet (SAD), our carbohydrates are amplified. Most carbohydrates in America are refined and stripped of their nutrients. Additionally, America’s carbohydrates are laced with culprits such as high fructose corn syrup, potassium bromate and refined white sugar. This only exacerbates the damaging effects of a carbohydrate heavy diet.

Too many refined carbohydrates and high sugar foods in the diet can promote insulin resistance or Diabetes. Insulin is a critical hormone in your body. It helps balance your blood sugar and regulate metabolism of sugar and other foods. Insulin also helps balance your other hormones, including estrogen, progesterone and testosterone. Thus, it your insulin is out of whack because of carb overload or sensitivity, you may have more of moustache. It looks like milk isn’t the only thing that can give moustaches.

Consider supplementing your body with herbs that help regulate your hormone levels, specifically insulin. Carb helpers are great supplements to add, such as Slimatrol Carb Block or Psyllium.

Basics of Female Lip, Chin, and Cheek Facial Hairs # 3: Polycystic Ovarian Syndrome (PCOS)
This sounds scary, but no need to get alarmed. PCOS is not a disease. It is only a syndrome. This syndrome is not fatal. It can be treated naturally. But if left undetected, it can affect your facial hair growth. Typically, PCOS goes hand in hand with insulin sensitivity. You may experience depression, weight gain and of course, more facial hair. If you are currently not in perimenopause or menopause, you should check into the role of PCOS and facial hair.

When trying to attack facial hair from PCOS, keep it natural and focus on hormonal support. Great advanced herbal formulas are available. They contain extensive natural herbs that regulate insulin, estrogen, progesterone and testosterone. They can also help decrease your facial herbs. Comprehensive supplements and female hair reductions products by Wanji cream are recommended.

You Are What You Eat
This article’s goal is not to badger, but to help. Unfortunately, eating large amounts of meat can make you more vulnerable to facial hair growth. Often, the meat and poultry industry feeds animal natural hormones and artificial hormones to up their size and growth rate. Even with natural and grass feed meat and poultry, the addition of natural hormones can have effects on those who eat them. So, just keep this in mind as you eat meat and poultry. You may consider limiting your intake to about three times a week.

Posted under Live healthy life by Live healthy life on Tuesday 8 November 2011 at 4:49 pm