Brand Name or Generic?

Are generics as safe and effective as brand-name drugs?
Not always. Everyone needs to be cost-conscious, but in some cases brand-name drugs are better than generics. Generic painkillers like acetaminophen are fine, but I do not recommend generics when I prescribe hormone-based drugs (birth control pills, thyroid medications) or antidepressants, all of which require extremely precise dosages.

But don't generics have to be identical to the brand-name ones by law?
No. Although the FDA requires a generic to be bioequivalent to the brand-name drug, they are not exactly the same. That means you may get either a little more of a medication, or a little less, which could make a big difference. Generics can also have different fillers and may dissolve at different rates.

How do I figure out if a generic is right for me?
Talk to your doctor about what she would do in your situation. Bring all your prescription and nonprescription drugs -- not just a list -- so that she knows their exact brands, dosages, and expiration dates and can help you make an informed decision.

On my insurance plan generics cost less, so I switched to one. How can I tell if it's working as well?
Ask yourself: Does the generic drug's effect last as long? Does it cause any side effects? Even if you feel fine, talk to your doctor about the change you've made. She can monitor the way that your body is responding to the new medication at your next visit.

Originally published in Ladies' Home Journal, April 2009.