“Ask the Doctor”
with Dr. Rebecca Gilbert
Q: My Mom has PD and needs to take brand name Sinemet. When she takes a generic, she does not feel well. My pharmacy has told me that there is a shortage of brand name Sinemet. What should she do?
A: A generic and brand name of the same drug are required by the Food and Drug Administration (FDA) to have the same strength, dosage amount, route of administration, and quality. There are, however, two differences that are allowed between a generic and brand name drug:
- They can have different inactive ingredients and will often look different.
- A small range in the bioequivalence of the medication is allowed — typically the range is no more than 4%. (That would mean a 100 mg dose could be between 96-104 mg.)
Therefore, a small percentage of people who are extremely sensitive to these small changes may be able to tell the difference between different generics or between brand and generic. (The vast majority of people will not be able to distinguish.) If your mom is among the people who can tell the difference between the different manufacturers, the solution is to try all the different generics. One may be even better for her than the brand name version. You will need to talk to her pharmacist about how to obtain the different generics. One pharmacy may carry one particular generic but may be able to tell you if there is another pharmacy in the area that typically stocks another one of the generics. If trying multiple generics is not possible or all have been tried and they all cause the same problem, then she will need to choose one of the generics and work with her doctor to increase or decrease the dose a tiny bit to obtain a good clinical outcome.
Dr. Rebecca Gilbert is the Chief Scientific Officer at APDA. She oversees APDA’s research portfolio in conjunction with APDA’s Scientific Advisory Board. She also provides medical and clinical expertise to support APDA programming as well as print and web content.
Have a question for Dr. Gilbert? You can submit it anytime.