AboutDr Alan Galbraith Expertise I can answer most questions on most drugs. Answers can be given in either technical or layperson terminology. My main areas of interest are psychiatric, gastrointestinal and cardiovascular drugs.
Experience I have been a university lecturer/head of department for almost thirty years, but am now retired. My research interests were alcohol, smoking and cardiovascular disease. I am already a well established and highly rated expert in the pharmacy section of this site.
Publications Principal author of "Fundamentals of Pharmacology" Editions 1-4 published between 1994 and 2004 by Pearson Education, Australia. Author of the 5th edition published 2007.
Author of many scientific papers.
Education/Credentials BSc(Hons);MSc;PhD;HECert
Awards and Honors The 4th edition of my textbook was awarded the the Educational Book of the Year Award in Australia.
Past/Present Clients See my profile in the pharmacy section.
Question My husband's doctor marked "no not substitute" on his last perscription of Synthroid. Before that he had only paid $4.00 for the generic for it.Is there any difference between the brand names and the generic drugs? Don't they have to be the same thing? He also takes Lisino/HCTZ and Cardizem CD for his blood pressure. He has to get the name brands. Are there generics for these drugs? Do you know why a doctor would put "do not susubstitue" when we have to pay much more to get the name brand? Our insurance makes us take a generic when there is no name brand for the medication, but when he puts about not susstituting, they have to do what the doctor says? Any suggestions?
Answer Dear Connie
I see your predicament and with the lisinopril/HCTZ and Cardizem I see no reason not to use generics. However, with the Synthroid matters are not the same as the dose has to be very precise and not vary. It is a very potent drug and a slight variation in concentration can cause problems. The reason generics are cheaper is that there manufacturing process although not substandard can be different and the tablets so produce can deliver varying quantities into the blood from the gut. With less potent drugs this is not usually a problem but with highly potent ones like Synthroid it could be a problem hence your doctor's decision. Discuss this further with him.
