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Generic Oral Contraceptives? As Good as the Brand Medicines But Less Expensive

L. Kendall Shaw, PharmD
Published Online: Friday, November 1, 2002   [ Request Print ]

Women everywhere are concerned about the cost of prescription medications, but none are willing to compromise on quality or safety, particularly when it comes to oral contraceptives (also known as the pill). In the past, physicians were limited to prescribing brand name oral contraceptives. Now, a number of generic equivalents?pills that contain identical ingredients to the brand name oral contraceptives and the exact doses?are available at lower costs.

The US Food and Drug Administration (FDA) takes the quality of generic medications seriously.  Generic drug makers must prove that the generic medicine contains exactly the same amounts and quality of active ingredients as the brand name, or original, medicine. They must also prove that the medicine provides the same blood levels of the active ingredients as the brand name version. The FDA inspects and approves the manufacturing and packaging of all oral contraceptives. The inspection process is the same for both generic and original medications.

Are there any differences between generic and original medicines?
Generic medications must meet the FDA standards of strength, quality, and purity. Also, their active ingredients must be ?therapeutically equivalent? to the original product. Each generic medication is laboratory-tested to ensure that the same amount of drug is absorbed into the bloodstream as with the brand name medication. Generic medications can, however, contain different inactive ingredients, such as preservatives, dyes, and binders. These inactive ingredients are combined with the active ingredients for a number of reasons, including to keep tablets from breaking in the bottle or to ensure that the medicine dissolves properly once in the body. Thus, the generic oral contraceptive may be a different shape or color, but the quality and effectiveness are the same as the original medicine?and at a lower cost.

What else should I know about my oral contraceptive?
Whether generic or brand name, most oral contraceptives are supplied in a pack?a cardboard or foil blister pack or a plastic dispenser containing a 28-day supply of medication. The packaging is designed to help you keep track of your daily dose. Most oral contraceptive packs have 21 active pills and 7 ?dummy? or placebo pills. The pills for the last 7 days of the pack usually contain no active ingredients in order to allow you to have your period and to help you remember to take a pill each day. A few oral contraceptive packs contain only 21 active pills. When using these oral contraceptives, you must remember to start a new pack after you have been off the pills for 7 days.  Some of the oral contraceptives with 28 pills contain an iron supplement to be taken during the last week of each month (an example of an oral contraceptive containing an iron supplement is Loestrin Fe). Others provide very small doses of estrogen during some of the usual placebo-pill days (Mircette and Kariva). Some pill packs may contain more than 1 color tablet. Even though several of the pills are a different color, they are not necessarily placebos (dummy pills). These packs, known as biphasic or triphasic oral contraceptives, contain different combinations of the same hormones. Examples of triphasic pills are Ortho Tri-Cyclen, Enpresse, and Triphasil. 

Regardless of the type of oral contraceptive pill your physician has prescribed, it is essential to take all the pills in the correct order. Each pack of oral contraceptives comes with a patient information leaflet that provides you with information on how to take your pills safely and what to do in case you miss pills. You should also contact your health care provider or a pharmacist anytime you have questions. 

Other Benefits
Oral contraceptives are usually prescribed to prevent pregnancy, but they provide other benefits as well. You will experience these benefits whether you use a generic product or a brand name product. Oral contraceptives regulate the menstrual cycle and generally decrease pain and cramping felt with menstruation.  Oral contraceptives have also been shown to decrease the likelihood of:

? Endometrial cancer and ovarian cancer 
? Ovarian cysts
? Benign breast disease
? Iron deficiency anemia
? Ectopic pregnancy

Oral Contraceptives Are Not for Everyone
You should not take oral contraceptives if:

? You are pregnant or are breast-feeding
? You have a history of blood clots, heart disease, or stroke
? You have high blood pressure or are diabetic
? You have or have had breast cancer, liver tumors, or active liver disease
? You have migraine headaches with certain symptoms
? You are over 35 years old and smoke or are a heavy smoker (?15 cigarettes per day)
? You are bedridden or expect to be bedridden due to surgery

Possible Drug Interactions
As with all medications, oral contraceptives may interact with other drugs and with nutritional supplements. Because generic products are equivalent to brand name products, these warnings apply to all oral contraceptives. Always ask your pharmacist or health care provider about potential drug interactions when starting any new medicine. The following medications should be used carefully when taking oral contraceptives:

? Antibiotics, antituberculosis agents, and antifungal agents
? Antiseizure medications

These medications might decrease the effectiveness of your oral contraceptive, putting you at risk for pregnancy. Before starting any of these medications, tell your doctor that you are taking oral contraceptives, and ask whether you will need to use an additional form of contraception.

Examples of Generic Oral Contraceptives
? Apri (same as Desogen and Ortho-Cept 28)
? Aviane (same as Alesse-28)
? Lessina (same as Levlite 28)
? Necon (same as Ortho-Novum 1/35)
? Ogestrel (same as Ovral)
? Sprintec (same as Ortho-Cyclen-28)
? Microgestin Fe (same as Loestrin Fe)
? Kariva (same as Mircette)
? Enpresse (same as Triphasil-28)

Remember to refer to the patient information leaflet provided with each package of oral contraceptives whenever you have questions, or contact your health care provider.





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