Generic Thyroid Causes Problems

Q. For over thirty years, I have been treated for hypothyroidism. Originally, I was on a thyroid extract. Ten years ago, I was switched to Synthroid .125 mg. This year, when it was time to renew my prescription, the doctor wrote the prescription for a generic equivalent.
By the fourth day on the generic, my insides felt as though I was on the end of a tightly wound spring. I couldn’t sleep; I had a slight case of diarrhea; I was sweating more than usual and my heart felt as though it would pound out of my chest. When I finally realized that all these symptoms might be due to the change in medication, I contacted the pharmacist and went back to the brand name Synthroid.
Immediately I calmed down, my heart stopped pounding, my digestive tract started behaving and I was back to my normal self. I thought that generic drugs were supposed to be identical to brand-name drugs. What happened?
A. The symptoms you describe are typical of excess thyroid hormone, suggesting that perhaps the generic pills you were taking were not dose-equivalent to Synthroid. We have heard similar accounts from others.
The FDA encourages patients, physicians and pharmacists to report such cases so they can monitor quality problems. But one reader reported, “I tried reporting a generic drug reaction to the FDA, but getting through to them was difficult. Even the website is not very easy to navigate to report a problem. I was told someone would call me back, as everyone was in a training session. So far no one has called.”
If you suspect a generic you took was not up to standard, we will pass your story along. Reach us by email (pharmacy(at)mindspring.com) or by mail: People’s Pharmacy (Dept Generic); PO Box 52027; Durham, NC 27717-2027.
Q. Is it necessary to have a prescription for prenatal vitamins? My OB/GYN sent me home with about eight varieties and asked me to determine which I liked best. She’ll send in a prescription.
Of course, the vitamins vary in the amounts of most ingredients (all have 1 mg folic acid), so it is difficult to determine which one is best. However, I do find the smallest pill sizes the most appealing!
There will be a monthly $25.00 co-pay for any prescription that I receive. Am I better off buying a non-prescription brand of prenatal vitamin?
A. Prenatal vitamins generally contain more folic acid (800 mcg to 1 mg) and iron (40 to 60 mg) than typical multi-vitamin formulations. Nonprescription prenatal vitamins approximate these levels, but you could also take an ordinary multivitamin and add separate folic acid and iron supplements if your OB/GYN approves. The extra folic acid and iron come to about $8 for a three-month’s supply, so this may be the most cost-effective option.
Q. I am in the Army and would like to know if it is safe to take Provigil for times when sleep deprivation is necessary. Is this drug safer then amphetamines?
A. Provigil (modafinil) is a relatively new prescription medication for treating narcolepsy. People with this condition suffer excessive daytime drowsiness and often fall asleep at inconvenient times. Provigil is a stimulant that can prevent this.
Side effects of Provigil can include headache, nausea, loss of appetite, diarrhea, dry mouth and anxiety.