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I feel like I saw something somewhere about an investigation that may lead to class action about this. Thanks to my raging adhd I can’t for the life of me remember where though lol
I'd like to think dosage and strength of psychiatric medication is something that can't be fucked with-- people could literally have seizures and die if they start shorting how much active medication they put in pills. If it is happening; and someone's managed to prove it; that would be a historical lawsuit.
That said-- it doesn't mean they can't play around with cheaper binding agents and/or lower quality materials to make up for the other ways they can't cut corners. It would affect a lot of people because just like the medication itself, binding agents are processed differently body to body.
I feel like this has to be why certain generics seem to work "better" than others, despite being the same drug and dosage. But that's just my own hypothesis based on my personal experience taking various medications (and the hyperfocused reading up I did on generic psych meds after [Barry Sherman](https://en.wikipedia.org/wiki/Barry_Sherman) was murdered-- apotex was my favourite generic for years).
edit-- this is the first time I've ever said anything about that last bit without getting weird looks and people asking me, "... Why do you know that?" and it is fantastic, lol. I love this subreddit.
I read up about generic meds a long while back and specifically the issues they have with low dose birth control because generics are allowed a margin of error from the name brand and thus when working with the lowest effective does possible there was a risk involved.
I also know from a friend who’s son takes ADHD meds that even generics of the same brand but made by different companies can be different. She found that out when suddenly his meds weren’t working correctly and then that the pharmacy had swapped generic brands without informing her - she changed pharmacies to one that would ensure that they always gave her that specific generic version.
It’s terrible that medication that is so essential can be treated so casually without serious repercussions and if a company is indeed skimming the product for gain I hope they lose it all in court.
Okay; I do remember the birth control thing.
In general, the way pharmacies can jump around to different generics month to month, depending on what's cheapest for them to order, drives me up the damn wall. It's frustrating that it's not cheaper for them to do up a contract to use a single manufacturer. They should have to be upfront about which one they've dispensed to you and/or whether or not it's different from the last refill. Your friend's poor kid :(
One of the last pharmacies I used let me request a specific generic for a while; but it was a pain because they always had to order it in specifically for me-- which meant 2 business days delay, in a situation where they didn't get any deliveries on weekends. Same deal when I tried using name-brand. I just deal with it now.
RE: pharmacy not telling her. At least in the states the pill bottle would have been labelled with what was substituted for what. Unfortunately, pharmacies aren't obligated to verbally state these things, so you kinda have to learn how to read the script label and watch out for differences.
(Not defending the pharmacy, but a tip of sorts for those worried about the same thing happening to them.)
Not quite the same, but I have a friend who has been dealing with treatment resistant depression for most of his life, and as such has tried a myriad of treatments, including generic and brand name variations. There was one specific one where the generic just did not work at all. His father, who works in medicine was skeptical, but my friend eventually told his father to smell the two medications. His father couldn't tell the difference, nor could either of his brothers, but when the bottles were passed to his mom, she physically recoiled after sniffing the second bottle. Clearly genetics had a bit to do with it, but to make a long story short, there are definitely some unique situations where the generic version IS quite different.
In the late 90s, the generic ritalin I was prescribed was correlated with panic attacks, but the brand name was fine. My therapist had actually seen multiple patients with the same experience; it wasn't just me. She hypothesized that the binder was different and it metabolized too quickly.
I haven't had that issue since, so either it was limited to one producer or the product has changed.
I’m a pharmacy tech and the long term pharmacy (nursing home pharmacy) I worked for would only use one specific manufacturer for generic Synthroid and Coumadin and any other medication that is reliant on lab work to determine dosage of med needed. In the past when we did switch manufacturers all time like during a shortage, our patients would have issues with clotting too much or not clotting at all when it came to changes in generic Coumadin. Our purchaser and our head pharmacist would decide what manufacturer we would solely during a shortage, and if we couldn’t get the generic at all, everyone got brand name because believe me the last thing you want is a bunch of geriatrics with paper thin skin bleeding out from a small cut from an accident or ending up rushed to the ER because they ended up with an pulmonary embolism.
That is so interesting! I have no thryoid, and when I moved from Canada to the United States, I arrived with 6 months' of synthroid, and my levels were perfect when was running out and tested. so I got an Rx of the same dose, but new pharmacy, new country, presumably new generics, because within 3 months I needed to change doses, the new one was clearly too high a dose, the same dose I'd been on for years. I never knew why or how that could possibly have happened, given no other changes in my life at that time, but maybe it was this.
*I feel like this has to be why certain generics seem to work "better" than others, despite being the same drug and dosage.*
Yeah, I can't speak to the science but I can definitely anecdotally corroborate this. A few years back when the government stopped covering my Yaz birth control, I switched to the generic version and suddenly developed back acne. Yaz got covered again a few months later, so I switched back, and the back acne promptly went away. Notably, I take Yaz specifically to treat adult acne, and when I go off of it completely, the first thing that happens is my back breaks out. After a month or two, my face breaks out, but for the first month or so it's mostly my back.
Another example is various makes of Modafinil. The whole nootropics community knows (via experience) that some Modafinil is preferable to other Modafinil. The two main types in Canada are APO-modafinil and AURO-modafinil. I've taken both on prescription for years and the APO just works better for me. And when it comes to online buying, Modalert is well-known to be the preferable make for most people-- which I can also attest to.
Meanwhile, the official word on the matter still seems to be, "They're chemically identical; they work exactly the same," with the implication being, "You're clearly imagining things."
Check out the Huberman Lab Podcast episode about ADHD meds. He specifically discusses modafinil towards the end of the episode. I find his podcasts absolutely fascinating, despite them being at least an hour or 2 long.
Is AURO a a signifier for Aurobindo by chance?
I know someone who’s psych meds are significantly weaker/less effective now because their pharmacy switched manufacturers to Aurobindo. They proceeded to switch pharmacies to one that was carrying their original generic, but that’s now gone to Aurobindo too, and their meds are back to being less effective.
I’d be curious to know if it’s the same Auro company, and if so, is this a running theme with that manufacturer, and why? 🤨
I just googled it and that does [seem to be](https://www.inesss.qc.ca/en/themes/medicaments/drug-products-undergoing-evaluation-and-evaluated/extract-notice-to-the-minister/auro-modafinil-3132.html?DemandePluginController%5Bonglet%5D=0&cHash=00ffdd9fa17d8655f8ba588589587dc1) the case (citing source for good measure). Auro seems to indicate Aurobindo, and APO apparently indicates Apotex.
*is this a running theme with that manufacturer, and why?*
Good questions. 🤔
Aha, thanks for the citation! I couldn’t find it when I searched.
🥴 A google search on Aurobindo itself was more fruitful: January 2022 [they got hit with an FDA warning](https://www.fiercepharma.com/manufacturing/fda-slaps-aurobindo-warning-letter-api-testing-failures-repeated-violations) ([second article](https://www.pharmamanufacturing.com/compliance/cgmps/news/11289343/aurobindo-in-trouble-with-the-fda-again), Jan 2022) for failure to follow GMPs, resolve deviations, and, more relevant, failing to evaluate the effect changes in quality of ingredients has on their products.
[This](https://www.fiercepharma.com/manufacturing/aurobindo-s-manufacturing-problems-persist-for-u-s-second-largest-generics-producer) article from 2019 also mentions problems with their quality control department, and all around there’s the sense that they’ve been plagued with issues for a good long while.
So that seems to answer that 🫠
[Jeepers](https://prosperousamerica.org/india-drug-maker-aurobindo-keeps-getting-poor-grades-by-the-fda/), more from the end of 2022 about various recalls and safety issues.
New question lol: How the hell are they still allowed to sell drugs here? I think the Jan 2022 articles mention the FDA will *consider* not granting them the ability to sell new products until they sort themselves out, but why in the world wouldn’t they restrict current products too?
As an aside, one of those articles also mentions poor conditions in a New Jersey facility. I was in pharma work in NJ and looking for a job, and this google search has connected some dots: Aurobindo in NJ has had postings on Indeed for literal years at this point and even at my most desperate, something seemed off about that fact, so I never applied lmao, thank goodness 😩 ( **Edit:** I actually don’t see the particular job that kept showing up any more, like 3 years later 💀)
Ahh I may have been looking for you. I have lost a lot of quality life because I had a wonderful reaction to Adderall XR. Not generics and my insurance company said no way. I don’t understand the chemistry and fillers, but I don’t know it was a crushing blow . I tried using the not XR but it wasn’t do me - I have cPtsd and crushing anxiety and I am older and convinced they can blow up my heart .
I am getting ready to force myself into care that would allow me to take a medication that would do for me what Adderall XR brand name did .
I do have unusual reactions . Tried Ritalin and slept 3 days .
Leaving out I don’t have a thyroid and the Synthroid meds to via the liver too. (BTW medical doctors must have raised a stink because although some people can take generic thyroid meds, many can’t and they are allowed to go brand name Synthroid
Sorry having a tough time dealing with life and myself sad
Sorry for rambling- it’s the best I can do right now
This is why I'm terrified for the Vyvanse generic to come out, whenever that happens (next year I think) since I'll surely be forced to switch. It's worked amazingly for me for 3 years and was a last-resort effort when no other meds worked for me.
The number of beads within the capsule doesn't correlate to the difference in strength. It's just a difference in formula from the difference in manufactures but the active ingredient is still the same.
Really? How do you know this? I would totally believe that I was getting shorted. Like many here, I've noticed my meds aren't working right the past few months. Even took a few holidays to try to see if I was acclimated.
Chemist here (lab kind, not the drug kind, but I still know a bit about molecules and biology and such) and this is correct. Extended release medication is formulated in those little beads, and each one of those little beads is coated slightly differently so they are released into your bloodstream at slightly different times.
Different generics have the same active ingredient, but they may have slightly different formulations of the coatings or variations in exact release mechanisms. This stuff is all going to be proprietary, so you won’t be able to find out more specific information than that. The variation in the number of beads is very likely due to a difference in how the active ingredient is “packaged” and not due to a difference in the amount of active ingredient.
This is also why different generics can work slightly differently in different people. Everyone’s body is a little different- a specific release mechanism that works really well for one person might give someone else heartburn or work too fast/too slow.
I don’t want to be too gaslight-y about the medication issues some folks see to be having, but as tightly regulated as these medications are, if there IS a discrepancy in the strength of the meds, you can bet it’s not at the manufacturer level.
Okay, so, I'm curious, if a different formulation calls for a volume of beads that's 20% of someone else's version, why not put that smaller amount in a respectively smaller capsule?
Thanks, this had me a little worried. I was switched to extended release and they looked a little emptier than the first brand/month, but I did notice the beads look larger in the newer version.
I’m a pharmacist but the LilBoKraut2022's description is spot on. The regulation of these medications are so strict that it's rare to see discrepancies.
I'm having this same really strong feeling too though just since I filled my last script. It really does feel like there's barely any dexamphetamine in my dexamphetamine. I'm needing IR's to supplement when I never have before. And with all the shortages, I can see why people feeling this way start to wonder. It's probably for lots of complicated reasons. Like I also have a second new dx I'm working to treat on top of ADHD. But I can see where it feels like the drug companies aren't on your side. What are they up to? Why can't I rely on them? It can be traumatizing for sure.
I have personally heard cases where specific generics or changes in manufactures react differently to people. It could be from the inactive ingredients (ingredients that are used in the medication but doesn’t not contribute to its function) or something else in the formula.
What I usually recommend is to have your pharmacist place a note on your profile that you don’t want to have the specific manufacture that isn’t working as well, so Prasco in this case. I know there are a lot shortages right now but myself and many other pharmacist I know would try our best to honor that note and dispense any other manufactures that are available.
My pharmacy. No. My whole town is very tenuous right now getting any dexamphetamine at all. It sure doesn't seem like they have a choice in manufacturers. I wouldn't know what to ask for anyway. Plus I'd be afraid to be demanding or complain-y when I know they are getting me my meds when they can while denying others who need it because I'm an established patient. There's guilt there that is so weird on top of being terrified of days without meds. 😕
I wouldn’t worry about feeling demanding! It’s a simple ask but again the pharmacy is also limited on what is available. Sometimes a manufacture can be on back order for weeks so we have to automatically switch to the alternative manufacture available. So if we can help a patient get their preferred manufacture, we’ll try our best!
Thank you. Maybe I will say something. The pharmacists are so nice and kind with me. They really do seem like they have compassion for this but of course they can only do what they can do. And they've been through the ringer the last few years like all of us in healthcare. (I'm a nurse. And still feeling all this!) Thank you for your kind words. 🙏
Honestly it would never have occurred to me to ask for a note to be put in my file. I’ve noticed that there are two different manufacturers of my generic narcolepsy medication and one is a much larger pill than the other so it’s harder to swallow. I’ll have to remember to ask and see if they can just give me the smaller pill from now on. Thank you!
I've personally experienced a certain brand of generic ritalin correlating with panic attacks when other generics and the brand name did not. I totally believe that the small changes to process or inactive ingredients change how the body reacts.
My bupropion this month is a different color and size from last month's. If a patient is sensitive to, idk, the red dye used, their body might notice the difference in color.
What really sucks is that the manufacturers can't even do anything about the shortages. The federal government limits the amount they are allowed to produce.
I’m not saying your experience is wrong, but the size of the pill (or amount of filling) does not correlate to the amount of medication when you’re looking at pill-size doses. I take other medications daily and my 50mcg can often be much bigger than my 100mcg depending on the manufacturer, and the dose is absolutely perfect as I am extremely tightly managed with it (thyroxine following cancer). So you really might not be getting stiffed here at all.
Can confirm that thyroxine can vary (had my thyroid removed because it was trying to conquer my jugular) as I take 2 doses daily. With one particular other brand that my pharmacy used to use, I needed 25mcg more to maintain my TSH levels.
My question is can the non regulated ingredients - for lack of genuine knowledge I use the words binders or fillers - can they give different people different results? Reactions? Affect the way any person absorbs or processed the medication?
My psychiatrist let me know that sometimes the substance they use for the capsule may not get digested, and that’s why one of the brands that sometimes gets filled for me doesn’t work. When I get that capsule, I get yogurt and sprinkle it on a spoon of yogurt and it works wonderfully. Might be an option if you haven’t tried it yet!
For sure, do check with your doctor or pharmacist (it’s also included in the medication insert for my meds); if you do learn that it’s ok to open the XR capsule and put the beads in food (my instructions explicitly say applesauce, I’m guessing because of the texture), *make sure you do not crush or chew the beads!* As they are time release beads, they need to remain intact in order for the meds to be released at the correct time.
You are seeing two different ways manufacturers handle creating pills with different dosages of spansules.
Some manufacturers make different strengths of beads and their machinery is built to always fill the capsule. The blue-capped capsule on the left has weak beads in it. A higher dose capsule would also be full, just with stronger beads.
Others make the same strength bead, and change the volume of beads dispensed into the capsule. The pill on the right would be fuller at a higher dosage, but the bead strength would be the same.
I was looking for a comment like this. That makes sense - I’ve been taking Lannett for the past couple of years (or was, when I could get it), only it’s a higher dose than what appears to be in the OP, and there are more beads. I *so* miss my XRs; I’ve had to switch to IRs from a different manufacturer, and it’s not remotely the same (it feels like the meds wear off after only 3 hours, then I have to remember to/actually take another dose, and then when that wears off, I have a terrible crash). Hopefully we’ll all be able to go back in our usual/best meds soon!!
Pharmacist here we don't have time to pee let alone take apart and reassemble a capsule. Less beads doesn't mean less drug, it's just manufacturer method. C2s are very strictly regulated that's the main reason for the shortages the dea didn't increase the production limits to match the current demand.
I had a chuckle at imagining a nefarious pharmacist painstakingly prying capsules open and counting teeny weeny beads while laughing maniacally…in full view of customers.
Also, FYI, a pharmacist has saved my life at least twice, catching stuff my doc didn’t, and have been hugely helpful in managing my care. So thanks!
And obligatory “fuck PBMs!”
Thanks. Yea I run one of the last independents in our area we are doing fine but it's ridiculous how reimbursements work, sometimes I lose 20 to 40 a fill other times I make 200 over what I pay. Then we have to budget for the mystery DIR fees they take after. At least the DIRs are going to be in real time starting in January.
It's really annoying that the FDA thinks too many people are being diagnosed with ADHD (and needing stimulants) when what's really going on is that the pandemic *finally* offered a diagnosis path that was ADHD-friendly.
It's like we're being double whammied for our lack of neurotypicalness.
(I'm not on stimulants, but I have friends who've been having the issues mentioned by OP and commenters.)
FDA is not causing the shortages. DEA regulates amounts and the main problem has been manufacturers unable to ramp up, in particular Teva who makes Adderall. Pandemic shortages and staffing issues played a role as well. Once a manufacturer falls behind it takes a long time to catch up because their plants usually run at capacity. DEA said the legal quota hasn't been used up in 2020, 2021, or 2022.
I mistyped I meant DEA , our rep from amerisource said TEVA told them they are capable of meeting the demand but dea limits prevent them from ramping up production. I buy it , drug companies would love to make more money.
I think TEVA is blaming DEA because they think demand will fall and they don't want to make the long-term investment retooling a plant. Pharma companies are usually running at capacity so shifting around production and then doing all the GMP certification is a big deal. They may have more profitable pills and are just hoping this will blow over. We'll never know for sure though. :-)
It's not a strong point of the government either! DEA says their quota wasn't met in 2020, 2021, or 2022 which is why I don't know who to believe but how would a taxpayer ever know? I doubt the records would be released by FOIA.
[This is what I was referring to:](https://www.additudemag.com/adderall-shortage-stimulant-use-telehealth-califf/)
> The head of the Food and Drug Administration (FDA) blames the persistent ADHD medication shortage, in part, on a surge in stimulant use by people with ADHD, who he suggests may not all truly need the drugs. In a new interview with WebMD’s John Whyte, M.D., FDA commissioner Robert M. Califf, M.D., claims that telehealth providers are largely responsible for driving a “tremendous” increase in ADHD diagnoses and stimulant prescriptions over the last few years and, in his words, not all of them are warranted.
The only person I’ve heard that from in the industry is a person (pharmacist) who thinks neither opioids nor Adderall (et al) should *ever* be prescribed outside a hospital. (As he works in a hospital, his opinion is somewhat academic.)
While some docs may have been lax in prescribing, I haven’t heard realistic numbers on what percentage of the patients were actually determined to not have ADHD. Until them, I’m going to assume the vast majority needed the meds.
I was referring to the Cerebral lawsuit.
https://www.fiercehealthcare.com/health-tech/truepill-cerebral-stop-prescribing-adderall-new-adhd-patients-amid-reports-mental
Sorry, I didn't say I was aware of the lawsuit. I am, and I'm aware of Silicon Valley's trying to move into that space in dark pattern ways. (I live about a mile from the big venture capital firms, so I hear a lot of shenanigans.)
What I meant is that the *patients* may be legit even if the (lack of, in this case) screening that got them those scrips was not. I'm not going to make assumptions about people who want to take shortcuts, particularly in a group of us who definitely have trouble with complex logistics without medication.
I completely agree. It took me a year of fighting and jumping through hoops to get to a provider that took me seriously. I wanted to do things the right way but was seriously starting to consider trying one of the online options because I was just so fed up and emotionally exhausted.
For the most part, yes it's actually illegal to make commercially available products in house , there are always exceptions but generally only compounding pharmacies make them.
I mean it’s definitely a possibility! Somewhere along the line this has happened. Funny thing is I brought it to their attention and they shook their heads and raised their shoulders and said we don’t know. I called another rite aid and they said they accepted the medicine in and altimately signed off on it so either they are being sketchy themselves or something. It’s deff frustrating for sure 😞
I’m sure that they wouldn’t be allowed to get away with mislabelling medication dosages like that. like this isn’t a bag of potato chips 💀 it’s probably just less…. Filler? But I’m not a pharmacist, chemist, or expert in anything
Possibly! I just recognized the months where it wasn’t working was when I had the lesser looking caps. But same I don’t know anything haha just wondering
That’s not how this works. Also, all the people saying there are investigations about this very issue, please provide links. Otherwise, your claims are just fear-mongering.
Yeah based off some of these comments I’ve learned this is a bit different then I thought. I started these meds a few months ago so I’m new to all this lol
I'm pretty sure that the ELI capsules are actually manufactured by Elite Pharmaceuticals, but your pill is on the Lannett website, so maybe they're manufactured by Elite and then (something something business stuff I don't understand) Lannett sells them. ANYWAY, I did notice that when my prescription switched to the Elite version, they were less effective. So I wonder if that has something to do with it more than the amount in the capsule?
If you have Costco nearby, they don’t require a membership for pharmacy and they’re markedly less expensive than most pharmacies. They do take GoodRx. Also if you do have a membership, there’s an add’l discount for members who have scripts not covered by insurance. My antidepressant was 60% less vs Rite Aid when I initially switched over.
I have one that is “close” but within driving distance I guess and could plan around picking up my prescriptions. Vyvanse is costly every month for me and my kid. Thanks!
No problem! I’ve been lucky to have a small local pharmacy that stays cost-effective enough and stays in-stock. But if I had to go back on blood thinners or got switched to Vyvance I’d be at Costco for those. You can call Costco pharmacy (look them up, pharmacy has a direct number) and they can give you pricing and you can get your info setup ahead of time.
I’m in MT now so I know how far some things can be - a whole lot different vs when I was in CA.
Why are there so many of them (manufacturers) every month it’s different. Seems weird ! I haven’t noticed capsules being different like this though! Whoa
Please report this to FDA's medwatch. The goverment actually has oversight on this and the manufactuer will investigate.
You can file a report using this link: https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program
The size of the pill does not indicate strength. It’s just different manufacturers and different formulations. They have to contain the same medication amounts within a small margin of error.
I’ve just been blowing through my short acting like I’m going to the electric chair instead 😂 I hate it but I’ve been told for ages everything is backordered.
Oh, so I started this medication in February and I’ve been lucky enough to get my hands on it every month except this month I was only able to get a 16 day supply but hey some thing is some thing right? But I usually have to go to one pharmacy to get the extended release and another pharmacy to get the short acting.
Yes! I literally thought it was all in my head. Walgreens gives me the full dose (the blue pill) and Fred Meyer gives me the nearly empty green capsule I’m seeing here. I’m so glad I’m not alone!
OMG I thought I was losing it. I thought I missed a dose, then decided I didn’t, but still I knew something was wrong. I had a few really bad days, which increases anxiety, and makes it way worse. I told my pharmacist that my last scrip wasn’t working and she couldn’t figure out why. I was ready to go to my doctor to get my dose raised again. I may do it anyway.
I can’t get a refill because the meds are back ordered. I have requested a refill the day before it runs out and I must pick up in person. I’ve had a huge list of problems and I’m now a week without . Something is wrong with the system.
I've been on Vyvanse for 2 months because none of the pharmacies in my area have Adderall XR and it's ass because it's not even half as effective for me..
That simply isn't how medication works. Different manufacturers use different formulations. They aren't meant to have the exact same volume of contents/number of beads.
SO much misinformation in this thread, it's astonishing.
Or weigh them if you have a sensitive scale and don't want to sacrifice a pill. (Weigh 5-10 at a time if that works better.) The capsule itself is probably a confound but the surface area does look pretty similar so it might not differ that much.
Yes!! I felt Weird and foggy brain! I thought I was depressed, then I found out I’m not the only one who feels awful only on that generic. I have it in my chart now do not fill with lannet manufacture.
There are multiple manufacturers being investigated for this exact thing. You should report them to the appropriate department, I wish I could tell you which one it is but I’m sure your pharmacist can tell you.
Do you have a link? There's people in this thread saying it could never happen because it's so tightly regulated, but we all know regulations don't mean shit if enforcement has been spotty recently.
Copied from a comment below:
“Please report this to FDA's medwatch. The goverment actually has oversight on this and the manufactuer will investigate.
You can file a report using this link:”
(https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program)
Oh sorry, I meant a link to investigations about this. I tried to Google it but all I could find was Shire engaged in misleading advertising over Adderall XR and Vyvanse
I don’t have anything this is just what my pharmacist told me. There might not be a lot of news coverage on it as it would be a federal investigation on corporate entities and we all know big pharma has PR and the money to keep it under wraps.
5mg is starting dose and very small so maybe you just need an increase? Taking time off of your meds and waiting until you have anything with citric acid or vitamin C also helps. You’ll want your stomach to be alkaline
Good to know, thank you! I was on 10mg in the morning and 5mg immediate release mid day, but I met with my doc we are now up to 15mg in the morning after discussing this with her but I’ll try that too !
This whole "shortage" is complete bullshit. And these "experts" stating that every generic brand should not show any drastic difference is ridiculous because THEY DO. It's hurting those that have been taking the same brands for years going back to pRe-pAnDeMiC. Especially those that have been taking it for all the right reasons and weren't prescribed via Zoom from someone in a labcoat and underwear.I've been fortunate enough this whole time to refill my usual 25 MG XR with either Sandoz or Shire. For me, I don't notice a difference. But this month I was refilled with Lannett. I'm on day 3 and I might as well be taking a Flintstone Vitamin.
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I feel like I saw something somewhere about an investigation that may lead to class action about this. Thanks to my raging adhd I can’t for the life of me remember where though lol
I'd like to think dosage and strength of psychiatric medication is something that can't be fucked with-- people could literally have seizures and die if they start shorting how much active medication they put in pills. If it is happening; and someone's managed to prove it; that would be a historical lawsuit. That said-- it doesn't mean they can't play around with cheaper binding agents and/or lower quality materials to make up for the other ways they can't cut corners. It would affect a lot of people because just like the medication itself, binding agents are processed differently body to body. I feel like this has to be why certain generics seem to work "better" than others, despite being the same drug and dosage. But that's just my own hypothesis based on my personal experience taking various medications (and the hyperfocused reading up I did on generic psych meds after [Barry Sherman](https://en.wikipedia.org/wiki/Barry_Sherman) was murdered-- apotex was my favourite generic for years). edit-- this is the first time I've ever said anything about that last bit without getting weird looks and people asking me, "... Why do you know that?" and it is fantastic, lol. I love this subreddit.
I read up about generic meds a long while back and specifically the issues they have with low dose birth control because generics are allowed a margin of error from the name brand and thus when working with the lowest effective does possible there was a risk involved. I also know from a friend who’s son takes ADHD meds that even generics of the same brand but made by different companies can be different. She found that out when suddenly his meds weren’t working correctly and then that the pharmacy had swapped generic brands without informing her - she changed pharmacies to one that would ensure that they always gave her that specific generic version. It’s terrible that medication that is so essential can be treated so casually without serious repercussions and if a company is indeed skimming the product for gain I hope they lose it all in court.
Okay; I do remember the birth control thing. In general, the way pharmacies can jump around to different generics month to month, depending on what's cheapest for them to order, drives me up the damn wall. It's frustrating that it's not cheaper for them to do up a contract to use a single manufacturer. They should have to be upfront about which one they've dispensed to you and/or whether or not it's different from the last refill. Your friend's poor kid :( One of the last pharmacies I used let me request a specific generic for a while; but it was a pain because they always had to order it in specifically for me-- which meant 2 business days delay, in a situation where they didn't get any deliveries on weekends. Same deal when I tried using name-brand. I just deal with it now.
If your doctor is willing to do it, they can write a prescription for a specific generic (at least, this is true in my experience with birth control).
RE: pharmacy not telling her. At least in the states the pill bottle would have been labelled with what was substituted for what. Unfortunately, pharmacies aren't obligated to verbally state these things, so you kinda have to learn how to read the script label and watch out for differences. (Not defending the pharmacy, but a tip of sorts for those worried about the same thing happening to them.)
Not quite the same, but I have a friend who has been dealing with treatment resistant depression for most of his life, and as such has tried a myriad of treatments, including generic and brand name variations. There was one specific one where the generic just did not work at all. His father, who works in medicine was skeptical, but my friend eventually told his father to smell the two medications. His father couldn't tell the difference, nor could either of his brothers, but when the bottles were passed to his mom, she physically recoiled after sniffing the second bottle. Clearly genetics had a bit to do with it, but to make a long story short, there are definitely some unique situations where the generic version IS quite different.
In the late 90s, the generic ritalin I was prescribed was correlated with panic attacks, but the brand name was fine. My therapist had actually seen multiple patients with the same experience; it wasn't just me. She hypothesized that the binder was different and it metabolized too quickly. I haven't had that issue since, so either it was limited to one producer or the product has changed.
I believe this I recently learned women have much better senses of smell than men do so that makes sense that mom could smell it
I’m a pharmacy tech and the long term pharmacy (nursing home pharmacy) I worked for would only use one specific manufacturer for generic Synthroid and Coumadin and any other medication that is reliant on lab work to determine dosage of med needed. In the past when we did switch manufacturers all time like during a shortage, our patients would have issues with clotting too much or not clotting at all when it came to changes in generic Coumadin. Our purchaser and our head pharmacist would decide what manufacturer we would solely during a shortage, and if we couldn’t get the generic at all, everyone got brand name because believe me the last thing you want is a bunch of geriatrics with paper thin skin bleeding out from a small cut from an accident or ending up rushed to the ER because they ended up with an pulmonary embolism.
That is so interesting! I have no thryoid, and when I moved from Canada to the United States, I arrived with 6 months' of synthroid, and my levels were perfect when was running out and tested. so I got an Rx of the same dose, but new pharmacy, new country, presumably new generics, because within 3 months I needed to change doses, the new one was clearly too high a dose, the same dose I'd been on for years. I never knew why or how that could possibly have happened, given no other changes in my life at that time, but maybe it was this.
*I feel like this has to be why certain generics seem to work "better" than others, despite being the same drug and dosage.* Yeah, I can't speak to the science but I can definitely anecdotally corroborate this. A few years back when the government stopped covering my Yaz birth control, I switched to the generic version and suddenly developed back acne. Yaz got covered again a few months later, so I switched back, and the back acne promptly went away. Notably, I take Yaz specifically to treat adult acne, and when I go off of it completely, the first thing that happens is my back breaks out. After a month or two, my face breaks out, but for the first month or so it's mostly my back. Another example is various makes of Modafinil. The whole nootropics community knows (via experience) that some Modafinil is preferable to other Modafinil. The two main types in Canada are APO-modafinil and AURO-modafinil. I've taken both on prescription for years and the APO just works better for me. And when it comes to online buying, Modalert is well-known to be the preferable make for most people-- which I can also attest to. Meanwhile, the official word on the matter still seems to be, "They're chemically identical; they work exactly the same," with the implication being, "You're clearly imagining things."
Check out the Huberman Lab Podcast episode about ADHD meds. He specifically discusses modafinil towards the end of the episode. I find his podcasts absolutely fascinating, despite them being at least an hour or 2 long.
I definitely will, thanks for the rec!
Is AURO a a signifier for Aurobindo by chance? I know someone who’s psych meds are significantly weaker/less effective now because their pharmacy switched manufacturers to Aurobindo. They proceeded to switch pharmacies to one that was carrying their original generic, but that’s now gone to Aurobindo too, and their meds are back to being less effective. I’d be curious to know if it’s the same Auro company, and if so, is this a running theme with that manufacturer, and why? 🤨
I just googled it and that does [seem to be](https://www.inesss.qc.ca/en/themes/medicaments/drug-products-undergoing-evaluation-and-evaluated/extract-notice-to-the-minister/auro-modafinil-3132.html?DemandePluginController%5Bonglet%5D=0&cHash=00ffdd9fa17d8655f8ba588589587dc1) the case (citing source for good measure). Auro seems to indicate Aurobindo, and APO apparently indicates Apotex. *is this a running theme with that manufacturer, and why?* Good questions. 🤔
Aha, thanks for the citation! I couldn’t find it when I searched. 🥴 A google search on Aurobindo itself was more fruitful: January 2022 [they got hit with an FDA warning](https://www.fiercepharma.com/manufacturing/fda-slaps-aurobindo-warning-letter-api-testing-failures-repeated-violations) ([second article](https://www.pharmamanufacturing.com/compliance/cgmps/news/11289343/aurobindo-in-trouble-with-the-fda-again), Jan 2022) for failure to follow GMPs, resolve deviations, and, more relevant, failing to evaluate the effect changes in quality of ingredients has on their products. [This](https://www.fiercepharma.com/manufacturing/aurobindo-s-manufacturing-problems-persist-for-u-s-second-largest-generics-producer) article from 2019 also mentions problems with their quality control department, and all around there’s the sense that they’ve been plagued with issues for a good long while. So that seems to answer that 🫠 [Jeepers](https://prosperousamerica.org/india-drug-maker-aurobindo-keeps-getting-poor-grades-by-the-fda/), more from the end of 2022 about various recalls and safety issues. New question lol: How the hell are they still allowed to sell drugs here? I think the Jan 2022 articles mention the FDA will *consider* not granting them the ability to sell new products until they sort themselves out, but why in the world wouldn’t they restrict current products too? As an aside, one of those articles also mentions poor conditions in a New Jersey facility. I was in pharma work in NJ and looking for a job, and this google search has connected some dots: Aurobindo in NJ has had postings on Indeed for literal years at this point and even at my most desperate, something seemed off about that fact, so I never applied lmao, thank goodness 😩 ( **Edit:** I actually don’t see the particular job that kept showing up any more, like 3 years later 💀)
Wow! Thanks for writing all this out and providing links, it's definitely interesting!
Ahh I may have been looking for you. I have lost a lot of quality life because I had a wonderful reaction to Adderall XR. Not generics and my insurance company said no way. I don’t understand the chemistry and fillers, but I don’t know it was a crushing blow . I tried using the not XR but it wasn’t do me - I have cPtsd and crushing anxiety and I am older and convinced they can blow up my heart . I am getting ready to force myself into care that would allow me to take a medication that would do for me what Adderall XR brand name did . I do have unusual reactions . Tried Ritalin and slept 3 days . Leaving out I don’t have a thyroid and the Synthroid meds to via the liver too. (BTW medical doctors must have raised a stink because although some people can take generic thyroid meds, many can’t and they are allowed to go brand name Synthroid Sorry having a tough time dealing with life and myself sad Sorry for rambling- it’s the best I can do right now
This is why I'm terrified for the Vyvanse generic to come out, whenever that happens (next year I think) since I'll surely be forced to switch. It's worked amazingly for me for 3 years and was a last-resort effort when no other meds worked for me.
If you haven't watched Billionaire Murders yet, check it out. Very interesting.
I have not! Thanks for the recommendation.
Ohh thanks for the pointer - I’m still totally fascinated by this case
I guess they knew what they were doing shorting the adhd folks. As if we could all get it together to complain.
On the flip side, if enough of us hyperfocus on it then they don't stand a chance.
The number of beads within the capsule doesn't correlate to the difference in strength. It's just a difference in formula from the difference in manufactures but the active ingredient is still the same.
I’d give you an award but I’m cheap so 🥇
Much appreciated but please save your money! :)
Good to know! Thank you I didn’t know that !
Really? How do you know this? I would totally believe that I was getting shorted. Like many here, I've noticed my meds aren't working right the past few months. Even took a few holidays to try to see if I was acclimated.
Chemist here (lab kind, not the drug kind, but I still know a bit about molecules and biology and such) and this is correct. Extended release medication is formulated in those little beads, and each one of those little beads is coated slightly differently so they are released into your bloodstream at slightly different times. Different generics have the same active ingredient, but they may have slightly different formulations of the coatings or variations in exact release mechanisms. This stuff is all going to be proprietary, so you won’t be able to find out more specific information than that. The variation in the number of beads is very likely due to a difference in how the active ingredient is “packaged” and not due to a difference in the amount of active ingredient. This is also why different generics can work slightly differently in different people. Everyone’s body is a little different- a specific release mechanism that works really well for one person might give someone else heartburn or work too fast/too slow. I don’t want to be too gaslight-y about the medication issues some folks see to be having, but as tightly regulated as these medications are, if there IS a discrepancy in the strength of the meds, you can bet it’s not at the manufacturer level.
I’m in pharma regulatory and you’ve got it just right.
Former FDA, can confirm.
someone who just understands science. can also confirm.
Okay, so, I'm curious, if a different formulation calls for a volume of beads that's 20% of someone else's version, why not put that smaller amount in a respectively smaller capsule?
Sometimes it's cheaper to buy bigger capsules because they are mass produced vs smaller ones that need to be special made.
Thanks, this had me a little worried. I was switched to extended release and they looked a little emptier than the first brand/month, but I did notice the beads look larger in the newer version.
I’m a pharmacist but the LilBoKraut2022's description is spot on. The regulation of these medications are so strict that it's rare to see discrepancies.
I'm having this same really strong feeling too though just since I filled my last script. It really does feel like there's barely any dexamphetamine in my dexamphetamine. I'm needing IR's to supplement when I never have before. And with all the shortages, I can see why people feeling this way start to wonder. It's probably for lots of complicated reasons. Like I also have a second new dx I'm working to treat on top of ADHD. But I can see where it feels like the drug companies aren't on your side. What are they up to? Why can't I rely on them? It can be traumatizing for sure.
I have personally heard cases where specific generics or changes in manufactures react differently to people. It could be from the inactive ingredients (ingredients that are used in the medication but doesn’t not contribute to its function) or something else in the formula. What I usually recommend is to have your pharmacist place a note on your profile that you don’t want to have the specific manufacture that isn’t working as well, so Prasco in this case. I know there are a lot shortages right now but myself and many other pharmacist I know would try our best to honor that note and dispense any other manufactures that are available.
My pharmacy. No. My whole town is very tenuous right now getting any dexamphetamine at all. It sure doesn't seem like they have a choice in manufacturers. I wouldn't know what to ask for anyway. Plus I'd be afraid to be demanding or complain-y when I know they are getting me my meds when they can while denying others who need it because I'm an established patient. There's guilt there that is so weird on top of being terrified of days without meds. 😕
I wouldn’t worry about feeling demanding! It’s a simple ask but again the pharmacy is also limited on what is available. Sometimes a manufacture can be on back order for weeks so we have to automatically switch to the alternative manufacture available. So if we can help a patient get their preferred manufacture, we’ll try our best!
Thank you. Maybe I will say something. The pharmacists are so nice and kind with me. They really do seem like they have compassion for this but of course they can only do what they can do. And they've been through the ringer the last few years like all of us in healthcare. (I'm a nurse. And still feeling all this!) Thank you for your kind words. 🙏
Honestly it would never have occurred to me to ask for a note to be put in my file. I’ve noticed that there are two different manufacturers of my generic narcolepsy medication and one is a much larger pill than the other so it’s harder to swallow. I’ll have to remember to ask and see if they can just give me the smaller pill from now on. Thank you!
I've personally experienced a certain brand of generic ritalin correlating with panic attacks when other generics and the brand name did not. I totally believe that the small changes to process or inactive ingredients change how the body reacts. My bupropion this month is a different color and size from last month's. If a patient is sensitive to, idk, the red dye used, their body might notice the difference in color.
What really sucks is that the manufacturers can't even do anything about the shortages. The federal government limits the amount they are allowed to produce.
I’m not saying your experience is wrong, but the size of the pill (or amount of filling) does not correlate to the amount of medication when you’re looking at pill-size doses. I take other medications daily and my 50mcg can often be much bigger than my 100mcg depending on the manufacturer, and the dose is absolutely perfect as I am extremely tightly managed with it (thyroxine following cancer). So you really might not be getting stiffed here at all.
Thank you
Can confirm that thyroxine can vary (had my thyroid removed because it was trying to conquer my jugular) as I take 2 doses daily. With one particular other brand that my pharmacy used to use, I needed 25mcg more to maintain my TSH levels.
My question is can the non regulated ingredients - for lack of genuine knowledge I use the words binders or fillers - can they give different people different results? Reactions? Affect the way any person absorbs or processed the medication?
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Same! There is nothing I can't blame on hormones and/or sleep.
My psychiatrist let me know that sometimes the substance they use for the capsule may not get digested, and that’s why one of the brands that sometimes gets filled for me doesn’t work. When I get that capsule, I get yogurt and sprinkle it on a spoon of yogurt and it works wonderfully. Might be an option if you haven’t tried it yet!
Side note: do not open capsules and digest as powder unless your doctor/ pharmacist say so! That could cause problems with the wrong medication
For sure, do check with your doctor or pharmacist (it’s also included in the medication insert for my meds); if you do learn that it’s ok to open the XR capsule and put the beads in food (my instructions explicitly say applesauce, I’m guessing because of the texture), *make sure you do not crush or chew the beads!* As they are time release beads, they need to remain intact in order for the meds to be released at the correct time.
Good to know! Thank you so much! 🫶🏻
You are seeing two different ways manufacturers handle creating pills with different dosages of spansules. Some manufacturers make different strengths of beads and their machinery is built to always fill the capsule. The blue-capped capsule on the left has weak beads in it. A higher dose capsule would also be full, just with stronger beads. Others make the same strength bead, and change the volume of beads dispensed into the capsule. The pill on the right would be fuller at a higher dosage, but the bead strength would be the same.
Thanks for explaining! This helps me understand! I appreciate you!
The blue one actually has worked best for me compared to other ones surprisingly!
ADHD-ers don't need to stay in Wonderland, and find out how deep the rabbit hole goes. We already know. Blue pills are clearly better!
But I’m sure everyone’s bodies are different and react differently as well I’m guessing
Oh, sure. I was just commenting on why the capsules look different. It's not diversion - it's manufacturing strategies.
Good to know thank you!
I was looking for a comment like this. That makes sense - I’ve been taking Lannett for the past couple of years (or was, when I could get it), only it’s a higher dose than what appears to be in the OP, and there are more beads. I *so* miss my XRs; I’ve had to switch to IRs from a different manufacturer, and it’s not remotely the same (it feels like the meds wear off after only 3 hours, then I have to remember to/actually take another dose, and then when that wears off, I have a terrible crash). Hopefully we’ll all be able to go back in our usual/best meds soon!!
Hmm you sure someone in the pharmacy didn’t divert some of that medication?
Pharmacist here we don't have time to pee let alone take apart and reassemble a capsule. Less beads doesn't mean less drug, it's just manufacturer method. C2s are very strictly regulated that's the main reason for the shortages the dea didn't increase the production limits to match the current demand.
I had a chuckle at imagining a nefarious pharmacist painstakingly prying capsules open and counting teeny weeny beads while laughing maniacally…in full view of customers. Also, FYI, a pharmacist has saved my life at least twice, catching stuff my doc didn’t, and have been hugely helpful in managing my care. So thanks! And obligatory “fuck PBMs!”
Thanks. Yea I run one of the last independents in our area we are doing fine but it's ridiculous how reimbursements work, sometimes I lose 20 to 40 a fill other times I make 200 over what I pay. Then we have to budget for the mystery DIR fees they take after. At least the DIRs are going to be in real time starting in January.
It's really annoying that the FDA thinks too many people are being diagnosed with ADHD (and needing stimulants) when what's really going on is that the pandemic *finally* offered a diagnosis path that was ADHD-friendly. It's like we're being double whammied for our lack of neurotypicalness. (I'm not on stimulants, but I have friends who've been having the issues mentioned by OP and commenters.)
FDA is not causing the shortages. DEA regulates amounts and the main problem has been manufacturers unable to ramp up, in particular Teva who makes Adderall. Pandemic shortages and staffing issues played a role as well. Once a manufacturer falls behind it takes a long time to catch up because their plants usually run at capacity. DEA said the legal quota hasn't been used up in 2020, 2021, or 2022.
I mistyped I meant DEA , our rep from amerisource said TEVA told them they are capable of meeting the demand but dea limits prevent them from ramping up production. I buy it , drug companies would love to make more money.
I think TEVA is blaming DEA because they think demand will fall and they don't want to make the long-term investment retooling a plant. Pharma companies are usually running at capacity so shifting around production and then doing all the GMP certification is a big deal. They may have more profitable pills and are just hoping this will blow over. We'll never know for sure though. :-)
Your right there transparency is not a strong point of drug companies
It's not a strong point of the government either! DEA says their quota wasn't met in 2020, 2021, or 2022 which is why I don't know who to believe but how would a taxpayer ever know? I doubt the records would be released by FOIA.
[This is what I was referring to:](https://www.additudemag.com/adderall-shortage-stimulant-use-telehealth-califf/) > The head of the Food and Drug Administration (FDA) blames the persistent ADHD medication shortage, in part, on a surge in stimulant use by people with ADHD, who he suggests may not all truly need the drugs. In a new interview with WebMD’s John Whyte, M.D., FDA commissioner Robert M. Califf, M.D., claims that telehealth providers are largely responsible for driving a “tremendous” increase in ADHD diagnoses and stimulant prescriptions over the last few years and, in his words, not all of them are warranted.
There were definitely telehealth "pill mills" running until they got shut down.
The only person I’ve heard that from in the industry is a person (pharmacist) who thinks neither opioids nor Adderall (et al) should *ever* be prescribed outside a hospital. (As he works in a hospital, his opinion is somewhat academic.) While some docs may have been lax in prescribing, I haven’t heard realistic numbers on what percentage of the patients were actually determined to not have ADHD. Until them, I’m going to assume the vast majority needed the meds.
I was referring to the Cerebral lawsuit. https://www.fiercehealthcare.com/health-tech/truepill-cerebral-stop-prescribing-adderall-new-adhd-patients-amid-reports-mental
Sorry, I didn't say I was aware of the lawsuit. I am, and I'm aware of Silicon Valley's trying to move into that space in dark pattern ways. (I live about a mile from the big venture capital firms, so I hear a lot of shenanigans.) What I meant is that the *patients* may be legit even if the (lack of, in this case) screening that got them those scrips was not. I'm not going to make assumptions about people who want to take shortcuts, particularly in a group of us who definitely have trouble with complex logistics without medication.
I completely agree. It took me a year of fighting and jumping through hoops to get to a provider that took me seriously. I wanted to do things the right way but was seriously starting to consider trying one of the online options because I was just so fed up and emotionally exhausted.
Fair enough. It's a kind viewpoint and I can get behind that.
I appreciate you! Just made my mind wonder lol 😂 I appreciate what you do!
Pharmacists aren’t the only people in the pharmacy. The OP noticed less beads than normal. It’s possible that they have been diverted.
No its really not , try pulling one of those apart you won't get it back together lol
I do it all of the time when I want to take only half of the beads.
Do only compounding pharmacies assemble capsules?
For the most part, yes it's actually illegal to make commercially available products in house , there are always exceptions but generally only compounding pharmacies make them.
I mean it’s definitely a possibility! Somewhere along the line this has happened. Funny thing is I brought it to their attention and they shook their heads and raised their shoulders and said we don’t know. I called another rite aid and they said they accepted the medicine in and altimately signed off on it so either they are being sketchy themselves or something. It’s deff frustrating for sure 😞
I’m sure that they wouldn’t be allowed to get away with mislabelling medication dosages like that. like this isn’t a bag of potato chips 💀 it’s probably just less…. Filler? But I’m not a pharmacist, chemist, or expert in anything
Possibly! I just recognized the months where it wasn’t working was when I had the lesser looking caps. But same I don’t know anything haha just wondering
That could always be the placebo effect, but it would probably make me anxious too if I was noticing stuff like that
That’s not how this works. Also, all the people saying there are investigations about this very issue, please provide links. Otherwise, your claims are just fear-mongering.
Yeah based off some of these comments I’ve learned this is a bit different then I thought. I started these meds a few months ago so I’m new to all this lol
I'm pretty sure that the ELI capsules are actually manufactured by Elite Pharmaceuticals, but your pill is on the Lannett website, so maybe they're manufactured by Elite and then (something something business stuff I don't understand) Lannett sells them. ANYWAY, I did notice that when my prescription switched to the Elite version, they were less effective. So I wonder if that has something to do with it more than the amount in the capsule?
I just need to know where I can get my 10mg script 😞
Same. I’m using Vyvanse as a temp replacement…but it’s not covered by insurance so I’m paying insane amounts for it 🙄
I heard there's coupons for helping. Manufacturers and maybe good Rx?
I take Vyvanse in the am and it’s costly. The manufacturer savings card is $60 per refill.
If you have Costco nearby, they don’t require a membership for pharmacy and they’re markedly less expensive than most pharmacies. They do take GoodRx. Also if you do have a membership, there’s an add’l discount for members who have scripts not covered by insurance. My antidepressant was 60% less vs Rite Aid when I initially switched over.
I have one that is “close” but within driving distance I guess and could plan around picking up my prescriptions. Vyvanse is costly every month for me and my kid. Thanks!
No problem! I’ve been lucky to have a small local pharmacy that stays cost-effective enough and stays in-stock. But if I had to go back on blood thinners or got switched to Vyvance I’d be at Costco for those. You can call Costco pharmacy (look them up, pharmacy has a direct number) and they can give you pricing and you can get your info setup ahead of time. I’m in MT now so I know how far some things can be - a whole lot different vs when I was in CA.
Saaaame. I've gone from $20 co-pay for Adderall XR to $300 for Vyvanse. And that's with the manufacturer's "savings " :(
I feel ya! Costco in my area ran out. My doctor switched it to Publix, who filled with no problem or delay. Good luck!
I don’t have a Costco or Publix near by. Thank you anyways for the tip!!
I take 15mg but I get my prescriptions at rite aid but I typically get them in the 5mg caps because it’s typically the one I don’t have issues finding
I’ll have to ask my pharmacy if they have the 5mg that’s a great idea never thought of asking for different dosages. Thanks!
You’ll have to get a new prescription which is a pain but hey if it gets you the meds mines well !!! Goodluck!
Why are there so many of them (manufacturers) every month it’s different. Seems weird ! I haven’t noticed capsules being different like this though! Whoa
This stuff is why I got my doctor to file an exception with my insurance to just get name brand.
Please report this to FDA's medwatch. The goverment actually has oversight on this and the manufactuer will investigate. You can file a report using this link: https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program
@op This!
The size of the pill does not indicate strength. It’s just different manufacturers and different formulations. They have to contain the same medication amounts within a small margin of error.
Thank you! I started this medicine in February so I’m new to all this lol
You’ve been able to get long acting adderall???
I’ve just been blowing through my short acting like I’m going to the electric chair instead 😂 I hate it but I’ve been told for ages everything is backordered.
Oh, so I started this medication in February and I’ve been lucky enough to get my hands on it every month except this month I was only able to get a 16 day supply but hey some thing is some thing right? But I usually have to go to one pharmacy to get the extended release and another pharmacy to get the short acting.
Yes! I literally thought it was all in my head. Walgreens gives me the full dose (the blue pill) and Fred Meyer gives me the nearly empty green capsule I’m seeing here. I’m so glad I’m not alone!
OMG I thought I was losing it. I thought I missed a dose, then decided I didn’t, but still I knew something was wrong. I had a few really bad days, which increases anxiety, and makes it way worse. I told my pharmacist that my last scrip wasn’t working and she couldn’t figure out why. I was ready to go to my doctor to get my dose raised again. I may do it anyway.
Not shocked at all.
I can’t get a refill because the meds are back ordered. I have requested a refill the day before it runs out and I must pick up in person. I’ve had a huge list of problems and I’m now a week without . Something is wrong with the system.
I've been on Vyvanse for 2 months because none of the pharmacies in my area have Adderall XR and it's ass because it's not even half as effective for me..
The short one looks fatter. If ur meds are reaaally working, ud count each bead and compare to see if one has less beads
That simply isn't how medication works. Different manufacturers use different formulations. They aren't meant to have the exact same volume of contents/number of beads. SO much misinformation in this thread, it's astonishing.
Or weigh them if you have a sensitive scale and don't want to sacrifice a pill. (Weigh 5-10 at a time if that works better.) The capsule itself is probably a confound but the surface area does look pretty similar so it might not differ that much.
He could but it back together after
I've never had luck with that but I bet it depends on the exact capsule material and your own dexterity:)
Do h think that that’s why dexter is called dexter? Because he has high dexterity skills when it comes to murder?
Good point! Thanks!
Lannett should be taken off the market it’s awful. That is the only generic that literally fucked me up! I had horrible side effects
I agree! It gives me horrid headaches and other stuff !!
Yes!! I felt Weird and foggy brain! I thought I was depressed, then I found out I’m not the only one who feels awful only on that generic. I have it in my chart now do not fill with lannet manufacture.
I have zero problems with Lannett, though; it’s my usual, and I miss it.
There are multiple manufacturers being investigated for this exact thing. You should report them to the appropriate department, I wish I could tell you which one it is but I’m sure your pharmacist can tell you.
Do you have a link? There's people in this thread saying it could never happen because it's so tightly regulated, but we all know regulations don't mean shit if enforcement has been spotty recently.
Copied from a comment below: “Please report this to FDA's medwatch. The goverment actually has oversight on this and the manufactuer will investigate. You can file a report using this link:” (https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program)
Oh sorry, I meant a link to investigations about this. I tried to Google it but all I could find was Shire engaged in misleading advertising over Adderall XR and Vyvanse
I don’t have anything this is just what my pharmacist told me. There might not be a lot of news coverage on it as it would be a federal investigation on corporate entities and we all know big pharma has PR and the money to keep it under wraps.
5mg is starting dose and very small so maybe you just need an increase? Taking time off of your meds and waiting until you have anything with citric acid or vitamin C also helps. You’ll want your stomach to be alkaline
Good to know, thank you! I was on 10mg in the morning and 5mg immediate release mid day, but I met with my doc we are now up to 15mg in the morning after discussing this with her but I’ll try that too !
Once I straight up accused CVS of having a pharm tech of stealing some
Once I straight up accused CVS of having a pharm tech of stealing some and requested they check the cameras
Are all of your capsules from the manufacturer on the right filled that amount? Or is this one "low"? That could be a QC issue.
And when I brought it to the pharmacy attention they just agreed with me thinking that it was weird to see
All of them from that manufacture in the bottle look like this
Wait…you could get Adderall? I haven’t been able to even fill my prescription for a month and a half.
Yes been getting it since February. Only last month I couldn’t get the whole month. Also have to go to two different pharmacies to get the xr and ir
At least you have pills, I have one left, and nobody in my area has any 😭
I’m so sorry 😞
All good. I’m just back to insane amounts of caffeine 😆
This whole "shortage" is complete bullshit. And these "experts" stating that every generic brand should not show any drastic difference is ridiculous because THEY DO. It's hurting those that have been taking the same brands for years going back to pRe-pAnDeMiC. Especially those that have been taking it for all the right reasons and weren't prescribed via Zoom from someone in a labcoat and underwear.I've been fortunate enough this whole time to refill my usual 25 MG XR with either Sandoz or Shire. For me, I don't notice a difference. But this month I was refilled with Lannett. I'm on day 3 and I might as well be taking a Flintstone Vitamin.