The dermatologist said what?

[ilovepubmed]

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A dermatologist said:

1) If taking doxycycline for acne, its better to take the brand name, because it won't cause as much of a problem with OCP effectiveness.

2) Taking OCP's continuously (w/o placebos) worsens acne.

Has any of this been proven?

 

[sdn1977]

A dermatologist said:

1) If taking doxycycline for acne, its better to take the brand name, because it won't cause as much of a problem with OCP effectiveness.

2) Taking OCP's continuously (w/o placebos) worsens acne.

Has any of this been proven?

I'm speaking as a pharmacist and I'd have to say in my experience, dermatologists exercise the "Do Not Substitute" option more frequently than any other speciality. Is it necessary - no. Studies show there is no difference between measurable parameters (blood levels, tissue levels, kinetic parameters, clinical outcomes) to any degree of statistical significance. You may find one or two studies that show otherwise, but check to see who funded the study. The ONLY time a generic/brand name is significant is for a drug that has a narrow therpeutic index (phenytoin/Dilantin, warfarin/Coumadin, etc...) For years we used to not interchange digoxin/Lanoxin until hospitals uniformly switched to generic and now I don't know of any cardiologist who cares. Thats not to say a patient may fail on a particular antibiotic, but they rarely improve when the brand is switched - usually when the antibiotic is switched.

As for the influence of an antibiotic on an OCP.....the prescriber needs to be very cautious. There are many, many case reports of contraceptive failure (the patch as well as oral) due to antibiotic influence. The mechanism has NOTHING to do with who makes the drug and everything to do with the drug itself.