FDA Finds Not All Generics Created Equal

slimvictor

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"Darkness cannot be dissipated with more darkness.
The FDA's reversal earlier this week of its approval of a generic equivalent of the popular antidepressant Wellbutrin XL 300 ends a five-year saga that began with consumer complaints and a crusade by Joe Graedon, the cofounder of the consumer advocacy group the People's Pharmacy.

In 2007, Graedon began receiving disturbing complaints on his website from patients who had been taking the 300 mg dose of Wellbutrin and had recently switched over to the generic equivalent Budeprion XL 300. Budeprion products are sold by Teva Pharmaceuticals and made by Impax Laboratories, both headquartered in Philadelphia.

"People were saying, 'I've been on Wellbutrin for several years and things were fine and dandy, but once I was switched I started experiencing headaches, anxiety, depression and sleeplessness'," he said. "People who had never been suicidal were all of a sudden reporting suicidal thoughts."

At first Graedon said he was skeptical. But after he had received a few dozen messages, he decided to write about it in his syndicated newspaper column. That's when the floodgates opened: Soon more than a thousand messages poured into the People's Pharmacy website describing the same symptoms, in intimate detail.

Alarmed, Graedon contacted Consumer Lab, an independent testing group based in White Plains, N.Y, and asked them to evaluate the 300 mg dose of the generic pill. The findings of the Consumer Lab tests suggested that while the active ingredient in the generic Budeprion XL 300 mg and brand-name Wellbutrin XL 300 mg products was identical, the rate at which it was released differed.

"In the first two hours of a dissolution test, we found Budeprion released 34 percent of the drug, while Wellbutrin released 8 percent. At four hours, the Teva product released nearly half of its ingredients, while original Wellbutrin released 25 percent. The generic did not act like a once-a-day formula but more like an immediate release formula," Dr. Todd Cooperman, Consumer Lab's president, stated.

Cooperman said the problems arose because of an unusual circumstance where the patent on the drug itself had expired, making it available in generic form, but the time-release mechanism used in the original did not. The original pill has a membrane so that the drug seeps out over time. The Teva pill simply breaks apart.

Consumer Labs and the People's Pharmacy took their concerns to the Food and Drug Administration and requested information on the human drug trials that companies are typically required to submit for drug approval. After what Graedon described as "a lot of back and forth," the FDA revealed that the 300 mg product had never undergone bioequivalence testing even though this is typical agency protocol. Instead, their approval was based on tests of a 150 mg version of the drug.

Graedon said although it's well understood that different dosages of drugs frequently don't have the same results and can produce varied side effects, the agency stood by its approval of the 300 mg dose of the generic. However, they asked Teva to voluntarily perform its own trials involving people who had reported problems.

Citing difficulty recruiting subjects, the company never performed the tests. Then in 2010, the FDA took the unusual step of conducting its own independent trial of 24 subjects. It found that the maximum concentration of Budeprion XL 300 in the blood reached only 75 percent of the amount Wellbutrin XL 300 released.

cont at
http://abcnews.go.com/Health/fda-fi...ssant-original/story?id=17399399#.UHIYUo5K4f4
 
I was on bupropion (the generic form) for well over a year and liked the fact that the effects came on pretty suddenly. It was sort of like an ir amphetamine come-up in this respect.
 
Very misleading title. The drug was pulled for not meeting bioequivalence standards. It's very easy to say that generics aren't equal to brand when they are forced off the market for not meeting standards. Statements such as these are what keep big pharma in business.
 
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I don't understand how this generic company could of bypassed vital human trials in such a strictly regulated industry. Or so i thought.
 
It should be noted they are talking about the extend release bupropion. A lot of extended release formulations don't seem to be quite the same to other generics or brandnames of current or past. It's a little different than this case because its dealing with generics of bupropion that are out on the market currently simultaneously, and the fact that it is generic but the oxymorphone extended release tablets before the reformulation this past year are clearly different in how they break down in the GI track compared to the new formulation currently in use, or the oxycodone extend releases of the past compared to the extended release of the present.

It shouldn't be ignored that once again a pharmaceutical company is skipping steps required in the process before releasing/marketing their drug products, which isn't a rare thing. There are a lot of information gathered from pharmaceutical companies in human trials that are not published or sent along with the rest of the results gathered from trials. Also a lot of misrepresented text that implies one thing but doesn't quite tell you the whole truth behind it (i.g. pushing for prescribing of their marketed drugs by saying it preforms better in trials than its competitors (?) [forgot the word they used], when in reality the trial didn't have any groups using any other drugs and was compared against placebo - essentially it preformed greater at the examined criteria than a sugar pill + a tricked mind).

There are guidelines in place that help support a system where differences between drug products are represented using certain classifications, where the doctors prescription can be filled using various manufacturers product with out there being this issue of non-equivalency between products when they are marketed otherwise. Its good that the FDA brought this to light, but even with their laws it doesn't prevent all the illegal shady shit pharmaceutical companies have going on. It seems only once in a while the FDA will actually bring cases like in this article out in the public and requesting the discontinuation of their manufacturing. There is way to much shit that we are not aware of going on from big pharma as much as I'd like to have some faith that the laws that are in place, to allow me to consume medications that I allow a pharmacist to dispense with out question or concern of the path it took to get to my hands (the 11 or so years it took to be approved by the FDA before it hit the market, and the many years of continually distribution with out question). Hardly anyone questions the manufacture of a drug before purchasing, and even if they did, how would the consumer know if there was something shady in the approval process. Granted, I'd rather deal with the USAs pharmaceutics than a countries less regulated pharmaceutics, and I know that the illegal drugs I take are the opposite of regulated so its better than nothing.
 
I think there is a huge controversy arising in the US at least about the whole "abuse proof" er pain meds and their generic 'equivalence'. I hear so much bs about it. and as far as bupropion, I never got good effects so I cant say much about how it felt when i took it, other than bad.
 
Congratulations to the UN mandated pharmaceutical cartels which continue to break down under the pressure of providing us equitable care under record profits.
 
Apparently the FDA gave them a waiver for not testing the 300mg tabs to avoid the risk of seizures in healthy test subjects, and assumed they would also be bioequivalent. It sounds reasonable, I don't see any reason why bioavailability should differ between the two dosages, but apparently it does:

150mg:
The average bupropion AUC from the volunteers receiving the Teva generic product under fasting conditions was 98% (90% CI, 91.9%-104.4%) of the average AUC from all of the same volunteers after receiving the Wellbutrin XL under fasting conditions. Under fed conditions the average bupropion AUC for the Teva product was 108% (90% CI 101.4% -115.4%) of that for the Wellbutrin XL product.

The average maximum bupropion plasma concentration (Cmax) produced by the Teva product was 89% (90% CI, 80.3% – 98.2%) of that produced in the same volunteers by Wellbutrin XL under fasting conditions and 110% (90% CI, 103.2% - 118.0%) under fed conditions.

300mg:
The mean AUC for the 24 healthy adult volunteers after administration of Budeprion XL 300 mg was 86% (90% CI, 76.7-95.8%) of the value determined after administration of Wellbutrin XL 300 mg.

The corresponding Cmax value for Budeprion XL 300 mg was 75% of the value for Wellbutrin XL 300 mg (90% CI, 65.2-86.8%).

http://www.fda.gov/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/CDER/ucm153270.htm
http://www.fda.gov/Drugs/DrugSafety...ormationforPatientsandProviders/ucm322160.htm
 
A Drug Recall That Should Frighten Us All About The FDA

full http://www.forbes.com/sites/davidma...call-points-to-serious-problems-at-the-fda/2/

Pay attention, as I can’t say this seriously enough. Last week, the FDA took a drug off the market, and the reasons should send shivers of fear down the backs of consumers, investors, generic drug companies – and the FDA.

The FDA announced last week that the 300mg generic version of Wellbutrin XL manufactured by Impax Laboratories and marketed by Teva Pharmaceuticals was being recalled because it did not work. And this wasn’t just a problem with one batch – this is a problem that has been going on with this particular drug for four or five years, and the FDA did everything it could to ignore it.

The FDA apparently approved this drug – and others like it – without testing it. The FDA just assumed if one dosage strength the drug companies submitted for approval works, then the other higher dosages work fine also. With this generic, American consumers became the FDA’s guinea pigs to see if the FDA’s assumption was right. It wasn’t.

Background

In December 2006, the first generic versions of the popular anti-depressant Wellbutrin XL were approved by the FDA. The drug comes in two dosage strengths, 150 milligrams and 300mg. The 300mg dose is generally used for patients with more severe depression and anxiety and patients who don’t respond to the lower dose. The FDA approved generic versions of both dosage strengths from a few generic drug companies: Teva Pharmaceuticals (manufactured by Impax Laboratories and marketed by Teva Pharmaceuticals), Anchen, Actavis, Watson Pharmaceuticals and Mylan Pharmaceuticals. Almost immediately, the FDA started receiving reports from patients that claimed the 300mg dose was being associated with side effects and reduced efficacy.

The People’s Pharmacy, a well-known syndicated radio and newspaper columnist husband and wife team, notified the FDA that hundreds of patients had logged their own complaints of side effects with the then-recently approved generic version of Wellbutrin XL. The FDA brushed off the People’s Pharmacy and others that raised the issue, stating that they had faith that the drugs were equivalent and that perhaps the patients, who had mental disease, were more prone to perceived problems with a change in the medication than others. This was seen by many as essentially telling patients “it’s all in their head.” After several more years and public outcry, the FDA was forced to take action.

What Action Did The FDA Take?

Instead of doing its own study on the drug, the FDA asked the drug maker to conduct a study to determine whether the generic drug was equivalent to the brand. The FDA, in their recent press release, claims that Teva started the trial but later abandoned it because of slow patient enrollment. It was already 2010, several years after knowing there was a problem, the FDA was forced to do its own study.

Did The FDA Drag Its Heels?

The FDA study was completed in August 2012 – more than 5 years after the initial problems were reported. The FDA study showed that the 300mg dose from Teva is ineffective insomuch as it did not deliver enough of the drug.

Oddly, despite the result being available in August 2012, the public was only made aware of this in October 2012.

cont. http://www.forbes.com/sites/davidmaris/2012/10/10/fda-recall-points-to-serious-problems-at-the-fda
 
Wow.

This story is a must-read. After reading it, I feel like I've been violated. I've taken a lot of Teva buproprion and I always felt my doubts about it were delusional. Now I know they were factual!

And this is a problem that may be endemic to generics as a whole? They're not actually tested before being sold?

I'd like to apologize to buproprion the chemical. I'm sorry about all the shit I've talked about you.
 
This is not good. If it's like this for Wellbutrin just think about the other generics that it could be like this for. :\ I know people who take generic heart meds, blood pressure meds, and other meds.
 
one thing to keep in mind is that this is a generic extended release drug. most instant release drugs should not have this variability

teva is going to get fisted in court for this.
 
one thing to keep in mind is that this is a generic extended release drug. most instant release drugs should not have this variability

teva is going to get fisted in court for this.

This. XL and ER dosage forms and low therapeutic index drugs have issues as generics, but it highly unlikely to experience difficulties with most generics. Some generics are actually the branded medication in a bottle with just a different label. That being said, Teva is in deep shit, though they will soldier through since they have deep pockets.
 
What precisely is the difference between Wellbutrin and Teva's version at the level of physical composition? Is the problem just that, in the generic extended release version, the inert matrix of pill constituents that determines when bupropion is released during digestion doesn't dissolve when it is supposed to, whereas in the branded pill it does (for the 300 mg pill) ? If so, could users just mash up their far cheaper generic pills, guestimate the dose, and take the piles of dust as they would take an instant release pill while the government and companies hash this out?
 
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If so, could users just mash up their far cheaper generic pills, guestimate the dose, and take the piles of dust as they would take an instant release pill while the government and companies hash this out?

that's what I'd been doing.

The powder numbs the hell out of the tongue.

But it's perhaps a bit too anxiogenic when done that way.

The olde GlaxoSmithKline SR 150s were pretty close to euphoric. It's the only antidepressant I've found to be reinforcing; I would always run out of doses 5-8 days early.
 
^I'm actually surprised it's not a C-IV as some of its chemical cousins are scheduled as such as weight loss pills.
 
well this doesn't frighten me, as i stopped trusting them around the time i stopped trusting all cops (ie around puberty lol)
This does make a good case against the FDA tho, and at a great time (I imagine- as i assume they want heavy involvement on regulating mmj. ACTUALLY, on that note, any insights into who's fighting both sides behind the scenes right now? I mean, damn..think about if you're DEA or ONCDP, or FDA, and knowing how the landscape'll change as things transition. Must be weird trying to secure a drug warrior spot, while keeping your foot in to regulate legal-usage!)

[edit: 'all cops' comment just meant i realized there were bad ppl who had authority; they were not to be homogenously trusted just cuz of uniform/badge. I see how it could read as trusting 'no' cops, which would be ridiculous obviously]
 
i just checked, and luckily i take actavis generic bupropion. but it sucks that they blew this off for so long that so many patients had to suffer without the correct dosage of their medications
 
wow, read the entire article ppl.
What the fuck do still maintain an FDA for? Talk about some fat that needs trimming immediately.

EDIT: Okay, if ppl are able to constantly sue pharm companies for bad products, what reasonable actions could be taken here? I mean honestly, this government org is DANGEROUS when it acts like it's checking stuff that it is not. Then asks the companies to conduct their own testing? Err, they do that W/O needing an FDA, and if your role as "regulator" consists of what we're seeing, you need to be dismantled quickly (something i'm for, *regardless* of their efficacy; but, in light of how they actually operate in practice and what their effects are, most anybody should be for an extreme overhaul at the very least. Given the growing trend of both (open/accepted)recreational marijuana, and marijuana-as-medicine, we're at a very relevant time to reconsider the roles of orgs like the FDA and DEA)
 
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