I have often been given conflicting advice about brand versus generic medications. My great aunt, who is now in her nineties, refuses to take any type of generic medication because her pharmacist once told her they are not identical to the generic versions and it was best to stick with the original. This has cost her thousands upon thousands of dollars over the years.

Of course, I do not rely only on advice from my great aunt. There have also been numerous investigative reports that indicate that generic guidelines are not as rigorously controlled as those followed by the original patent holder. However, in all fairness, the primary differences are not in the active ingredients, but rather in the fillers and the time release mechanisms. In fact, the FDA requires that generics be the bioequivalent of the original medication, but they are not allowed to look like the original, which means the generic drugs are supposed to look different. So when do those two things really matter? To find out, I spoke with two of my doctors and my pharmacist regarding a few of my own specific questions.

According to those I spoke with, it really does not matter if you take a generic or a brand name medication. What matters is that you stick with whichever one you do choose, and this only matters sometimes. For example, thyroid medications and other medications that affect blood chemistry should not be alternated. This can affect the blood tests, which are monitored closely. However, if you begin on a generic drug, it should work as well as the brand name as long as you stay on it.

An example where it does not matter if you switch between the two or between to generics is antibiotics. This was recently demonstrated when I went to fill an especially large prescription for antibiotics for my husband. They told me they only had half of the required prescription at the time, but that I could come back later in the week for the other half, although it would be from a different manufacturer and it would look different. I was concerned because of the advice about not switching between brands I had received before, and the pharmacist explained that with antibiotics it never matters because of the way they work.

I must admit the different rules make it hard for me to remember when I should or should not switch brands, or raise a fuss if they are automatically switched. For me, I have decided to always ask the doctor who is prescribing the medication to tell me if it matters specifically if I use generic or brand name, and if it does, have them note in on the prescription. If it does not matter, I ask the advice the pharmacist when I’m filling the prescription and always ask if my medications suddenly look different. After all, the doctor and the pharmacist spent all of that time in school learning when generics matter I guess I can trust their judgment.

When do you think generics matter, or do you think it is simply a matter of cost?

When Generic Drugs Matter is a post from: Sunbelt Staffing

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Recently, my husband informed me that our health insurance coverage was going to be changing. We had four new options, all with benefits different from what we have had for the past several years. Some of these changes are good, but some, like our prescription medication coverage, is not so good. My husband works for a company that employs a large portion of the population where we live, and I knew these changes would be affecting all of their employees to some degree.

I was thinking about this, and how much of a headache it was going to be for me when I went to my pharmacy to get my prescriptions refilled. I am very familiar with the entire pharmacy staff, as I have been using that pharmacy for most of my life. We started chatting, and I told one of the pharmacists that he needed to brace himself because big changes in the group policy were going to be coming up. He sighed, shook his head, and asked what I could tell him. I told him the details of the policy my husband and I had chosen, and he just closed his eyes for a moment. He said that when refills started coming in, he was going to have many unhappy customers. I had figured as much, but had not realized it would be as bad as he soon described.

He told me that every time there is a mass change in insurance benefits, whether from private companies or Medicaid and Medicare, they have very stressful days. Apparently, because many of the policy documents are extremely long, and often complex, the customer doesn’t always read all the way through their explanation of new benefits. Then when they visit the pharmacy and their bill is significantly higher, or the medication they had previously been taking is no longer covered, they often become irate at the pharmacist or sales clerk ringing up the order. Because the pharmacists and staff at my pharmacy are so nice, they usually try to help explain changes to customers. If they notice a significant difference in price, or what is and is not covered, they will try to get the information so they can go over it with the customer when they come in. Of course, this is not always possible, but they do have the phone number for the insurance company’s customer service line for all of their clients in case they are not able to explain the changes.

I could not believe they go to such lengths to help their customers. This is what I call going far beyond a job description. It continues to amaze me how much the pharmacy staff is willing to do for their customers. I am sure my pharmacy is not unique in their desire to help their customers; however, I am not certain that all pharmacists think about what they may need to do for their customers before they begin preparing for their future career. Being a pharmacist is more than making sure the right medications go to the right person, and that those medications that shouldn’t be mixed are not. It is also about caring for the customer as an individual and making a difference in their lives when possible.

Are you ready to go the extra mile?

When the Customer has Changes in Prescription Coverage is a post from: Sunbelt Staffing

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1. When Generic Drugs Matter
2. How to Become a Pharmacist

It is completely normal for people not to want to take medications. There are adverse side effects to worry about as well as the potentially overwhelming cost. Because of these concerns, many people opt to try herbal or “all natural” remedies for their ailments. They may even try these remedies just to improve their overall health. Unlike prescriptions, however, these remedies do not usually come with a warning about any harmful drug interactions.

Because herbal remedies are not prescribed, the pharmacist or doctor is only aware that the patient is taking them if the information is volunteered. While it is very important that patients be encouraged to volunteer the information, doctors and pharmacists need to make an effort to ask for this information because some herbal remedies can cause serious problems when taken in conjunction with a medication. If you prescribe or dispense medication, you should encourage your patients to disclose any herbal remedies they are taking. If not, you can still encourage your loved ones to provide their health care providers with this important information.

Hawthorn and Lanoxin

Hawthorn is often used to regulate blood pressure and improve blood flow. Lanoxin is used to slow down the heart rate and help alleviate symptoms associate with heart failure. Using the two together can increase the effects of Lanoxin and potentially cause problems with the heart rate of the patient.

Ginseng and Coumadin

Ginseng is taken for a number of reasons; one of the most common is to improve overall energy. Coumadin is a popular anticoagulant and is prescribed to keep the blood from clotting, often to combat serious conditions. Ginseng has been found to reduce the efficacy of Coumadin.

St. John’s Wort and Antidepressants

St. John’s Wort is a very popular herbal remedy used to treat depression. Many people will self medicate with St. John’s Wort before consulting a doctor and will continue taking it after receiving a prescription antidepressant. Combining the two can cause serotonin syndrome in patients, which in extreme cases can be fatal. Fortunately, a fatal reaction is rare, but more moderate reactions are more common and should be considered a real concern.

Kava and Sedatives

Kava is typically used to reduce anxiety or improve sleep, as are sedatives. There are indications that combining the two can lead to disorientation in patients.

Primrose Oil and Thorazine

Primrose oil is used to treat a number of conditions including eczema, nerve damage, diabetes, and chronic fatigue syndrome. Thorazine is used primarily in the treatment of schizophrenia and is also used to treat some behavior disorders. Combining the two can increase the risk of seizures, especially in people with a prior history of seizures. Primrose oil interactions have also been indicated with other medications that treat mental illness as well as with anticoagulants.

This is just a small selection of problematic interactions between prescription medications and herbal remedies. Prior to dispensing a new medication patients should be asked some basic questions such as:

• Are you currently taking any herbal or all natural products?
• Have you recently discontinued taking an herbal or all natural product?
• Are you taking any dietary supplements?

Taking the time to question patients may help prevent an unpleasant, or even deadly, interaction with their new medication.

When Herbal Remedies and Medications Don’t Mix is a post from: Sunbelt Staffing

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Becoming a pharmacist takes a lot of training.  Pharmacy used to be a five-year degree, but it is now a six-year degree.  To be a pharmacist, you must earn your Doctor of Pharmacy degree, or PharmD.  This is a professional degree, not a graduate degree. While pharmacists may be referred to by the title of Doctor, they can dispense drugs but not prescribe them.

The PharmD program is very science-intensive.  High school students should take science every year in each of the disciplines offered – earth science, biology, chemistry, and physics – in order to gain entrance to the university degree program.   AP classes are preferred, if they are available. College courses will include a lot of chemistry, and students who do not do well in chemistry will not do well in pharmacy.  Organic chemistry is often offered early on, as it is a very difficult subject, and it helps to weed out students who are not a good match for the discipline. (I could never have been a pharmacist. I did well on my AP exams for both chemistry and physics, but I never quite grasped organic chemistry!)

Once you get your PharmD, you must pass NAPLEX, the North American Pharmacist Licensure Exam. It is a computer-adaptive text that was developed by the National Association of Boards of Pharmacy.  After you’ve passed NAPLEX, you are officially a licensed pharmacist.  You aren’t done with your education, though, because you must renew your licensure every two years.  This requires taking 30 units of Continuing Education coursework, which will help to keep you abreast of new information as it pertains to your work.

The last step to becoming a pharmacist is to find a job. Sunbelt Staffing can help you find a job near your home or across the country. We can help you get licensed in other states if you accept a travel assignment, so you don’t need to worry about staying in-state.  We’ll even reimburse you for your licensing fees when you complete your assignment!

How to Become a Pharmacist is a post from: Sunbelt Staffing

Related posts:

1. When the Customer has Changes in Prescription Coverage
2. When Generic Drugs Matter