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Peony

Cymbalta Going Generic?

122 posts in this topic

Posted

I have just started taking the genaric form of cymbalta 3 days ago. I couldnt figure out why i was feeling a little off the 1st day and i got steadily worse with day 2 and 3. Then my fiance who knows me all to well asked if i had forgotten to take my cymbalta... I then realized what the problem was. I feel like someone pulled the plug, complete brain fog, body aches, no conentration, hard to even complete 1 thought and blank emotion except the slowly increasing anxiety because of all of this. Total unvolintary disconnect. I c others are having similar problems and we are only the small % of people who refilled the first week and realize why we feel this way and will talk about our mental health. Please people ive never joined a forum or even wrote a review in all my internet days until now. It is EXTREMELY IMPORTANT that each of us make a report to the FDA on our negative and dangerous symtoms of switching to this genaric. There is clearly a problem with this drug substituting for cymbalta and it needs to be known and fixed. If we dont speak up and in places we are heard noone will know or correct this

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Posted

Speakout, thanks for your post.

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Posted

Speakout,

I truly believe it's much harder to switch TO a generic, for many medications. With the generic Cymbalta, I knew it was a matter of figuring out how the timed release actually was working - and I just couldn't do it. It's almost as if it wasn't a "steady" release at a low rate, it felt like big releases which had to wear off - which is why I felt foggy and confused.

I have been back on the name brand Cymbalta again and feel much better. The insurance company did contact my Doctor for the signature on the medically necessary "override" form and it will have to be renewed next year.

if you have insurance, you should inquire about how to do something similar. If you're paying out of pocket, check on the Eli Lilly website to see if you qaulify for their patient assistance program.

Good luck and speak up - if you don't feel well, it's hard to be yourself.

As for the FDA.... the big pharmaceuticals receive patent protection because the drugs are developed in the US, which is why Americans pay 3 times as much for the medications after it's approved. The patent protection lasts for 10 years and the pharmaceutical can request an extension - which Lilly did receive. After the patent protection expires, the drug can be manufactured by other companies.

The issue is that the insurance companies encourage the use of generics to keep their costs down. Patients have to work hard to ensure that they receive the medication that works for them - and the amount of paperwork and phone calls can be discouraging. But don't give up because that's what some insurance companies want you to do - be persistent.

I was lucky to speak with a benefits rep who cared enough to offer me the override - but if it's not offered, inquire about how to get it done.

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Posted

My bipolar teen has been on a combination of Cymbalta, Abilify and Lamictal and doing well. Our last refill of Cymbalta was to generic (insurance decision, not mine) and I voice my concerns to her med doc, but he assured me 'it should be fine'. Well after 2 doses of the generic (she takes in am) she started a major depressive episode and by the 3rd day she was as bad as I've seen in a long while and was wondering if a trip to the hospital was necessary. This was over the weekend and Monday morning I went to to the pharmacy and purchased a few doses of brand name at almost $10 a pill!

I have yet to call the insurance company....they will 'pay' for brand name because of this reaction, but at $191/month! She's been back on Cymbalta brand name now 3 days and still having trouble with sleep, but mood is getting better. NEVER again will we do generic after being stable on brand name ANYTHING.

What can be done?

Sara

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Posted

I'm on day 8 of generic duloxetine. Seems to be getting better and I can probably stand to stay on a bit longer. My main issue is being able to sleep. I still wake up multiple times during the night but it's managable, not like the horrible first night. Also I broke open a generic capsule today. There are about 6 large granules inside (30mg). In the Cymbalta caps, there are many dozens of microgranules. Clearly that has to have an impact on the way it released into the system. I'm not commited to staying on the generic but would like to give it a fair shot. My mood is great, just need to get through the sleep part.

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Posted

I was searching for any testimonies related to switching from Cymbalta to the Teva generic and found this site. My wife is on day 4 and has gradually descended into a depressive state. Today we got pretty close to the bottom. Physician advice was to take it on an empty stomach and take an extra dose 12 hours after the regular dose. She is "happy" she is not alone with these symptoms but this kind of happy is just less miserable, not enjoyment.

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Posted

I switched to Generic about a week ago (Teva) and it felt like start up side effects again but they seem to have subsided for now.

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Posted

Wishing you the best, Windshear. Let us know how it goes.

I got feeling back to normal after a few days back on the non-generic and my doc says the prior approval went through so I'll just stay on the brand name product.

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Posted

The generic that I tried was from Citron Pharma in New Jersey. Some of the posters have mentioned Teva Pharma, which is an Israeli company with manufacturing facilities in many countries. The US manufacturing is in Puerto Rico.

The Citron generic had about 200 of the microgranules, similar to brand name - I take 60 mg. per day

Phil C mentioned that his generic was from Lupin Pharma and that there were 6 granules for the 30 mg.

I'm curious about how many microgranules are in the Teva generic. If someone doesn't mind opening one before they take the med, it might offer some insight as to the variance.

Phil C is having problems with sleep:

I'm on day 8 of generic duloxetine. Seems to be getting better and I can probably stand to stay on a bit longer. My main issue is being able to sleep. I still wake up multiple times during the night but it's managable, not like the horrible first night. Also I broke open a generic capsule today. There are about 6 large granules inside (30mg). In the Cymbalta caps, there are many dozens of microgranules. Clearly that has to have an impact on the way it released into the system. I'm not commited to staying on the generic but would like to give it a fair shot. My mood is great, just need to get through the sleep part.

I could not break out of the fogginess after 9 days of the med. I wasn't depressed but I was definitely down and the fybromylagia aches were starting.

It was definitely a dosage change - and the idea of taking an additional capsule is actually a good one. My primary care physician told me that many people have trouble adjusting to generic meds because the active medication level can be as low as 70% of the name brand - and the generic still passes FDA requirements because of the test requirements.

If the generic is really at 70% (and not 80% or 90%, which can happen in manufacturing) - then 2 doses would equal 140%. One would have to have their doctor prescribe for 2 capsules per day.
If a single dose isn;t working, and you try 2 capsules - you're probably getting a higher dose than name brand - but at least you feel better. Talk to your doctor.

It's also possible that a 30% drop in medication has caused many of the side effects, in addition to the way the medication releases (based on the number of microgranules). Cymbalta is a time-release medication, so changes in timing will probably affect how we feel.

I could not get the timing right, no matter what time I took the med.

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Posted (edited)

BRAND VS GENERIC EXPERIMENT:

I counted (3) 60mg TEVA capsules - Total Granules in each:

300

313

301

I counted (3) 60mg Brand capsules - Total Granules in each:

200

200

201

The Brand granules appear smaller and more round than the Teva Generic.

The Citron generic had about 200 of the microgranules, similar to brand name - I take 60 mg. per day

Phil C mentioned that his generic was from Lupin Pharma and that there were 6 granules for the 30 mg.

I'm curious about how many microgranules are in the Teva generic. If someone doesn't mind opening one before they take the med, it might offer some insight as to the variance.

Edited by Ronnie

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Posted

I am on cymbalta for chronic back pain from arthritis. I've never been depressed and I've had trouble getting up every morning this week. I made it on the Teva generic for 8 days before my pain came back. On day 9 I found some name brand cymbalta left in a bottle. Does anyone like their generic manufacturer? I will try to get an override of some sort but I don't expect my insurance company to be very helpful.

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Posted

Giving my day 15 update on Generic Duloxitine (Lupin): My mood has been great and for the most part able to sleep. I tried taking an Aleve for a few nights and I seem to sleep better. I don't want to have to rely on Aleve but it did help me out a few days. I do have headaches some days but where I live we have a LOT of cedar & mold allergens this time of year so that could be the cause. I will continue and provide and update around day 30.

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Posted (edited)

Tomorrow will be my first day on the Teva generic. I am hoping for the best, but expecting some difficulties as others have experienced here. I am glad I came back to the thread and learned that there are some issues with the generics.

My insurance is still charging $125/3mo for the brand name. And it's on the formulary, otherwise it would be even higher.

Edited by dante1231

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Posted

Last time I picked up my cymbalata , the pharmacist was like "Yay, you are going to save some money because it became generic" and I was happy! But ever since I've been taking the generic kind I have tremendous anxiety, and last week I felt very weird....headaches, (that swoosh feeling that people describe) and I couldn't figure out why.

I am so scared, because even taking a sedative is not helping my anxiety, and I had to leave work early, and all i want to do is sit at home and cry.

I am seeing my doctor in 2 days and I hope that I can be put back on the brand name, because I don't know if I can handle this anymore.

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Posted (edited)

Last time I picked up my cymbalata , the pharmacist was like "Yay, you are going to save some money because it became generic" and I was happy! But ever since I've been taking the generic kind I have tremendous anxiety, and last week I felt very weird....headaches, (that swoosh feeling that people describe) and I couldn't figure out why.

I am so scared, because even taking a sedative is not helping my anxiety, and I had to leave work early, and all i want to do is sit at home and cry.

I am seeing my doctor in 2 days and I hope that I can be put back on the brand name, because I don't know if I can handle this anymore.

hi ladysmurf & everyone,

I saw my Doctor today and we talked about the brandname problems that many folks are having. He said that Teva Pharmaceuticals has had a bad track record with generic meds, so check your prescription label. I was lucky, Citron Pharma has a better record - but I had the headaches and that dizzy feelingthat you described as a "swoosh feeling".

Blue Cross didn't process my form until last Friday, Jan 17th. The Doctor had signed and returned it but the pharmacy couldn't dispense the name brand until today because Monday was MLK day and the "approval" wasn't released by Express Scripts, the company who manages the prescription portion of many health care plans. My Doc felt badly when I told him that I had no choice but to take the generic after I ran out of Cymbalta on the 14th. The Lilly rep had dropped off a few cases of Cymbalta samples and I could have been using Cymbalta.

I've been dizzy and anxious for a week. The blue feeling started to creep in yesterday, so it was good that I had an appointment today.

My Doctor said that Blue Cross sent a form for 90 days of Cymbalta, which means that I would have to actively manage forms & the pharmacy - which is time consuming. The insurance companies know that most of us just don't have the time or that we get worn down from trying to get the correct medication.

He told me that the Forest Pharmaceutical rep had delivered a few cases of Fetzima. My Doctor said that the Fetzima is probably closer to Cymbalta than the generic Cymbalta is acting. Fetzima is also an SSNRI (serotonin and norepinephrine reuptake inhibitor) like Cymbalta is. The way he explained it is that the body will take what it needs from the med and there's just not enough med in the generic, so the generic won't work for me.

I have 8 weeks of Fetzima samples and I'm going to try it for a few days. I've already gone a week with the generic Cymbalta, so it's worth a try. I should know if it's working and if it doesn't, I'll pick up my Cymbalta and deal with forms every 3 months.

The Fetzima patent is until 2024, so if it works, I won't have to deal with forms....

You can read about it here:

http://investor.frx.com/press-release/corporate-news/forest-announces-new-fetzima-levomilnacipran-er-capsules-now-available-

Edited by Sayonara2013

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Posted

I took Cymbalta in the past and was able to stop without any severe withdrawal side effects (I counted out granules). I went back on Cymbalta in November 2013 (30 MG - one week, 60 MG next). I felt fine on 30 MG, and my BP was under control, but after about three days on 60 MG, my BP started going up even though I take Lisinopril. Asked my MD to give me a script for 30 MG, and surprise, it was generic (TEVA). After one week, my BP skyrocketed, and now three weeks later, the blurred vision intensified, the headaches are unbearable, and I have absolutely no motivation; on brand at 30 MG, I started feeling much better and was going out more often. I also started taking a liver detox combo because I was having pain in that area. I only have one kidney which is another concern (taking dandelion root extract for that). Not sure that I even want to go back to the brand after reading more about it.

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Posted

I've prescribed Cymbalta frequently over the past years and the switch to generic has caused many patients to experience severe side effects, recurrence of depression and pain and complaining that "this feels like a different drug"

The FDA has been politicized and just cares to reduce the cost to the govt which pays the lions share of med costs. They don't give a damn about efficacy or collateral damage. Please file a complaint with the FDA!

When generic welllbutrin caused half my patients to falter we filed many reports, when the FDA finally took the teva brand off the market last year they said they'd only received 60 some reports nationally , which has to be a massive lie--so they will need thousands of complaints to take action

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Posted (edited)

I just saw my doctor yesterday, and he said there are certain medications in which the generic and Brand are not equivalent. This was news to me because I always thought they were the same, other than the price. Two examples are Synthroid (for hypoactive thyroid) and Coumadin (blood thinner).

At this time, there is not "enough evidence" to suggest Cymbalta falls into the same category, but without hesitation, he kept me on the Brand, so I am very thankful. I'll be more thankful once I see the bill from the insurance company. I'm supposed to be paying the same as I did before Cymbalta went generic, but we'll see...

I do wish there was another antidepressant that worked for me because I've gained 42 pounds in a 4 and half year period... The only time I lose the weight is when I go off Cymbalta temporarily, but then I always go back on because the depression too much to bear. My doctor just added Wellbutrin to counteract the weight gain and also assist with the depression. While Cymbalta does work for me, I don't feel like it's working as well as it used to, so he wants to try Wellbutrin. Fingers crossed.

Edited by Kaitlyn

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Posted

I reacted really weird to the genetic cymbalta!

It has been about 10 days on the brand name and I am starting to feel less anxiety so I am happy that I am able to get some relief from the brand name again. Yeah it's expensive, but its the only thing that has helped me so far with anxiety..

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Posted

I went back to Cymbalta yesterday - took the Fetzima for 10 days.

My blood pressure went sky high (180/90) and I had racing thoughts, sweats, headaches, twitching, fast heartbeat, blood pressure, nausea, and agitation ias described in the serontonin syndrome section of the medication guide. I felt like a crazy squirrel that’s running from tree to tree. I had gotten thru the nausea and the headaches after 4 days but I could not deal with edgy, hypomanic side effects.

Most of the patient discussion boards have described Fetzima as making people feel edgy and manic - here’s a sampling. It’s how I felt and I felt empowered to tell people off, so I realized it was hypomanic. I tried to isolate myself to get thru it but found that I started talking to myself, just to get the racing thoughts out of my head.

  • “Yeah, my first two days of the 20mg Fetzima, I was on a fast bus to Crankytown.”
  • “Started at 20 mg for two days, then up to 40 mg. The first day or two I was extremely manic - couldn't sleep, racing thoughts, nausea. I held on because I so wanted it to work. Now it's almost 2 weeks later and I feel more energized. I don't need to sleep 10-11 hours a day. I've stopped taking my second dose of tramadol in the afternoon as it made me too hyper and I couldn't sleep. Am I less depressed? I don't know. Sometimes I feel like I'm outside of myself - calm and distant. It's an improvement over the blackness so I'll go with it and see how it works out.”
  • “Hello, I just wanted to pop in and say that I just started taking Fetzima on Dec 24th. I started at 20mg and am now on 40mg. I had been taking Effexor and came off of it slowly to start the Fetzima. For me, it has had its pros and cons. I think it has been helping me feel a little more like myself, less sad/anxious/guilty, however, I believe it is making me VERY edgy. I am a very calm laidback person, with a lot of patience. I work with children, and I have a toddler of my own, I am a nurturing person. But lately I have been mean, short, and testy. It has given me much more energy, and this is coming from a person who had to take two naps a day, just to take care of my child and make dinner in the evenings. So much so that I wake up at night feeling fully rested.”
  • “Started taking 40 mg of Fetzima for a week and just started taking 80 mg yesterday. I have been severely nauseated plus I have been 'edgy' and have had tremors as well.”

Fetzima pushes the norepinephrine reuptake harder than the serontonin reuptake, which stops that Cymbalta brain zap feeling - but it didn't help with my fibromyalgia and feeling shaky & twitchy is no way to live.

Levomilnacipran is indicated for treating MDD in adults and is unique compared with other SNRIs because it is relatively more selective for norepinephrine reuptake inhibition (NRI) compared with serotonin reuptake inhibition (SRI).1 In vitro studies demonstrate that the drug has >10-fold greater selectivity for norepinephrine reuptake inhibition than it does for serotonin reuptake inhibition, compared with duloxetine or venlafaxine.2

Levomilnacipran’s exact mechanism of action is unknown. Similar to other SNRIs, it binds with high affinity to the serotonin (5-HT) and norepinephrine (NE) transporters and potently inhibits 5-HT and NE reuptake. Levomilnacipran lacks significant affinity for any other receptors, ion channels, or transporters tested in vitro.2 It differs from other SNRIs such as venlafaxine and duloxetine in having higher selectivity for norepinephrine vs serotonin reuptake inhibition. In vitro studies demonstrated a 2-fold preference for NE over 5-HT reuptake inhibition.

It's back to Cymbalta, brand name for me, no more experiments. If you're offered a Fetzima prescription, do your research. It might not work as well as Cymbalta for you.

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Posted

I got switched to the Teva brand too and consider it to be crap compaired to Liilly's. I'm going to try and get my doctor to switch me back to Lilly. If not I'll try to find a phamacy to buy Sun brand for me. I've tried Sun and it's pretty close to Lilly's. I found a couple articles about Teva you might be interested in reading.

http://thetoddblog.com/2010/05/teva-the-death-of-quality-generics/

http://management.fortune.cnn.com/2013/01/10/generic-drugs-quality/

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Posted

Hyperspace,

I knew that Teva had the worst track record of the menaufacturers (1st article)

The 2nd link is far worse - I tried not to laugh out loud at the irony of what was reported. The FDA repeatedly tells Americans that we are putting our healthcare at risk when we buy NAME BRAND medications from our Canadian neighbors, that the drugs may be counterfeit or inferior.

What I took away from the article is that if I buy a Lilly, Novartis, Pfizer, Merck, etc manufactured product in Canada - it's the real medication:


"The patent reveals the components, but it doesn't explain how to make the drug. In reality, manufacturing a generic requires reverse engineering, and the result is an approximation rather than a duplicate of the original."

And that the FDA does not inspect the active drug ingredients used to manufacture the generic:


"With an estimated 80% of active drug ingredients and 40% of finished medications coming from overseas -- in some cases from manufacturing plants that the FDA has not yet inspected -- quality can be significantly compromised."

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Posted

I never knew about the reverse engineering until I read that second article. That helps explain why generics aren't exactly the same as the original.

I got switched to Teva without knowing it. I noticed the capsules were a different color but didn't think much about it. Then a few days later I wasn't feeling a good as I use too and I had more back pain than normal. I looked at the Cymbalta bottle and sure enough I discoved I got switched to Teva. I wasn't happy at all and wrote my insurence company about it and I'll see what my doctor says next time I see him.

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