Brand vs Generic Drug

Ophthalmologist Carolina Valdivia, MD answers a question about the use of a brand vs generic drug for the treatment of glaucoma.

I have been taking Xalatan ophthalmic solution 2.5 ml to treat my glaucoma for the past four years. My prescription drug plan now is suggesting that I switch to generic Latanoprost, but I am skeptical. I know that not all generics work the same as the branded versions. Can you give me guidance?

Thank you for your question and your trust in glaucoma-eye-info.com.

Like most pharmaceuticals, Xalatan eye drops are expensive, with costs rising regularly. Nevertheless, Xalatan is the form of Latanoprost that I prescribe to my patients for control of their elevated intraocular pressure when it is indicated.

It has been my experience that generic versions of Latanoprost are slightly lower in effectiveness compared to Xalatan. To illustrate, Xalatan can reduce intraocular pressure by as much as 10 mmHg in some patients. However, generic versions of Latanoprost in the same patient typically can lower intraocular pressure only by about 7-8 mmHg. In some cases, this difference can be important.

Your question relates to a broader issue about the effectiveness of brand vs generic drugs. The truth is that the decision between using a brand vs generic drug depends upon the type of disease condition being treated and the type of drug. For example, generic versions of acetaminophen appear to be as effective in relieving pain and fever reduction as brand names, such as Tylenol^TM or Panadol^TM. However, in chronic conditions like glaucoma, the precision of a drug's effectiveness is critical. Even small variances potentially can have negative consequences.

You should not make a choice between a brand vs generic drug without the knowledge of your doctor. I recommend that you ask your ophthalmologist during your next visit if generic Latanoprost is appropriate for you. She or he will be knowledgeable about the effectiveness of the different generic versions of Latanoprost that are available in your area and can make a determination if any of them are a good option for you.

My goal in providing information about medications is to give you a starting point for having an informed conversation with your doctor. However, under no circumstances should the information presented here be used as a substitute for an ongoing consultation with your doctor. Since I have not examined you, I only can speak in terms of generalities, whereas your doctor has sufficient clinical details to evaluate your case specifically and prescribe appropriate treatment.

SHOULD I USE A BRAND VS GENERIC DRUG?