The best news! The FDA announced today that the two approved generic versions of Concerta manufactured by Mallinckrodt Pharmaceuticals and Kudco have been downgraded. It’s horrifying that so many people have already been adversely affected, and without warning, not to mention having their concerns dismissed by some pharmacists. “It’s the same as the brand,” some pharmacists said. “No, it’s not!” we said. And the FDA heard us.
You can bet ADHD Roller Coaster readers had much to do with that! Many of you followed through by filing a complaint with the FDA’s MedWatch program, as I’ve encouraged repeatedly over the past year. (I would share the links but I’m on the road, traveling with a very slow connection, and wanted to get out this news stat!). That form was NOT easy to complete, especially if your meds were underperforming! And I’m sure Dr. Kristen Stuppy, who blogs at Pediatric Partners, is celebrating. She has worked hard to publicize this issue, too.
PLEASE NOTE: A MORE RECENT POST UPDATES INFORMATION ON THIS TOPIC, THOUGH YOU’LL WANT TO READ THE DETAILS IN THIS POST FIRST.
Congrats and hooray!
The full press release is below, but I’m pulling out this very practical point here for emphasis:
This means the Mallinckrodt and Kudco products are still approved and can be prescribed, but are no longer recommended as automatically substitutable at the pharmacy (or by a pharmacist) for Concerta. If you take Concerta, it’s worth having a chat with your physician about this. Perhaps bring in a copy of this announcement.
Methylphenidate Hydrochloride Extended Release Tablets (generic Concerta) made by Mallinckrodt and Kudco
[11-13-2014] FDA concerns about therapeutic equivalence with two generic versions of Concerta tablets (methylphenidate hydrochloride extended-release)
Based on an analysis of data, FDA has concerns about whether or not two approved generic versions of Concerta tablets (methylphenidate hydrochloride extended- release tablets), used to treat attention-deficit hyperactivity disorder in adults and children, are therapeutically equivalent to the brand-name drug. The two approved generic versions of Concerta are manufactured by Mallinckrodt Pharmaceuticals and Kudco Ireland Ltd.
FDA has not identified any serious safety concerns with these two generic products. Patients should not make changes to their treatment except in consultation with their health care professional.
If you or your health care professional are concerned the drug product is not providing the desired effect and you do not know the manufacturer, contact the pharmacy where the prescription was filled to verify the product’s manufacturer. If you, or those under your care, are taking the Mallinckrodt or Kudco products and have concerns about lack of desired effect during the dosing period, contact the prescribing health care provider to discuss whether or not a different drug product would be more appropriate.
FDA’s Scientific Evaluation of Generic Concerta Products
An analysis of adverse event reports, an internal FDA re-examination of previously submitted data, and FDA laboratory tests of products manufactured by Mallinckrodt and Kudco have raised concerns that the products may not produce the same therapeutic benefits for some patients as the brand-name product, Concerta, manufactured by Janssen Pharmaceuticals, Inc. Janssen also manufactures an authorized Concerta generic, which is marketed by Actavis under a licensing agreement and is identical to Janssen’s Concerta. FDA included the authorized generic in its analysis and found it to be bioequivalent to, and substitutable for, Concerta. Apart from the Mallinckrodt, Kudco, and Actavis products, there are no other generics for Concerta.
Methylphenidate hydrochloride extended-release products approved as generics for Concerta are intended to release the drug in the body over a period of 10 to 12 hours. This should allow for a single-dose product that is consistent with the effect of a three times per day dose of immediate-release methylphenidate hydrochloride.
In some individuals, the Mallinckrodt and Kudco products may deliver drug in the body at a slower rate during the 7- to 12-hour range. The diminished release rate may result in patients not having the desired effect.
As a result, the FDA has changed the therapeutic equivalence (TE) rating for the Mallinckrodt and Kudco products from AB to BX. This means the Mallinckrodt and Kudco products are still approved and can be prescribed, but are no longer recommended as automatically substitutable at the pharmacy (or by a pharmacist) for Concerta.
Consequently, FDA has revised its draft guidance for industry for bioequivalence testing for methylphenidate hydrochloride extended-release tablets (Concerta). FDA has asked that within six months, Mallinckrodt and Kudco confirm the bioequivalence of their products using the revised bioequivalence standards, or voluntarily withdraw their products from the market.
FDA will continue to evaluate its testing and approval standards and bioequivalence guidances for other generic methylphenidate hydrochloride extended-release products and revise as needed.
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