Generic Lexapro...

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And now doctors switch customers to this Viibryd nonsense

..edit .. i just realized the sexual dysfunction side effects are minimal to none with this drug..
 
How can something be a partial agonist of serotonin?
 
Haha I'm not searching anywhere that tells me that something can partially agonize an agonist. I was
 
Just being technical 🙂
 
A partial agonist binds into the receptor but doesn't activate the maximum response of that receptor. This affects the ability of full agonists to exert their effects.
 
Kwiz said:
Just being technical 🙂
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That's my point. Do we call tamsulosin a norepinephrine agonist? That thing is like an agonist of a subtype of a subtype of a subtype of the alpha subtype of adrenergic receptors. I was just joking around bc it's easier to communicate something thoroughly. Probably came off wrong now 🙁 .
 
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Btw, I wasn't being technical just there...but it is pretty specific supposedly. Haven't had BPH so maybe I'm giving too much credit
 
Kwiz said:
That's my point. Do we call tamsulosin a norepinephrine agonist? That thing is like an agonist of a subtype of a subtype of a subtype of the alpha subtype of adrenergic receptors. I was just joking around bc it's easier to communicate something thoroughly. Probably came off wrong now 🙁 .
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Well, that's an issue of specificity... to bind to the subtype of a receptor so that receptors in the rest of the body aren't activated to illicit other responses leading to side effects

EDIT: potency and specificity aren't the same thing.
 
Ok ok ok. I'll just come out and sound like a jerk. He didn't say receptor and that was the point that I was making. Don't gotta go whippin out the dose-responses on me haha
 
Kwiz said:
Ok ok ok. I'll just come out and sound like a jerk. He didn't say receptor and that was the point that I was making. Don't gotta go whippin out the dose-responses on me haha
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I guess I missed the sarcasm. Joke's on me :laugh:
 
Haha it's ok. I didn't mean to start anything. When I hear something like ondansetron is a serotonin antagonist and sumatriptan is a serotonin agonist, for example, I half do it to remind myself, half to make sure everyone's talking about the same thing. I'll just do one of these next time :-x haha
 
Don't feel bad bub, I got what you meant. It binds the receptor, not directly to serotonin. Certainly not the best joke I've heard all day, but oh well.
 
Ackj said:
Don't feel bad bub, I got what you meant. It binds the receptor, not directly to serotonin. Certainly not the best joke I've heard all day, but oh well.
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Its the only joke I heard today. I suppose I should really get out more... 🙁
 
All4MyDaughter said:
I heard the generic doesn't work as good as the brand...
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Now some idiot will google walk to this thread and proclaim that their instant release medication doesn't work because it was made in West Virginia rather than St Louis. Because they have magical tableting machines at brand name drug factories. When Mylan makes brand Maxzide, they use the "good machine" over in the corner.
 
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WVUPharm2007 said:
Now some idiot will google walk to this thread and proclaim that their instant release medication doesn't work because it was made in West Virginia rather than St Louis. Because they have magical tableting machines at brand name drug factories. When Mylan makes brand Maxzide, they use the "good machine" over in the corner.
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I had someone almost want to fight with me b/c I told her that the switch to generic atorvastatin was probably not what was affecting her patient's INR. Especially b/c her patient was on Watson brand and it's just brand name Lipitor repackaged/relabeled. She kept repeating, "Any change can affect the INR" and I kept telling her that the only change was what was written on the bottle. But I don't know what I'm talking about or anything...
 
All4MyDaughter said:
I had someone almost want to fight with me b/c I told her that the switch to generic atorvastatin was probably not what was affecting her patient's INR. Especially b/c her patient was on Watson brand and it's just brand name Lipitor repackaged/relabeled. She kept repeating, "Any change can affect the INR" and I kept telling her that the only change was what was written on the bottle. But I don't know what I'm talking about or anything...
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Should have told her they were putting Watson brand atorvastatin in the Lipitor bottles now.
 
out-demons-of-stupidity1.png



I got in trouble for having a big poster of this and referencing it. But you may not. 😉
 
Farmercyst said:
Should have told her they were putting Watson brand atorvastatin in the Lipitor bottles now.
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Thats what I did at my store.. I took all the watson atorvastatin and put them into the lipitor brand bottles. Saved us some $$ ..

I do that with everything in which its the same manufacturer, same pill. Wanna pay $50 for xyzal brand? Well here you go idiot..
 
farmadiazepine said:
Thats what I did at my store.. I took all the watson atorvastatin and put them into the lipitor brand bottles. Saved us some $$ ..

I do that with everything in which its the same manufacturer, same pill. Wanna pay $50 for xyzal brand? Well here you go idiot..
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Sarcasm doesn't really travel well over the internet, but isn't that fraud?
 
Thats what I did at my store.. I took all the watson atorvastatin and put them into the lipitor brand bottles. Saved us some $$ ..

I do that with everything in which its the same manufacturer, same pill. Wanna pay $50 for xyzal brand? Well here you go idiot..
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I've always wondered about this topic... Anyone care to elaborate?

Identical pills, the only difference is that the pharmacy, insurance, and patient have all purchased something more expensive for no reason.

Same issue with protonix until they altered it to a "P" instead of "Protonix" on the tablet. Not to mention the bottle never changed and still scans as brand or generic...
 
When I did my rotations in an independent I went to go fill a generic pantoprazole Rx for a customer .. I saw there were 2 generic manufacturers .. I picked the one in which the tablet said "PROTONIX" and looked just like the brand ...

I took it off the shelf and the pharmacist, such a smart woman, said "No, no, no, no.. that's the one we use for the customers who want the Protonix brand.."

You bill the insurance for brand, dispense the identical medication (which is made by the same manufacturer), and wind up saving money bc you did not spend the actual amount of money buying the brand..

Why wouldn't you do this? We all know winthrop makes both Xyzal and generic levocetirizine and its made in the same place, but just distributed differently. The pill is the same. Same thing with the generic Concerta by Alza and brand Concerta by Alza, and etc, etc.

Is it really fraud? So the difference between these brand and generics manufactured together is who distributed them..

When I own an independent (if that ever happens with this economy and what the third party's and CVS is doing right now) that's what I would do, which is what a lot of places do.


.. Lastly, when Lipitor generic first came out, it was made by watson, it was the same exact pill saying PD155 or whatever. I wrote the note on the Rx for atorvastatin that THIS IS THE SAME MEDICATION YOU BEEN TAKING, the only difference is literally the writing on the bottle. One woman said she would not take the generic, that she would pay $50 more for the brand.. I had my tech talk to her, and I took the bottle back from her, switched the Rx to "LIPITOR" on the computer, and slapped the new label right on the same bottle without her knowing, and she was content. Snot is snot.
 
Yes it is fraud. I work for an independent and we do not do this. I believe that in addition to fraud, it would be misbranding because the NDC for the brand is different than that of the generic. Even if the generic and brand are identical (which they often are), if customers want to pay for brand, you should give them brand and not try to trick them.
 
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All4MyDaughter said:
Yes it is fraud. I work for an independent and we do not do this. I believe that in addition to fraud, it would be misbranding because the NDC for the brand is different than that of the generic. Even if the generic and brand are identical (which they often are), if customers want to pay for brand, you should give them brand and not try to trick them.
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It's also going to be misbranding because lots and exp won't line up. It's a super scum bag thing to do and I'd punch a pharmacist in the throat it I knew they were doing it (or at least report them to the BOP and CMS, having them tear your store apart is probably worse than getting it in the Adam's Apple). It's only one step from diluting chemo drugs to save money.
 
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npage148 said:
It's also going to be misbranding because lots and exp won't line up. It's a super scum bag thing to do and I'd punch a pharmacist in the throat it I knew they were doing it (or at least report them to the BOP and CMS, having them tear your store apart is probably worse than getting it in the Adam's Apple). It's only one step from diluting chemo drugs to save money.
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It's definitely insurance fraud, and a federal offense because of the misbranding. But to equate it with diluting chemo drugs??? Diluting chemo drugs led to people's death, labeling a generic that is made from the same company as a brand is illegal but it's going to have a neglible effect on someone's health.
 
NaOH said:
I just spent the last week looking at this pitcher in my notes. I don't need to see it here, too. :lame:
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I laughed... :laugh:

I cried... :cry:

I channeled Owl's sarcasm. 😉
 
This is where you might run into a problem...
If the insurance company gets a rebate from one or the other, and you falsely bill, then the company sponsoring the rebate may have just cause to audit you (sort of like the diluted chemo case where the drug rep *knew* that the Ohio pharmacist wasn't buying as much of the chemo drugs as he was dispensing). If you didn't bought enough brand-name to cover the rebate program, then they might figure it out!
 
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First complaint! Guy called and told me that within 2 hours of taking 30g of mylan escitalopram he was drooling and "tripping balls". He was not receptive to my reasoning.
 
npage148 said:
First complaint! Guy called and told me that within 2 hours of taking 30g of mylan escitalopram he was drooling and "tripping balls". He was not receptive to my reasoning.
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Is that a complaint or a compliment? We have many patients who fill scripts for the sole purpose of tripping balls.
 
npage148 said:
First complaint! Guy called and told me that within 2 hours of taking 30g of mylan escitalopram he was drooling and "tripping balls". He was not receptive to my reasoning.
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For comparison's sake, what would taking 1500 of the 20mg brand name Lexapro do? Or did he get the liquid?
 
I'd imagine taking 1000x the therapeutic dose of something would lead to all sorts of interesting effects.
 
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