Generic Birth Control Pill?

September 19, 2006 10:42 AM

Generic brands of the Birth Control Pill: Are they really as terrible as I'm hearing?

I'm on Ortho Tri-Cyclen Lo, and I love it. It actually makes me feel better than not being on a pill at all -- smooth mood, soft skin, lots of nice effects. I have no problems with it whatsoever.

....Except that it's costing me $50 a month. My insurance covers only a few dollars of the prescription price. I know there are generics for this pill, but in the Googling I've done, I've encountered only stories of the negative variety. Seems as though people notice a big difference when they switch to generics. This concerns me, because I'm happy with the way my body's working now, and if a cheaper pill would cause problems, it's not worth it.

I'm seeing my GYN in a week and will of course ask her, but I wanted to gather some reports from the field, as well.

posted by Miko to health & fitness (26 comments total)

I switched from Cyclessa to the generic Velivet when I switched insurance providers, and I noticed no differences.
posted by rachelv at 10:49 AM on September 19, 2006

I read in some Glamour-like magazine that they're not held to the same standards of how much the hormone content can deviate from the stated amount, and of course the only way you would know is if your birth control fails. I'm not sure how accurate that is, though.
posted by transona5 at 10:54 AM on September 19, 2006

I never had a problem with any generics, though I never tried the one for OTC-lo, which I'm also on now. I'm really surprised about that price! I only pay $13...even without insurance I'm surprised it'd be that much.

I used to get OTC-lo from Planned Parenthood for $20 without insurance. I'd call your local chapter if I were you. Also, see if your GYN has any free samples. Everyone I've seen has tossed those things around like they've got a OTC-lo factory out back.

Before OTC-lo, I used Aviane with is a generic for Alesse, also a low-dosage but it's a consistant dose all 3 weeks. Never noticed a difference.
posted by lampoil at 11:01 AM on September 19, 2006

I have used generics & the original versions of a variety of birth control pills. I have *not* noticed a difference. The ones I've been on include Alesse, Desogen & Mircette. Desogen & its generics being my preferred bcp.
posted by tastybrains at 11:04 AM on September 19, 2006

The first month or so after switching from name brand to generic, I had a little spotting. But otherwise *knock on wood* no problem. Your pharmacist may require your Doc's ok to switch you, but since you are planning on discussing it with him/her anyway, easily done.
posted by ilsa at 11:09 AM on September 19, 2006

I've never had a problem with Trivora, the generic regular Ortho-Tri-Cyclen.
posted by desuetude at 11:11 AM on September 19, 2006

I am very susceptible to BCP side-effects, in general, and I noticed a lot of differences when I started using generics. In most cases, I had more spotting with generics. One time I filled my Rx at a new pharmacy and they gave me a different brand of generic, which turned out to have FEWER side effects than the brand-name. Unfortunately this was several years ago and I can't remember what it was...it definitely wasn't Ortho-tricyclen Lo.

My doctor told me that this is not because of hormone content deviations (it really, really shouldn't be!) but because sometimes they use different types of artificial hormones, and other times they use different (most likely cheaper) binding agents in the pills which affect rates of absorption in your system.
posted by chelseagirl at 11:15 AM on September 19, 2006

I've used two different generics for Orthocyclen (not tri), Sprintec and Monessa, and noticed no difference.

When I switched to generic thyroid medication, my endocrinologist told me the same thing as chelseagirl's doctor - the binding agents differ, but there is NO difference in hormone content.
posted by ilyanassa at 11:30 AM on September 19, 2006

I'm currently on the generic version of mircette (kavira), and I don't notice a difference. Best pill ever for a migraine sufferer like myself.
posted by missmobtown at 11:35 AM on September 19, 2006

I was switched to the generic version of Levlen 28, but what sucked is that someone (the doc or pharmacist, I guess) didn't notice that the dosage was slightly different, which led to much spotting and anxiety on my behalf. So just check the percentages/dosage and make sure the generic really is the equivalent to what you were getting.
posted by np312 at 11:36 AM on September 19, 2006

I was on the generic version of Loestrin (microgestin) for years and noticed no difference from when I was on the brand name (except for paying less!). I eventually developed side effects that made me quit hormonal birth control all together, but given how long I'd been on the generic version I don't think it was a case of generic vs. brand name that was the problem -- I think my body just doesn't tolerate hormonal tinkering the way it used to. (O glorious middle age!)
posted by scody at 11:45 AM on September 19, 2006

I took Ortho Tri-Cyclen, and switched to generic. Had an almost constant yeast infection until I switched back.

Since my new insurance makes my new Ortho Lo (love it too!) prescription only $25 instead of $40, I'm not going to risk switching to generic again.

(Damn, why are these medications so expensive? It really irks me.)
posted by agregoli at 11:58 AM on September 19, 2006

I never noticed a difference between brand and generic, but I agree that you should check the label carefully to make sure the dosage matches what you're used to. Also, keep in mind when Googling that you're more likely to find negative/bad/horror stories online than "everything went perfectly fine" stories.
posted by hsoltz at 12:00 PM on September 19, 2006

I noticed a slight difference in the side effects initially, but nothing major. Maybe a little more cramping than when I was on the brand name, but still significantly less than when I wasn't on the pill at all. I've been using generics for years and haven't had any problems.
posted by thejanna at 12:06 PM on September 19, 2006

How well the generic works for you is probably going to depend on your individual physiology. The FDA has fairly strict rules about how much variation there can be in amount of active ingredient, how bioavailable it is (ie, how well it dissolves and gets into your system), etc. I'm in pharmacy school - we had to study these rules - I could dig up a reference if you want.

If you're a person who is very sensitive to the hormones, you might like one brand better and if you're not so sensitive, you may not notice a thing.

One big reason for sensitivity could be "glorious middle age" as scody says above! With age, the liver does a worse job clearing many drugs out of your body, so the drug can build up - more drug => more side effects.

It sounds like you've been happy with the brand drug with no unwanted effects, so my guess is that you would be equally happy with the generic. But really the only way to know is to try.
posted by selfmedicating at 12:07 PM on September 19, 2006

Another thought, Miko, related to price -- do you have the option of a health savings account? If so, you could set aside the $50/month pre-tax, meaning you'd have $600 less a year that's subject to income tax -- so you'd save a little that way, in the long run.
posted by scody at 12:20 PM on September 19, 2006

"Glamour-like magazine that they're not held to the same standards of how much the hormone content can deviate from the stated amount"

First, please don't trust a women's fashion magazine for advice on the efficacy of generic medications. Remember, they are beholden to their advertisers.

Second, the testing demanded of generic drugs assures patients that the drugs are effective. That's what our FDA does --- it ensures the efficacy (and supposedly the safety, but that's another Ask MeFi topic) of prescription drugs sold in the US ---- I am a pharmacist and I have worked for both generic and brand-name pharmaceutical companies.

Buying generics is a way of sticking it to the man, if that's your thing, or just an informed/smart way to save money.

There is not an increased risk of becoming pregnant due to deviations in the hormone levels of generic oral contraceptives compared to brand name.

Many, but not all, generic contraceptives are made by the same brand-name manufacturer. The generic company is a "division" of the brand-name company.

Brand-name oral contraceptives come in prettier, bulkier, and more (expensive) plastic packaging than generics. The brand name drug companies will argue that they need to recover the price of R&D.

From my experience in both the brand and generic worlds, the extra prices charged are for the 3 inch-thick carpet pad and flying first class that the brand companies employees are accustomed to. Generic companies are leaner with their overhead, and therefore pass on the savings to their customers. I think that's a good thing for patients.

Given a chance, I always purchase generics. To me, it's a waste of my hard-earned money not to.

However, if you have been taking a medication for a long time (brand or generic) and switch to the other formulation for whatever reason, it is no guarantee the new formulation will work exactly as before.

As mentioned above, it may be due to the fillers in the formulation. But it's definitely not due to cheaper or inferior fillers. Brand and generic companies frequently buy their ingredients (again, all FDA-approved) from the same suppliers.

By no means am I guaranteeing that whatever generic you get in place for your Ortho TriCyclen-Lo will be exactly the same, but I can assure you that it will prevent you from getting pregnant when used correctly.

As for your skin, the only way you'll know if the generics work the same keeping you soft and smooth, is to try them. I wouldn't base my decision on random MeFi responses, because of individual biological/physiological differences.

And, in switching from one formulation to another, (be it brand to brand/generic to generic/brand to generic/generic to brand) you may find spotting. The spotting has nothing to do with the inferiority of one product to another, but rather is your body's transitioning from a different formulation/type of hormone (they're all synthetic hormones).

So, you might find yourself spotting when you try the generic. And if you then decide to go back to the Ortho product, then you might find yourself again spotting.

And, BTW, it literally costs pharmaceutical companies pennies to make oral contraceptives. So every company, brand or generic, is making lots and lots of money off of oral contraceptives.
posted by Pocahontas at 12:20 PM on September 19, 2006 [7 favorites has favorites]

Is there a generic for OTC Lo? I was told there wasn't. I know there is for the regular (I used the generic, and to echo what most others have said, I noticed no difference between generic and regular).

And I second the Planned Parenthood - I also got the OTC Lo from them for $20 per month, which is what I also pay now on insurance.
posted by bibbit at 1:05 PM on September 19, 2006

Sounds good. I appreciate the responses. Looks like I'll first see if Planned Parenthood can be my dealer, since $20 is a much more acceptable cost. If not, I'll go with my doctor's recommendation.

The point is well taken that Googling is far more likely to result in horror stories. People don't rush to spill their stories on the internet when everything's going peachy.

And I agree, sisterhood, it's obnoxious that these drugs are so expensive, and obnoxious that insurance plans assign them to higher prescription co-pay categories than other drugs. I'm actually pretty outraged that ED drugs are covered, abortions are covered, psychological drugs are covered, but not this simple thing.

No, I haven't written anyone a letter about it yet. But it's been on the back burner of my mind for 10 years or so. Just another of the expenses added to life for being a woman. Seriously, when you add up everything you've spent over a lifetime for ibuprofen, hygeine supplies, dry cleaning, and higher haircut prices, that 84 cents to the men's dollar looks like even less. ;)
posted by Miko at 2:27 PM on September 19, 2006

Seconds on the Planned Parenthood recommendation! There was a point at which I was so poor PP practically paid me for their services, but even later when I was in their highest income category (which doesn't mean much, mind you) I don't remember paying more than $30 for OTC Lo. I don't think there's any way it could be more than that.

You do have to get your exams there, though, I believe. I don't think they'll act only as your pharmacy.
posted by catesbie at 2:52 PM on September 19, 2006

First, please don't trust a women's fashion magazine for advice on the efficacy of generic medications. Remember, they are beholden to their advertisers.

That's true of any print media source. These magazines generally do a decent job of fact-checking. I notice that you're not arguing that generics and name-brands are subject to exactly the same standards for consistency. Are they, or aren't they, and do you have a cite?
posted by transona5 at 3:39 PM on September 19, 2006

I'm on Ortho Tri Cylen regular, and I've been taking the generic for as long as it's been available. I've had both Tri-Sprintec and Trinessa, due to a change in pharmacies. I didn't notice anything at all when I switched to the generic version, and after several years of sex I'm still not pregnant. Seems to work fine.
posted by croutonsupafreak at 7:01 PM on September 19, 2006

By the way, you should shop pharmacies if you're uninsured. I saved $10 a month by going to a cheaper pharmacy when I was on the name brand stuff.

I was uninsured when OTC went generic, and my monthly cost dropped from $45 to $22.
posted by croutonsupafreak at 7:02 PM on September 19, 2006

I've taken two different brand-name BCPs and their respective generics and have never noticed a difference. But I'll second (or third?) problems with thyroid med generics.
posted by lunalaguna at 8:08 PM on September 19, 2006

You have no idea the relative numbers of people who have switched and not had problems, so you can't draw any statistically valid conclusions. The people who aren't having problems aren't going to complain, and the relative numbers of people who have problems switching to brand name are much less, so you don't hear them either.

In case you're wondering what a guy is doing attempting to answer this question - I've been reading about the poor health decisions people(both patients and healthcare providers) make due to lack of statistical understanding a good bit lately, and I think this is just a specific case of that.
FYE - More reading here, for those so inclined. Here he explains why mammography at 40 may do nothing but waste your or your insurance companies' money.
posted by Mr. Gunn at 8:46 PM on September 19, 2006

I switched from name-brand OTC regular, and I had to switch back after a few months because all of the problems I had had pre-OTC came back (my skin got worse, for one thing, and my cramps were back to really bad). Your experience will vary, obviously.

That said, before you call around, I'm going to recommend (again) that you ask your doctor for samples! My OB-GYN seems to have more OTC-Lo samples than he knows what to do with. Big Pharma might give them out for promo purposes, but, hey, why not use them if they're there?
posted by anjamu at 9:41 PM on September 19, 2006