View Full Version : Is there a difference (pic)?

10-17-14, 08:14 PM
Is there any real difference between these two pills?

If so, what is the difference?

I am confused.

10-17-14, 08:39 PM
"A" is "real" Concerta -- either brand-name, or the "authorized generic", both produced by Alza. This pill uses the osmotic release system (OROS) that controls the speed at which the medication is squeezed out of the capsule. If you have one of these in front of you, you will see a tiny hole on one end.

"B" is a different generic, produced by Mallinckrodt. It has the same active ingredient (methylphenidate), but it does not use an osmotic release system.

In theory, generics are supposed to be demonstrably similar to brand-name products in terms of pharmacokinetics (roughly speaking, how the active ingredient finds its way through the body and is metabolized). In practice, this equivalence has been questioned. I'm not sure whether the question has been resolved in this case.

10-18-14, 04:36 AM
Thank you for a clear and precise response. That's exactly what I needed to hear (and found difficult to parse on other sites).

The person taking the medication has suffered a brain injury, so the effects cannot be self-reported as easily as they otherwise might, and I am monitoring it from an outside perspective.

If "B" did not work the same or as well, what would the difference actually feel like to the person taking it?

10-18-14, 11:22 AM
You're welcome. I take this medication myself, and had the same question when the new generic came out.

It's hard to say how any given individual might feel while taking one or the other, as both the intended effects and side effects can vary.

In general, if a medication isn't working well, the symptoms or deficits that the medication was intended to treat will be more prominent and less controllable by the person.

Although the situation may be slightly different depending on the type of brain injury, the deficits that are shared with ADHD (and thus treated with stimulant medication) often include poor impulse control (in speech and action), increased distractibility, very poor short-term memory, restlessness, and difficulty regulating emotional responses (which can affect anger, excitement, motivation, and other aspects of emotion).

People with ADHD and people with brain injuries, because of the nature of their deficits, are also often poor self-observers, and don't always recognize how their impairments manifest themselves or affect their actions and relationships.

But from my own perspective, when I've had problems with ADHD medication, the main feelings have been frustration and exasperation with myself, and feeling somewhat out of control. I want to get things done and behave in certain ways and be a responsible adult, but it's a great struggle to actually make it happen, and often it doesn't happen.

My doctor currently writes my prescriptions with a note to fill with the "authorized generic". This way, I can pay the "generic" co-pay, but get the pills that have the osmotic release system, since the Mallinckrodt version didn't seem to work as well or last as long for me. If the person you're concerned about has a similar problem with the generic, this might be an option to discuss with the prescriber.

Best wishes.

10-19-14, 11:31 AM
The Concerta perscription from my doctor had no substitutes typed at the
top then he wrote 'no substitutes' across the middle of the page. Guess
what? The pharmacist gave me the generic substitute! If I hadn't seen the
picture here I never would have known! Thanks for the info namazu!