Prozac (fluoxetine) was the first of the new generation antidepressants. It got the green light from the FDA in 1987 and was first marketed in 1998. It remains one of the most prescribed antidepressants in the world. At last count, over 5 million Americans take generic Prozac every day. By the way, the average retail cost for brand name Prozac would be $624.74 a month according to GoodRx.com. Generic Prozac has an average retail price of $26.75 according to GoodRx, although the big box pharmacies sell it for between $4 and $6 for the same month’s supply. But can you rely on generic fluoxetine?
Stories About Generic Prozac:
Seventeen years ago we published this message from a reader of our syndicated newspaper column:
Q. My husband has been taking Prozac successfully for years. He was recently switched to generic fluoxetine. In the last several months he has become much the same person he was before Prozac–angry, depressed and easily irritated. The pharmacist says the generic is the exact same ingredient. Would it help for him to go back to Prozac?
We answered that question this way:
A. It might be worth a try. Another reader had a similar experience with generic Prozac:
“My husband has taken Prozac faithfully for about three years. We get our prescriptions through a mail order pharmacy.
“He sent in a new prescription for Prozac because all his refills had run out. Four to five days after the new bottle arrived I noticed a lot of his old symptoms reappearing. He said he was taking the medicine but the capsules looked different.
“The bottle was labeled fluoxetine. The mail order pharmacy told him that unless the doctor wrote ‘Dispense as Written’ they would send this generic.
“The doctor wrote him another prescription for Prozac with a note not to substitute. Within a few days of starting back on Prozac, we both could tell that the drug was working again. While he was taking the generic, it was as if he wasn’t taking any medication!”
That was a long time ago and the price of brand name Prozac is now out of sight for most people.
A Shaggy Dog Story About a Fluoxetine Failure:
Fast forward 17 years to a brand new message from a reader:
Q. You’ve written about problems with generic drugs and I wanted to share that pets can also be adversely affected by changes in generic medications. Our dog was prescribed generic Prozac nine years ago for severe dog aggression. She was given the same generic (same manufacturer) which worked beautifully for eight years. No dog aggression.
About a year ago the pharmacy changed its fluoxetine supplier to a different generic. I did not think much about it: same drug, same dose, right? Wrong! We had two significant episodes of unprovoked dog aggression, both requiring vet care, within four weeks.
At that point it dawned on me that the only change we had made was the generic fluoxetine. We asked the pharmacy to switch her back to her old generic. That was 18 months ago. She has not had a single incidence of aggression since.
A. Many readers have reported problems with their own generic drugs over the last two decades. Yours is the first to describe a problem with generic medicine in an animal.
Not all generic drugs are perfectly interchangeable, even if they have the same active ingredient. Different formulations and excipients (inactive ingredients) as well as quality control at the manufacturer may result in differences in effectiveness. Thanks for alerting us that generic drug problems may also impact our pets.
More Sad Stories About Generic Prozac:
Our readers have shared their experiences with generic Prozac:
Christy offers this:
“Prozac works great for me. However, Medicare doesn’t cover its cost. Generic fluoxetine has never worked for me, even at 4x my regular dose. I have tried 7 different antidepressants, and NONE of them have worked for me, or worked but with severe reactions. Currently, I have been on Desvenlafaxine ER Tabs 50mg (generic Pristiq) for 2 weeks and am hopeful that this one will work as well as Prozac!”
Darcy’s daughter had problems with one company’s generic Prozac:
“My daughter is taking M’s version of fluoxetine, and it is really helping her. There’s no way I can pay for name brand.
“She was originally given the M tablets, but then got switched to T’s fluoxetine capsules. It was AWFUL. Switched her back to the M tabs and adjusted her dose, and she’s much better again. I want her to have good quality meds but T’s generic Prozac just didn’t work for her. It was like she was taking nothing at all, like so many others have mentioned.
“I heard your program this morning with Ms. Eban (author of Bottle of Lies) and it really got me thinking, and now I’m worried.”
In Bottle of Lies, Katherine Eban investigated generic drug manufacturing overseas and uncovered a number of serious problems. You can listen to our free interview with Ms. Eban on this podcast.
Tee shares another scary story about generic Prozac:
“I just want to let others know that I have been taking generic Prozac for 15 years successfully, that is until the last month. I was shipped a different manufacturer of generic fluoxetine, made by a company out of India. Almost immediately I was back in full blown depression and anxiety.
“Upon doing more research there is growing evidence that some of the Indian and Chinese manufacturers aren’t following FDA guidelines. I am now getting better today while being on Par Pharmacy tablet fluoxetine. An Israeli company’s fluoxetine is also highly recommended.
“I had not had any type of relapse to this extent since being diagnosed over 20 years ago!”
The Take Home Message:
The Food and Drug Administration states unequivocally that if it approves a generic Prozac product it is absolutely equal to the brand name. The FDA’s motto seems to be, Don’t Worry, Be Happy. Any perceived problems with generic drugs approved by the FDA must be psychosomatic in nature.
Readers of our newspaper column and visitors to this website aren’t so sure, though. And since dogs should not be susceptible to suggestion, the story about doggy aggression on a different generic Prozac suggests that not all fluoxetine pills are created equal.
People who would like to know more about using generic drugs wisely may be interested in our eGuide to Saving Money on Medicines. This online resource is found under the Health eGuides tab.
Share your own generic drug story in the comment section below.
