What’s Up With Generic Concerta?

Here at the ADHD Roller Coaster, I’ve long cautioned about generic medications for ADHD, including Update on Generic Rx: Approach with Caution and Consumer Reports on Autos? Yes. ADHD Medications? No!

I’m now hearing that Concerta is recently available in a new generic form in the United States. (A generic has been available in Canada for some time, but it is a different type of generic.)

The question: Does this generic perform as reliably as Concerta? Yes. We know this because this Concerta generic is the brand; it is only marketed as a generic.

You can read updated details about generic Concerta in this 12/31/17 post; please subscribe to this blog to stay apprised of developments.

Original Concerta, 54 mg

Searching for Clarity

The pharmaceutical industry swims with lingo: co-licensed product, single-source generic, authorized generic, bioequivalent and clinically equivalent, and so forth.

As I sought clarity on this issue, I spoke with pharmacists and the Concerta manufacturer’s scientific liaison. It all left me thirsting for straight talk with no tricky qualifiers.

Even more confusing: Reading first-person reports in online forums. For example, there is a marked difference between Canada’s generic Concerta and that in the U.S..  Yet, forum participants seldom specify where they live. Presumably, that’s because most don’t realize there is a difference between the two countries’ generic versions of Concerta.

An Authorized Generic IS the Brand

For this post, I’m addressing only the U.S. generic for Concerta.

It’s not a” true” generic—that is, a medication that is produced to be a reasonable facsimile of a brand. It is an “authorized” generic. In other words, this is the brand marketed as a generic.

On the label,  you’ll see methylphenidate hydrochloride extended-release tablets.  It is a co-licensed product by exclusive agreement — that is, a deal between the original manufacturer (Ortho-McNeil) and the pharmaceutical marketing arm of Watson Laboratories.

Both brand-name Concerta and this authorized generic are manufactured in the same plant, said a spokesperson for manufacturer Ortho-McNeil  by phone. And, this authorized generic is both bioequivalent and clinically equivalent.

Does that mean it’s the exact same medication?  Yes, according to this FTC report on generic drugs, it is the same product:

An authorized generic is a lower-cost, generic-label version of a brand-name drug that is already sold by the same manufacturer.

The Hatch-Waxman Act is designed to ease the introduction of generic drugs by, in certain circumstances, granting a 180-day period of marketing exclusivity to the first generic competitor of a brand-name drug, known as a “first-filer.”

During that exclusivity period, no other generic company can receive FDA-approval to sell its product. However, this marketing exclusivity period does not prevent brand-name companies from introducing their own authorized generic versions.

When Patents Expire, Deals Are Sometimes Struck

According to a press release from Watson Laboratories, the first patent for Concerta is set to expire in 2018. Thanks to a legal settlement between two pharmaceutical manufacturers, however, a generic version became available much earlier, in May 2011. Due to the settlement, Watson Laboratories is allowed to sell an “authorized generic” version of Concerta through 2014. [Update 2019: Generic company Teva is now distributing the authorized Concerta generic, but the company and Concerta manufacturer Janssen have made public no deals about their agreement.]

Here is the apparent bottom line:  The original manufacturer, Ortho-McNeil. supplies Watson with brand-name Concerta tablets; Watson packages and sells the tablets as an authorized generic drug.

That means the generic version is exactly the brand-name Conceta in every way, except in price. For example, our mail-order pharmacy was charging $120 for a 90-day supply of Concerta; for this authorized-generic version, the charge is $20. Quite a savings!

[Update: Other “true” Concerta generics entered the scene later, and that’s when all the troubles started.]

If you have solid information to share on this topic, please do! Just scroll down; no registration or annoying codes!

256 thoughts on “What’s Up With Generic Concerta?”

  1. Hi Gina,

    I’m from Portugal and here we only have one concerta’s generic, it’s form the lab SANDOZ.
    Have you ever read something about it? Or do you have some feedback on it?
    I really can’t find anything useful to decide if i should keep going with the original or switch to this Sandoz generic.

    Thanks!

    Ps: Your blog is really good, and helpful!

    1. Hello Ana,

      I’m happy to have a grateful reader in Portugal!

      I just did a little research on this Sandoz generic. It looks to be a generic, similar to our “problematic” generic.

      It does not have the OROS technology (the laser-drilled capsule that makes Concerta, Concerta).

      Here’s one study….interesting to note that the food in the gut seems to affect absorption.

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4317218/

      If you can, I’d stick with the brand. Of course, you could always try the generic, to see if it works well for you. And, if not, go back to the brand.

      Good luck!

      g

  2. Pingback: Consumer Q&A on Concerta and Generics

  3. Hi there,

    I work in a pharmacy and we were told by our corporate headquarters that all generic concerta medications could not be sold except for Watson brand because the FDA said that they are not equivalent to brand concerta. So if a Dr writes for a Concerta prescription that does not state brand only we can substitute with Watson because that is a recognized equivalent. Also just be aware what your insurance requires with the new guidelines. I have seen after 3 to 4 years after a generic is available that insurances will not cover a brand name medication even if it is medically necessary. So just be aware that insurances can change their mind on what they will approve at any time and do not have to give any notice to anyone. It is super frustrating for those working in the pharmacy to be the bad news givers.

  4. Is there any information on whether or not Watson will continue making their generic in the same form they have been making it after the legal agreement is no longer valid in 2014? We have just started my daughter on Concerta. We got the generic (Watson brand) the first month and switched to the brand name the second month. It was only after getting the brand name that I realized that the prior months prescription was exactly the same as the brand name. My concern is that if we switch back the to generic (Watson) that they will start to manufacture it differently (more like the other generics) and we’ll be back where we tarted with paying the full price for the brand name.

    1. Hi Helen,

      I’ve written about the various types of generics several times on my blog. I encourage you to use the “search” function and read all the posts about generics.

      In short, the Watson/Actavis Concerta IS the brand. It is simply marketed as a generic, price-wise. These are called “authorized generics” but it’s not a generic at all; it is the exact same Rx.

      Best,
      g

  5. I am having a hard time finding Concerta brand or the generic from watson. My son has issued with generic and all I can get is the pink. My question to the pharmacy was “if its pink does it have red dye 40 which a lot of children have issues with. I specifically request Watson and they told me it has not been available. I also had the dr go back to do not substitute and still received the generic (which I sent back) I had to go to a different state to find the brand because not one pharmacy had it. This is getting ridiculous.Does anyone know whats up?? With our plan I can only go to cvs or rite aid.

    1. Hi Donna,

      Sorry to hear you’re having so much trouble. My best advice is to avoid the local pharmacies, if at all possible. If your health insurance policy includes a mail order provision go with that. Other than that, Walgreen is the only store I’ve heard that regularly carries the Watson generic.

      tx
      g

  6. Hi all!

    It is definitely not the same as the Concerta with the OROS release. 6 years I have used Concerta. I was prescribed the new generic and had to go back as well. 1. It hits you hard all early in the day and makes you gittery and then you hit a wall and it is like a caffeine high falling off a cliff. I get to 3 or 4 pm and could pass out and nap anywhere. And I am not a napper.

    Ask your Dr. to make sure to not allow a subsititute and makw sure it is Alza with the dot on the side.

    Good luck!

  7. I was delighted to get the Mallinkrodt generic because I saved $80 on my co-pay. Then I tried it. I was not looking for problems, but noticed a day in that the drug was not working as the Alza version did. Now I am working to get my pharmacist to switch his generics to the Watson version.

    1. Thank to everyone who figured out there was a problem. January 2013 ish, after having never been on ADHD medication before (I am 46 yr Old female, just graduated college 2012 & now have a stumbling block in grad school), I was prescribed concerta and was given a generic, I’ve continued to have problems and concerns about my medication. Earlier in the year I received a letter from my insurance company they are re-evaluating if concerta will be a covered medication and would have a final answer in August. I called my Dr and he was going to switch me to Ritalin, I’ve been taking 2 36mg per day. I decided to wait to hear what my insurance company came back with before changing even though the cost for the prescription was very expensive. When it came time to refill, I called my insurance company and the cost was actually going to be significantly lower from before. The pharmacy said my insurance required only the name brand and does not permit or will not cover the generic.
      I’ve just started the name brand and will see how it goes. I had gotten to the point I’ve been raising such a fuss over asking if I am on the right medications after so many medical problems my dr. did a DNA test. He said that rather then guessing and messing around with anything now the test will show what medications metabolize best in my system.
      I’ve been relentless trying to figure out what’s been going on. Now finding out that it could have been because of a generic drug, I am hoping that things will get better in some way. I don’t think they could get any worse at this point.
      Barbara

  8. Pingback: ADHD Roller Coaster: "Is It You, Me, or Adult A.D.D.?" · We Did It! Concerta Generics on FDA Watch List

  9. Gina, I came across your site by accident while looking for Concerta price deals. I have recently been diagnosed with Adult ADHD and my insurance company has just refused to cover me because I’m over 25 years of age.
    I managed to get a 30 day trial and it changed my world. Now I’m left in a dilemma because my local pharmacy is asking $180 for 30 54 mg tablets. I just don’t have the extra cash to do this every month. I was interested to know were you got the 90 days supply for $120 and $20 for generic.
    Thanks in advance for your advise.

    1. HI Mark,

      Are you in the U.S.? That will make a difference as to insurance guidelines.

      The FDA has approved Concerta for adults, so the insurance company cannot use age to deny you.

      I would try to fight that restriction. Talk to customer support (for the insurance company) and explain your situation. Ask for your options or ways you can appeal this. There is almost always a way to appeal.

      It might be that the insurance company objects to the brand name, and wants you to take generic instead. Sometimes what happens is that you have to try the generic and report the adverse effects (if indeed they are adverse) and then you can get the brand.

      In other words, I wouldn’t take this lying down.

      But maybe I am misreading; you say “my insurance company has just refused to cover me because I’m over 25 years of age.” Do you mean you “aged out” of your parents’ policy?

      As for the 90 supply I wrote about, that is from my husband’s insurance coverage, with the Rx mail-order option.

      Gina

    2. Hello Gina, Yes, I am in the USA. I live in Massachusetts and in this case I am the parent with the policy. In fact, Im 50 years old and have gone un-diagnosed until I read a very good article on a recent American Airways flight which defined every symptom I have had all of my life. I was tested and came in high. On checking today, because the denial is as recent as yesterday, I have discovered that it is my company who are refusing to cover ADHD medication for Adults over 25 and my insurance is simply doing as my company says.
      Im not sure how they can do this if the Government have approved it? As we live in MA, Im also told that I can not have more than 30 days on one prescription. Is this true?
      If I decide to pay myself, what is the cheapest option for me?

    3. Hi Mark,

      I don’t know the applicable rules. It just doesn’t sound right that your employer can stipulate this restriction.

      My understanding is that the Affordable Care Act (Obamacare), among other reforms, prevents the insurance companies from discriminating against “mental” illness — as if the brain were not an organ and the most complex organ of all!

      I would think that, by state law, there should be some kind of information on that denial letter of how you can appeal this.

      Have you asked your prescribing physician?

      As for the 30-days prescription, yes, this is a standard limitation with prescriptions covered by insurance when filled at the local drugstore. But most policies offer a 90-day or 60-day supply by mail-order.

      As for cheaper options, you should check with the patience-assistance program for Concerta. Here is their customer service info:

      For more information, please call CONCERTA® toll-free.The CONCERTA® phone number is
      1-800-JANSSEN, and we are available from Monday through Friday, 9:00 am – 5:00 pm ET.

      Meanwhile, I would encourage you to read my book: http://www.amazon.com/dp/0981548709/tag=wwwginaperaco-20

      Sometimes the stimulant medications cause problems over time because most adults with ADHD have another condition, such as anxiety, depression, etc. Those conditions can be exacerbated by the stimulants. So, often there is a pairing of medications to treat both conditions (e.g. a stimulant and an antidepressant). My book covers in detail how to get better results from medication.

      Good luck!
      g

    4. Thank you Gina, I feel reassured after reading your good guidance. Next stop Amazon.

      Regards,
      Mark.

  10. My daughter also noticed that the generic was not as effective as the brand name. I use the generic, but have a few of the brand name still left, for when I need to really concentrate. This past refill I asked the doctor to do a Brand Name Only Rx.

  11. Thank you for posting/

    I thought I was given the wrong med. that is how I found your post. I thought I would do some research before going back to the pharmacy. The generic I was prescribed is exactly what is posted Lbir: Kremers Urban / Methylpenidate ER 54 MG Tab.

    I picked up my refill and today was the first time I took it. There is no point in taking this generic medicine it does not work. I will contact my doctor to see if there is an alternative.

    I will print out your website for him to check out, and to see others are having the same issues.

    1. Hi Alicia,

      I’m glad you found my blog, too!

      I would try to return that medication. Even if they won’t give you your money back, you can register that as a voice of protest.

      If the pharmacy knows they are going to be dealing with problems on an ongoing basis, they might think twice about not carrying the authorized generic.

      Good luck!
      Gina

    2. I have a child with ADHd. The first month he received actual Concerta, the alza 54 tablet listed above, for the second refill he was prescribed the generic, it does not work at all.

  12. You raise a fair point: if FDA scientists are able to show, and have reported, that non-OROS generics are not as effective as OROS, there must be some sort of undue influence hiding the science, incompetence in the FDA, or some other reason. If so, then it’s quite possible that lobbyists are at least partly responsible.

    However, your comments seem to make it feel as though there were some “dirty” CEOs conspiring together in a dark room plotting the doom of every patient. I doubt this is the case. No doubt companies like Kremers Urban are looking at the huge opportunity for a generic Concerta and coming up with a formula and delivery system that fits the FDA requirements. They’re just trying to make a profit (as a public company) and are under regulatory guidance. Luckily for us in the USA we’re talking about delivery effectiveness, not the fact that the drug is actually methlyphenidate or something else (like talcum powder) as you might find in China.

    If the law is faulty, however, such as using terms like “bio-equivalence” when that means 80-125% the same as the original when plotted on a chart, then it’s not strictly the company’s fault who produces medicine that fits the profile. Unfortunately for those with ADHD, having a “bio-equivalent” drug may not be good enough, even though it may be fine for some other drugs, like an antibiotic.
    Perhaps there needs to be rules that for drugs with unique delivery systems such as Concerta it’s not a generic until and unless the delivery system is matched. After all, Concerta isn’t Concerta without OROS – it’s just methylphenidate otherwise.

    I would also add one other step that people can take. If the generics don’t work as well (or at all), ensure you tell everyone about it – the pharmacist, the drug company, the distributor, people at the doctor’s office, and so on. And, of course, write “OROS only” and log a complaint with MedWatch. Won’t argue with you there.

    1. It’s not the FDA scientists’ job to do that (show that non-OROS are not as effective). Their job is to make sure all regulations are followed.

      As far as telling the pharmacist, etc. that’s all well and good, but many pharmacists don’t understand the problems with some “bioquivalence.” Smart MDs understand, but some will argue with you.

      You know how laws are….there’s always some clever legal mind that exploits the language and loopholes.

      Call it what you like, I find it unconscionable to make money from people’s misery.

      As far as alternatives, that’s the point: MANY people no longer have the alternative of getting the OROS. Their insurance companies and pharmacies will not carry it, because the “true” generics are cheaper.
      g

    2. I hear you, and feel other’s pain. My formulary no longer covers brand-name Concerta and we’re facing the same issue with the Kremers generic that many other people face. I’d bet, though, that there are others who aren’t as sensitive to the non-OROS generics. I can only hope that there are enough MedWatch reports logged that the FDA looks into it.

      It does bring up a question – if the drug companies are manufacturing in line with the regulations, and the FDA scientists only job is to compare dots on a chart to make sure it’s adhering to the regulations, how does anyone really determine if these regulations are appropriate and effective? I wouldn’t trust my Congressman or Senator to know, nor their staff. This will be hard to change, at least until OROS goes generic and perhaps the delivery systems improve.

      So like many others I’m spending time hunting for pharmacies that carry Watson or will have to pay over $200 out of pocket every month for a DAW script not covered by my plan. I’m lucky enough that I’m in an urban area where there are many pharmacies (big and small) in a 20 mile radius. I feel for those who are remote and have little choice.

    3. Hi Marcus,

      My general understanding is that the guidelines have not kept up with the novel delivery systems (OROS, etc.).

      g

  13. Gina and Rose both, in this case it’s not about Obamacare or “greedy companies”. Both statements are rather offensive and take the focus off the real issue:

    It’s the FDA deciding that a non-OROS generic from companies like Kremers Urban is bio-equivalent to Concerta. That’s the crux of it.

    Anecdotal evidence, including my own experience, shows that they’re not equivalent, and all anyone can do at the moment is hunt for the Watson generic (try Wal-Mart, as of today they still distribute it as confirmed by a Watson rep) and log a complaint with MedWatch.

    1. Thanks, Marcus. In fact, I think it is greedy companies. We know how public policy is over-influenced by lobbyists, and it’s hard to believe that’s not happening with the FDA as well in the case of these generics. I suspect that scientists at the FDA are as upset about these problematic generics as the rest of us.

      I interviewed a patent attorney on this topic the other day, because some reading on the topic was leading me to question if in fact Mallinckrodt overstepped some legal boundaries. This attorney said, “No, actually, they’ve been very wise in how they took advantage of opportunities.”

      “Wise,” he said. I said that in my opinion, it was not wise but socipathic to turn people’s lives upside down in the interest or profits. This attorney had no clue; he has completely bought the line of bioequivalence.

      And I believe we can do more than what I’ve suggested thus far: Ask the MD to write “OROS only” on the script and log a complaint with MedWatch. We can complain to our representatives in Congress, and we can pay attention to political campaigns.

  14. I had the same thing happen to me. I was concerned but decided to see what happened if I took this generic instead. I noticed a marked increase in my impulsivity and my tolerance for stimulation lowered dramatically. I am a teacher and it really started to cause problems for me, especially in the afternoon. It seemed to wear off more quickly. After research, I found one post that says your doctor has to put OROS on the scrip which is the patented time release system used by the people that make Alza. My doctor was no help. She simply put time released and all the pharmacies told me all generics were time released. I explained yes but not in the same way. They weren’t interested and acted like their hands were tied with the statement they have to prescribe whatever is sent by corporate. I did find a local pharmacy that still has alza and switched there but they too said that they aren’t sure how long they will keep this type of generic. One thing I started to do was to wait until lunch to take my medicine. This allowed the medicine to start kicking in during the most stressful part of my day. Good luck with this very frustrating change! 🙁

    1. Hi Rebecca,

      Thanks for sharing your experience. I hope you will report the problems you found with this generic at the FDA’s Medwatch website. I provide the link at the end of this recap of the best current information on these generics of Concerta:

      https://adhdrollercoaster.org/the-basics/a-recap-consumers-guide-to-generic-concerta/#.Ur3IAfZUjZo

      You probably the suggestion about having the MD write “OROS” on the script on my blog. I’ve written that advice in several blog posts since this original one.

      Your doctor doesn’t know her stuff, obviously. If she would not write OROS, then she is ignorant. Period. I understand if you don’t want to change doctors, or there’s not a better option. But I will just tell you, that is embarrassingly ignorant of that MD. Shame on her.

      Good luck!
      g

    2. Rose,

      These generics were LONG into play before Obamacare was even passed.

      If you want to look for scapegoats, look to purely-profit-driven companies who want to foist inferior products on you. Look to greedy politicians who are bought and sold by entire industries to subvert government institutions that are meant to protect us.

      Even stores such as CVS have much to gain by selling these generics, because they make more profit on them than they do in selling brand or the authorized generic. These stores are making choices about the quality of product their customers are receiving. Trouble is, customers in many areas have very little choice.

  15. Hello,

    I I’m glad to see that this thread appears to still be active. Hopefully, I can get some useful information from here. I am a grad student, and have been on Concerta for a very long time. After trying many different brands and doses, somewhere around 5th or 6th grade (I think, it’s been a while), I was started on two 54mg Concerta capsules every day. This worked significantly better than other brands and doses. I have been on the exact same dosage since then (~12-13 years). A few years ago I switched to the generic. It looked the same and I didn’t really notice a difference. I had been warned by my doctor to avoid the generics, because there were various problems with them.

    Today, I went to pick up my medicine from the pharmacy as usual. On my way back to campus (I was home for the weekend) I noticed that the pills looked different. At first I was concerned that they might have made a mistake as both would be described almost the same way. I was wondering if anyone had any experience with the Kremers Urban generic Concerta. Not much of a difference at first, but I feel more jittery than I used to, and I’m finding myself more distracted. (I’m here instead of studying for my last final) I wouldn’t have minded trying a different manufacturer over the break, but a trial by fire in the middle of finals was not something I wanted.

    If I remember to, I will update in a couple of days when I get back home. Maybe I’ll be able to give a better analysis when I don’t have papers and finals causing their own interfering signals.

    Thank you,
    -Ryan

    1. Sorry to reply to my own post. I am in the US.
      And I also apologize for not proofing before I posted. Error in the first word=not a good start.

    2. I would not be so quick to blame Obamacare, Rose, for your troubles.

      Has it occurred to you that many companies are using Obamacare as a pretext to raise prices (as they have annually for decades, before Obamacare) and have people blame it on Obamacare (aka, better regulation of an out-of-control healthcare and insurance industry)?

      If you want to support better consumer protection, you will think about blaming poor regulation in these issues.

      Clear thinking is required on this topic and many others.

    3. Same thing. I had to go back to my doctor and get at new script and junk the rest of the Kremer Meers medicine. Kremer Meers should not be allowed to qualify as a substitute for Concerta. The difference in effect is compelling enough to make me question how this drug made it through testing as a qualifying substitute for Concerta. Don’t be afraid to tell your doctor. You should not be penalized for the FDA’s screw up on this. I was able to get my usual script and was able to work with my insurance to minimize the cost of the Brand name I replaced the Kremer Meers garbage with.

    4. So glad to have found all of these experiences. My son is 13 with ADHD. When we picked up the generic Concerta a few days ago, he noticed that it looked different from the previous generic. I checked the bottle and decided that they must have switched manufacturers but told him to go ahead and take it. With the Kremers pill, he is having problems with black spots in his vision, dizziness, headaches, & numbness in his fingers.
      Thankfully, our doctor is great and told us to discontinue for a few days to ensure the reaction goes away and can for sure be linked to the Kremers generic. After that, she will make sure that we only get the brand name and will write the insurance if needed.

      It’s amazing to me that pharmaceutical companies can get away with subpar work such as this.

    5. Hi Heather,

      I congratulate your son on his attention to this important detail. 🙂

      Yes, the generic manufacturers are a different breed, compared to the major brand manufacturers. They come in with these inferior products (for ADHD, at any rate) and make them so cheaply the drugstores are lured to the greater profits.

      So much for caring for the consumer. Then again, consumers must be smart and vigilant, not passive.

      Best,
      Gina

    6. Ryan,
      Thank you for your comment. My son has also been on a dosage of 2 36mg Concerta tablets daily for over a decade without incident. In December he got the Kremers Urban generic and for 4 straight days had a dizzy-headache effect at the 4 hour mark. He stopped taking the drug, return to the pharmacy, notified his doctor, and reported the adverse effect to Kremers Urban and to the FDA. It is only through reporting these issues to the FDA that a database on the issue can be maintained and the manufacturer is forced to dig deeper into the performance of his product. My son has returned to using only Concerta which for him ends up being $490/month. Thank you for telling your story. I suspect that you two are not alone.

  16. Gina, I, too am glad I found your website — very informative and clear. My first month of Concerta was brand b/c I had no insurance but was desperate to try something that might work, so I paid cash for it around $300. Seemed to help.
    Next month, I had insurance, so got the “generic” — not the “authorized generic” though! 🙁 I didn’t know, so I took it & have been a royal pain-in-the-lower region, according to my friends — short-tempered, impatient, talkative, scattered and unfocused– all the things I was trying to fix.
    After finding your website, I shopped to find a pharmacy selling the Watson “authorized generic” — just got it tonight, so I will try again tomorrow to get on track.
    Thanks for your help. I also checked out your book from the local ibrary a couple of weeks ago but of course now I totally can’t find it…. Sigh… Perhaps tomorrow I will. :/
    Thanks, Althea

    1. Hi Althea,

      I’m so glad the post was helpful to you.

      Look at how smart you are — to find this post, to figure out the problem, to listen to your friends.

      Good luck! You’re on the right track!

      g

  17. Pingback: ADHD Roller Coaster: "Is It You, Me, or Adult A.D.D.?" · A Recap: Consumer’s Guide to Generic Concerta

  18. Wow! I am so glad to find this site. Both my daughter and I have ADHD.
    I was on Concerta 27 mg. last year and my daughter needs to start on it this week. I’ve really missed the clarity I felt while on concerta, so I talked to my doctor about renewing. My daughter has reservations about the new medicine and I told her that I would take it with her and together we will be okay.
    So I have this all planned out and until the pharmacy throws me a curveball. You know, if you have ADHD and your plans change without being in your control, it can be unnerving. When I couldn’t get the brand name I ran a google search and found this site. I am not HAPPY!
    I didn’t want my daughter getting generic that would have a negative impact the first time she started using it and that can have long lasting consequences.
    After reading this site, I called the pharmacy and asked them the name of the manufacturer for the generics. I was told it was the Mallinkrodt brand. Well, I freaked!
    I called my doctor and my daughters doctor and the pharmacy. Fortunately, I later learned that pharmacy carried the Watson version in 18 mg. Which is what my daughter is going to take. Whew! But the version for me was the Mallinkrodt. So I have a hill to climb.

    a few items for you that I haven’t read from this post yet. I am sorry if I missed a few items. lots of comments to read in this post and I might have missed something already posted.

    1. Watson was purchased by Actavis. So the Actavis and Watson generic are the same.
    2. Both my doctor and my daughter’s doctor didn’t know about the issues you have been seeing in your kids and didn’t know there were more than ONE generic. It pays to be informed. Please provide your findings to your doctors. They will thank you, I promise.
    3. I’m working with my pharmacy and hopefully they will be able to order the Watson/Actavis version of the generic. Give them the chance to make it right. I don’t think they want to lose a customer. I was totally ready to hit another pharmacy, but they told me they will try to get the Watson/Actavis version for me.

    ADHD = long winded, but bullets or numbers help. lol

    thank goodness for this site!

  19. Thank you so much Gina for responding and for also being so quick at getting back with some informative answers. You’re right about the long-winded part 🙂 I apologize because I know I seem to ramble, but it’s more that I don’t want to leave any pertinent information out of the topic/post.

    I also thought that maybe I was prescribed the 54 mg. However the pill does state 36 on it. Everything I’ve read about the Kremers Urban was stating they were releasing FDA approved Generic Concerta 36 mg ER, so I just figured no update with pictures of the medication yet. I did view their NDC # and when punching that into the internet, it came up as 36 mg, however I just found out that is a National Drug Code, perhaps used for all 36 mg Generic Concerta’s out there (???)

    Lastly, I only say the whole Policing bit, because my doctor’s office and NYS is really cracking down on all controlled substances, including ADHD medications and narcotic pain relief. Unfortunately, not only having ADHD but joint disease and other factors that cause me to rely on pain meds once in awhile, many of us patients here in NYS really do feel the policing of these medications is causing more issues for us the innocent patients than the actual crime suspects that they should be after.

    Anyhow, I will take your advice and some information from this site and contact my doctor’s office. Thank you again and have a good day 🙂

    1. You’re welcome, Cindy.

      I understand about the “policing” part. Unfortunately, substandard physicians and rampant addiction do create problems for everyone else.

      And I, for one, appreciate the good details that you offer. I just know that sometimes physicians are busy and like patients to get to the point quickly. So, I offer the bullet points with that scenario in mind. 🙂

      best,
      g

    2. I just wanted to add that my son’s most recent refill for Generic Concerta 36 was filled as Methylphenidate ER 36 from Kremer. It is a reddish brown pill of about half the size as our previous prescriptions. I was surprised at both the color and the size, and even more so at the description which no longer stated “generic for Concerta”. There is absolutely no way this can have the OROS delivery system due to the size, (it is smaller than even the 27mg and maybe the 18mg) unless some major advancement in the process has been made, and then, why would it be generic?
      We have oftrn thought that the generic versions were questionable, but felt good that this was still in the initial offering from the same manufacturer. I do believe that at some point ours no longer stated ALIZA on them, though.
      We just requested a refill with BRAND only due to medical reasons, and should have it by next week. The out of pocket for brand vs. generic has gone from $45/90 day supply ($15/month) to $304. That is almost 7 times more. I look forward to seeing if there are any changes.

  20. Oh what a relief that I have found this website. I was diagnosed just about 7 years ago with ADHD as an adult when I was approximately 35. I was put on Strattera back then and did not stick with it because I could not stand the way it made me feel. Within the past couple of years and back in the work place I found that my ADHD was interfering with my daily organization/prioritizing/concentrating abilities as it always does. At that time my doctor put me on Concert 36 mg ER. I have been having it filled at Aetna RX Home Delivery as that is what our Insurance Company makes the employee of my Corporation go through with all maintenance prescriptions. However, we just found out that beginning in January of 2014 we can start using a local CVS to supply our 90 day maintenance prescriptions. Living in New York this will much more convenient than having my maintenance prescriptions filled in Florida and then waiting, however I have the timing down pretty good so that I don’t run out and if I do it’s usually due to a storm system moving up the East coast delaying Mail/UPS Delivery.

    Of course, that’s not what I’m writing about. For the two years of being on 36 mg extended release formula of Concerta, I used to always get a white capsule like pill. The Alza one looks so familiar to me, however I cannot prove at this time what the mfg was as I don’t have any old containers or pills. The most recent order I had filled by Aetna was in October 2013 and I received a reddish/brown pill with a 36 marked on it, no disclosure of “it’s the same medication, just a different supplier due to the change in appearance.”

    I have been taking this medication for about three weeks now and also started noticing dizzy spells, loss of appetite, loss of weight, extreme nausea and headaches, irritability with severe anxiety and agitation. I could not eat, I just kept feeling like I was going to vomit, I forced myself to eat but it wasn’t nearly like my previous appetite. I kept thinking back about that medication and the appearance. I worried that maybe the pharmacy messed up and filled it with the wrong dose. When I went home the other night, I pulled the pill bottle down from the shelf and identified the pill, but cannot find a picture of it anywhere on the internet. It is reddish/brown, small hard caplet with a black 36 on it. Unlike the white capsule I had been receiving. My prescription bottle read Manufacturer Kremers Urb

    I did a search for the Manufacturer of the new medication I received and it brought me to this site. I have read the same exact stuff that I have been encountering. I don’t know what to do at this time, what steps should I take from here on out? I thought about completing the FDA complaint form, however always hesitant about giving out all of my information, especially when it’s a controlled substance and the Government is on some type of Big Brother Watch system thinking that everybody WHO NEEDS THIS MEDICATION are criminals. WHICH WE ARE NOT!!!

    I guess I need some advice and guidance. Should I consult my pharmacy and find out what they have to say or offer once I tell them that I am not tolerating this new generic? Should I contact my doctor’s office? Which I sometimes despise doing because I can never talk to the doctor himself, I’m always made to tell it to the Nurse and my message always gets misconstrued and turned around like a bad rumor when the message from the doctor is returned to me. Is it recommended that I complete the FDA complaint? If so, can someone send that link in a message again on here when or if replying to me? At this time, I’m not even taking this medication, it’s the first thing I did to determine if in fact that was what was causing my discomfort. For two days now, I have not had any nausea and I’m making up for my lack of eating. I’ve had no headaches, no dizziness, no extreme sweating, etc…That medication is BAD, I’m afraid that it could really do some damage to somebody with any kind of heart issues or not even. I’m quite sick of the FDA just approving medication without proper studies or more in depth studies. Thank you in advance for your help and for reading this.

    1. Hi Cindy,

      I’m sorry to hear of your struggles.

      First, I can assure you that it is untrue that the “Government is on some type of Big Brother Watch system thinking that everybody WHO NEEDS THIS MEDICATION are criminals.” If that were the case, the medications would not be legally available and growing in number.

      Second, you said that you used to take Concerta 36 mg, and that it was white. That is correct. And that you were most recently given a reddish-brown pill with “36” marked on it, and the label says Kremers Urban.

      Alas, I cannot find an image online of the Kremers Urban 36 mg generic Concerta. It would be unusual, I would think, to make it a different color, too. I would think the 36 mg would be white in either case. Because the true Concerta 54 mg is reddish-brown, and they wouldn’t want the confusion.

      So, this leads me to wonder…are you sure you have the 36mg generic or is it possible your dosage was increased to 54mg?

      Third, the only way to fix your dilemma is to talk with your doctor’s office. I would try to write something first, because untreated ADHD can tend to make some people a little “long-winded.” So, the doctor’s office might tune out from a “long-winded” explanation. (It shouldn’t be this way; they should understand that ADHD can make it hard to prioritize useful information from extraneous. But if it’s the way it is and you cannot find a new MD, then you’ll have to work with it.)

      I would write a very concise statement….such as this, below.

      Feel free to copy and past this into a document that you can print. Also print for your doctor’s office this blog post: https://adhdrollercoaster.org/the-basics/an-update-on-generic-concerta/#.Uo5Zg41UjZp

      1. In the past, I have taken brand Concerta, 36 mg, to good effect.
      2. With my most recent prescription, I have been given a new generic from Kremers Urban. Not only has it not been effective, but it has caused intolerable side effects, including:

      -dizzy spells
      -loss of appetite
      -loss of weight
      -extreme nausea and headaches
      -irritability with severe anxiety and agitation

      3. After suffering such side effects for three weeks (and wondering if instead I had the flu), I thought that the pharmacy must have made a mistake and given me the wrong medication. That’s when I discovered that this was a new generic.

      4. I researched this online, and found a blog post by a respected ADHD expert. She and medical experts on this topic are recommending that physicians specify on the prescription “OROS delivery only.” That way, patients do not receive the inferior generics. Note that a MarketWatch complaint has been filed with the FDA. This is a legitimate problem.

      Good luck!
      Gina

  21. My daughter was given the generic when it first came out a couple of yrs ago. We didn’t immediately notice because we were charge the same as the name brand & it looks the same. She broke out in hives after taking it for 3 days. Nothing had changed as far as diet, other meds, or lifestyle. I checked her Concerta and realized it was the generic. I was very upset with the pharmacy for not informing us of this change. After fighting with the pharmacy & insurance co, we were able to get her back on the name brand & have had no problems since. Now I have been told, she will be unable to get the name brand after Dec. She is allergic to a filler or something in the generic. For all the people who think there is a difference between the generic & the name brand, YES THERE IS!!!!

    1. Hi Amy,

      You might not be able to get the “brand” but you might be able to get the “authorized generic” (which is the same as brand).

      Ask your physician to write “OROS only” and see what happens.

      good luck.
      g

  22. I’m sitting at CVS right now with no good explanation. My 7 year old is on 18mg Concerta generic. Until last week he had been taking AB Activus, but last week when we refilled they gave us Kremers Urban. It’s like he’s taking sugar pills. NO EFFECT. Explained this to pharmacy and they say we can’t exchange (they didn’t have the old generic lastbweek so they gave us this stuff). Can’t get new perscriptiin because. It’s a controlled substance. I’m pretty PO’d at this point.

    1. Kevin – you should be able to call your insurance company and get a waiver on getting a second prescription. It’s worth a try, anyway.

      good luck!
      g

  23. I was wondering if anyone knew where I can find generic Concerta that’s not going to break the bank. My son is a senior in high school and has been on it since 5th grade. We stopped it last spring after seeing a naturopath and having some encouraging results with supplements. I was happy to see his personality come back. The Concerta seems to blunt his personality and makes him a bit sluggish. However, he is now doing horribly in school and is so unmotivated and indifferent to anything related to school. He’s got 20s & 30s in most of his classes.

    I’ve figured I just need to bite the bullet and just put him back on the Concerta. At least to get him through his senior year. The problem is that he doesn’t have health insurance right now and the prices I’m getting for generic Concerta from my area pharmacies is around $200 for a 30-day supply.
    Thanks!

    1. Hi Kim,

      The appropriate medication shouldn’t blunt personality. It might be that the dosage needs adjusting. Or, it could be that you are seeing his “personality” as being tied in with ADHD symptoms. “Personality” is a very squishy concept.

      The availability of generic Concerta is going to vary by region. You could try Costco but I’m pretty sure they don’t carry it.

      I would look into health insurance for him. It’s a good idea.

      good luck,
      g

    2. Thank you, Gina. Your comment that Concerta shouldn’t be blunting his personality makes me think he needs a better evaluation and treatment plan. He’s been on every dose up to 72 mg and I wasn’t really happy with the place he used to go for counsling and med Rx. So a few years ago his pediatrician took over prescribing and frankly did a better job.

      I’m in the process of applying for health insurance which is proving to be more drawn out than I thought. I saw that there is a center for ADHD here in CT where we live (although its 1 hour away) and I’m thinking I should take him somewhere like that where they are more specialized.

      What do you mean regarding personality being tied in with ADHD symptoms? Is there a good resource you can point me to? I read a lot about ADHD 10 years ago when he was first diagnosed, but haven’t stayed on top of information. There is just SO much out there now. I see your book is geared towards adult ADHD. Do you think this would be useful for me dealing with my teenage son?

      Thanks so much!

    3. Hi Kim,

      Yes, information on ADHD is proliferating on the web, but much of it is not well-researched. It’s purely marketing-driven.

      Still, it’s vitally important to keep up with the information on ADHD. We have advanced quite far in the last 10 years.

      You could start at the National Resource Center on ADHD: http://www.help4adhd.org
      And become a CHADD member: http://www.CHADD.org

      That way, you will receive their monthly magazine (overseen by a professional advisory board), access to the online archives, and access to online support/discussion groups with other parents and some professionals.

      Yes, I think my book is helpful for all ages of people with ADHD. Many of the core challenges remain through the lifespan. And the medication strategy is the same. There should be a method — and not the common “method” that resembles throwing spaghetti at the wall and seeing what sticks! 🙂

      good luck!
      g

  24. Thank you Gina.
    I read the entire post and the talk backs.
    After reading the post I thought it’s just in my head, but after reading the talk backs I learned that others noticed different affect with the brand and the Watson generic.
    I have a very structured rutine during the week since the beginning of the semester. Diet, excersise, work etc. nothing had changed but my AADD prescription.
    I’m “saving” the few concerta pils I have for when I need it the most, and I can see the difference in my concentration, efficiency and attention.
    Furthermore, if the Watson generic and the brand are the same, why would any one want to pay for the brand? It makes no senses.
    For me there is a noticible difference between the generic and brand.

    1. You asked:
      “Furthermore, if the Watson generic and the brand are the same, why would any one want to pay for the brand? It makes no senses.”

      Yes, it makes sense. You just have to understand the patents. Watson agreed to hold off on introducing its own generic if Janssen would cut a deal and let Watson market the brand-Concerta as a generic. It’s an AUTHORIZED-GENERIC, made at the same plant, with the other Concerta. There is no difference, by law. If your pills say “Alza” you have Concerta. No two ways about it.

      Yes, other people have remarked that they’ve noticed a difference but many have been confused about the difference between generic and authorized-generic.

      I would not discount the placebo factor — that is, some people might perceive the Watson-delivered generic as not working because they expect it not to.

      You can confuse yourself a great deal if you give reported/vetted information the same weight as unsubstantiated comments.

      good luck,
      g

  25. Hi.
    I’m so glad I found this article.
    I’m a 31 y/o phd student in my first semester back at school.
    A few weeks ago I got my first prescription through my student insurance plan. I started taking the generic watson 36mg instead of the concerta. I felt the difference immediately, but decided to give it a few more days. Sadly things are the same. I’m back to the lazy forgetful me. I’m not focused and I can’t concentrate for a long time.
    I’m sorry to say that the Watson generic does not work for me.

    1. Hi David,

      The Watson generic IS the brand Concerta. Please read through my blog posts on the topic.

      If you’re back to “lazy and forgetful,” something else is up.

      good luck!
      g

  26. My daughter is 11 and has been on the 18 mg (2x) Watson generic for the last 4 years…just got her mail-order in today and it is the Kremers UR!! Needless to say I found your site while trying to figure out what the heck I just received!! So glad I found this!!

    Our insurance does require us do the mail order through CVS/Caremark. I will be calling them tomorrow and asking for the Watson generic as I do NOT even want to try these other generics that just got FDA approval….

    Is it enough that I just tell them I won’t accept the Kremers?? Or do I need to do anything else?

    Also, an FYI I read in an earlier post…new laws in certain states (well, new to mail-order companies) mandate 30 day supply UNLESS your script has the diagnosis of ADHD written/typed on it then they can give a 60 day supply.

    1. Hi Deana,

      Yes, the physician will have to specify which generic to accept or reject.

      Here is a later post:

      https://adhdrollercoaster.org/adhd-medication/concerta-generics-dealing-with-the-pharmacy/

      I haven’t heard about that mandate. I know that initially (years ago) the mail-order company required the diagnosis on the script. They haven’t asked for it lately. I’m pretty sure the doc adds it, anyway, as I reminded him so many times in the early days.

      Gina

  27. This month my daughter’s pharmacy gave her the Klemers Urban generic Concerta. It’s like she is taking a placebo. And it makes her more tired!
    As this generic gets out in the marketplace, I am quite positive there will be more negative concerns.

    1. Gina,
      Thanks for getting back to me. I have already filed the complaint, tried to return, called the CEO office of CVS (who called my pharmacist and told them order) and talked to my doctor. Trust me…I am not be passive about continuing a mediocre medication.

      I do know that Klemers Urban was just approved and will start making it’s way into pharmacies as we speak. While I don’t intend to continue, I would like to speak out to other families who may soon be prescribed this medication. Be aware that this lab is producing a sub-par product that does not use the OROS pump that Concerta uses.

      As I was just informed, speak up, make sure you check labs before you sign out the meds, file complaints, and let your doctor know.

    2. Good for you, April!

      I’ve been traveling, with no time to write a wrap-up. But I should summarize what actions to take, including checking labs before you pay for the meds, as you suggest.

      Of course the trouble is that so many people get 30-day Rx, and they can’t do without meds. Even a bad generic might be better than nothing.

      tx
      g

  28. Hey, just to weigh in from adult perspective…I’ve been using Converts 27 mg for about five years. Every so often I start feeling like I’ve gone dumb or something. Memories just lift out of my head…there’s an empty spaces where my working memory should ne. I don’t even know I’ve forgotten til later. It differed from Ashford lapses in that there isn’t a flurry of thought covering the working memory; there’s nothing. It’s quiet, I’m calm, and I’ve so forgotten what I was doing that I don’t even know there was something to forget. I forget words and names. Anyway, once I tried adderall or higher dose Concerta, but that wasn’t.the problem. The peoblem, I realized, was that. I I had been dispensed generic. Now, I’ve been
    told it’s the same, and read this article, but
    SOMETHING is different. Could it be that they slip
    Watson an older or know-to-be inferior product, so as
    not to lose money? I do not mind paying the higher copy, and believe me, I’m very cheap. I’m 33 yo female. 130 lbs. Also, I take my meds at about 5 am and they’re done by moon. I take another around noon/1. Depends on when I woke up. I take it first thong, mornings are hey dif. I don’t understand ppl who only take it for school or work, cause I can get onto a lot of trouble mputh-wise, tardiness-wise, or driving. Also, just started a new generic concerta, it’s yellow with a 27 printed. They didn’t have the brand and I was out. This one is consistent, but seemed weaker, and also like it wore off early, but no brain gaps so far.

    1. Hi Maureen,

      I don’t think the manufacturer could be “slipping Watson an older or known-to-be-inferior product.” One, that would be illegal. Two, the FDA highly regulates these matters. (Yes, I know, the FDA regulates generics, too, and look at how that turns out sometimes. But that is a matter of the established guidelines for generics, not lack of FDA oversight.)

      As for your new generic Concerta, maybe it’s the Kudco generic. If it works for you, great. You might need to tweak it a bit, such as a higher/lower dosage, given the range of efficacy that is allowed by FDA guidelines.

      Thanks for posting.
      Gina

  29. Looking at some of the prices people are talking about for scrips on here makes me shake my head… I live in Washington State and my 8 yr old son takes generic Concerta. The GENERIC costs us $189 a month = $6.30 per pill. Time to go for dual citizenship? lol could be… could be.

    1. Danny – the price you pay depends on your insurance plan. Prices are not set by the FDA. My husband and I pay about $20 for a 90-day supply of the generic Concerta. If you have a mail-order plan, it might be worth looking into.

      Also, Canada is not better and might even be worse. They have long had a generic Concerta that is extremely inferior.

      g

  30. I thought I would share my son’s story and information I just received from Express Scripts (formerly Medco). My son has been on name brand Concerta for several years. Over a year ago, we filled a 30 day supply here in our small town as we had neglected to get our 90 day mail-order refill submitted in time. Our local pharmacy filled it with a generic version unbeknownst to us until we opened the bottles and saw the different looking pills. We called the pharmacy and were assured that the generic is ‘just like’ the name brand (not sure what ‘generic’ we received back then). We tried it and like the stories here, found the effect with our son to be intolerable — it brought out more anxiety, depressive symptoms, and beligerance than we’d ever seen. We immediately called the pharmacy who couldn’t understand it, informed our pediatrician and got another refill of brand-name and have been sticking with that ever since. This past month, we found that all 7 local pharmacies no longer carry name brand Concerta — only the generic. Thanks to this site, I’ve now learned that at a minimum, if we’re going to try generic again, we should request the Watson version and hope. Half the pharmacies in town carry that brand, half carry the Mallinkrodt. I called Express Scripts this morning and they said they use both brands. So, if you don’t call ahead before submitting your RX to find what they have in stock, you could receive the Mallinkrodt brand. This is a big mail-order service so wanted to let all those who use it be aware than just because you’ve received Watson once, doesn’t mean you’ll receive it the next time you get a prescription filled. I called a month ago, and they were filling with Watson so the change can happen quickly. The other frustration is that the Express pharmacist I spoke with said that both generic versions are absolutely equivalent to the name brand Concerta or the FDA wouldn’t allow it. I explained about the difference in the delivery system of the drug and he said they’re the same methodology and would deliver the same effect which obviously shows how underinformed these mass production pharmacy delivery services are. We’re going to try 30 days of the Watson generic and we’ll see how it goes. Thank you so much for this website and for all who are sharing their stories. This is definitely something to watch and take action on.

    1. Thanks for your vigilance, Siena. I am biting my nails as I write (not an easy feat) because I just submitted the Rx to Express Scripts. We’ve been getting the Watson/brand-generic and I hope I don’t have to deal with returning the Malinckrodt. Because return it I will. My husband and I had enough ups and downs on the Rx roller coaster in the early days. We are not going back.

      g

  31. Hi, this may not be the best discussion thread to ask on, but our son was recently prescribed this medicine. It is supposed to be the generic, but when we try to go to various pharmacies (and a few online that I was able to check) to price it out , the prices are sky high like we are really getting Concerta instead of generic. ($120 to $170 per month). Our insurance company even told us it would be that much which sounds ridiculous to me.
    We are on HSA and have to pay the insurance negotiated price out of pocket, so we can’t afford that much per month.
    Is anyone else having this kind of trouble? I thought the generic was supposed to be a lot cheaper.

    1. Hi Ronnie — The price you pay is entirely determined by your insurance health plan. The Watson/Alza “generic” is much cheaper than brand for some people and almost the same for others. It just depends on your plan.

      If you have the option, look into the mail-order pharmacy. That should be cheaper, in general, and you get a larger supply. So, fewer hassles each time you have to get it refilled.

      good luck,
      g

  32. What is your thought on the generic from Kremers Urban? My son has been taking, what the pharmacy considers generic Concerta(the one with Alza 18 imprinted on it) for awhile now, but when I filled his script last night I was given a small reddish/brown pill with just an 18 on it. Nowhere on the internet could I find what this pill was. I brought it back to the pharmacist, and she said, its the same thing, you’ve been getting a generic this whole time. I tried to explain I did not want to change and I was not notified it was going to be changed. Let me know what you think or have found out about this generic. It seems too new to find any info. Thanks.

    1. Hi Jeremy,

      I can’t find an image of the Kremers Urban generic of Concerta.

      I know that it doesn’t use the OROS technology, though, and that’s what makes Concerta… Concerta.

      Did your son try the new generic?

      And the pharmacist is wrong. If you have been getting the Alza, you have been getting the brand marketed and sold as a generic.

      g

  33. My 10 yr old son has been on Concerta for 2yrs and we have had great success with it! Over the summer the pharmacy started filling it generic. Omg what a a bad change I saw in him 🙁 his imulsiveness wa back worse then ever and his anxiety is off the chart. I live in the US and and the generic in my town has M with a box around it and then the mg. it is also shaped very differently! They are now writting on his script NO GENERIC name brand only! I am was glad to come across this post because now I know my son isn’t the only one that has this problem. Thank you guys for sharing all your stories!

  34. Just to make life even more complex … I just went to the pharmacy (that has always carried the generic from Watson w/OROS) and they no longer have it. I adamantly told them that I didn’t want Mallinckrodt supplier but they didn’t have that EITHER. They showed them to me and they were little round pills (not the elongated ones w/blunt edges and OROS technology that we’re used to) and the lab is Kremers Urban. I tried to google and it seems there was some type of recent settlement and are now FDA approved. I can’t, however, find ANY feedback about them. Anyone have any experiences???

  35. I’m having a hard time finding a drug store in our area that carries Concerta Alza. We to are having the same problems with the new switch to M27. We live on the east coast and CVS is big in our area, but they have made the switch. Any suggestions?

  36. I’m so glad I just found your site. Our son has been on Concerta for seven years and it worked great. The past couple of months the pharmacy gave us the pills with the M on them and said they were the same. He has not been able to sleep, has flushed cheeks and ears, and has had four major episodes of mental instability where he has completely melted down with intermittent screaming, shaking, and tense muscles. He had never shown these symptoms before. Last night we almost had him admitted to the psych ward because he was having those symptoms, plus his face was numb and he was having trouble walking because he was so tense. We thought he was having a “nervous breakdown.” He eventually got somewhat better. When he started the new refill today that had alza on it like he had taken before the M pills, it dawned on me that perhaps the pill change had caused this. He was much better but was still “twitchy.” Desperate, I looked on the internet and found your site. I’m going to call the neurologist tomorrow.

    1. Oh Kathy, that sounds so scary!

      I wish pharmacists would stop perpetuating this myth, that the generic is the same thing. There are many possible reasons why someone might react differently to generic than brand. They should know that and stop towing the party line, if that’s what they’re doing.

      Good luck!
      g

  37. Pingback: ADHD Roller Coaster: "Is It You, Me, or Adult A.D.D.?" · An Update on Generic Concerta

  38. Thanks for your support, RS!

    Yes, I agree. Just like the budget stalemate… Congress sure came together to make sure they’d get to fly home. Hungry babies? Head star programs? Student loan interest hikes. Not important…..argh.
    g

  39. Dear returning student,

    Thank you SO MUCH for taking the time to write your note. I cannot tell you what it means to me, to know that my work has the intended goal: that of helping to elevate people’s lives and validate their perceptions about ADHD symptoms and treatment.

    When I first heard of this Mallinckrodt “generic,” I immediately thought of all the people who will take the pill, with all hopes of it working as it should. Then, when it didn’t, I thought of them giving up on ADHD medication entirely, given the side effects. Often, people with late-diagnosis ADHD give up easily; they have tried many things, most of which didn’t work, and so they have no reason to be optimistic. That this cynical marketing and inferior generic should rob them of optimism makes me angry. It’s just not right.

    I also think of the parents who, against their better judgment, try medication for their child. They’ve heard the scare stories but are willing to try. Only to have this “generic’s” side effects scare them off. Again, it’s not right. And we need to speak up about it.

    You have renewed my energy to write an update about this– I hope, today. It has been impossible to find accurate information or people willing to go on the record about this issue. Hence the delay. After I while, I just got worn down. But today, it’s onward and upward!

    Best of luck with your studies!

    g

  40. It’s hard to find info but I saw announcements that FDA approved Kudco (Ireland), Kremers Urban and Teva versions. I might have misunderstood and I don’t know the process between FDA approval and actual manufacture and marketing. I thought I saw, a while back, that the agreement between Watson and Jenssen was through 2013 then I saw something that said 2018. I want to be on the lookout.

    Thank you for this article and the links, by the way.

    1. Hi Suzanne,

      I’ve been amassing information on this topic. Just need some time to piece it all together!

      I found this from Kremers Urban: http://www.kremersurban.com/products/Generic_Reference_Guide.aspx

      Just a Metadate generic. But perhaps they’re trying to pass it off as a Concerta generic. The Mallinckrodt Concerta generic seems little more than Ritalin LA to me.

      There’s this announcement, but not much of a clue as to what it really means:

      http://www.empr.com/kremers-urban-approved-for-generic-concerta/article/302420/

      g

  41. Michelle Rogers

    I recently lost prescription coverage with my insurance, so had to switch my daughter to the generic 36 mg concerta. I was really nervous about what was going to happen, as I’d read bad things about the generic. However, I get the stuff home and compared it with an older bottle I had, and realized that she had been on the generic all along! So, it works for her, always had. I just want to get it out there that possibly it’s not going to completely wreck your kid if you have to go generic. And maybe it’s more people looking for an explanation? But, that’s just my experience.

    1. Hi Michelle,

      You do not specify which type of generic you received, and that is extremely important.

      Please read the post and note that there is a difference between the Watson generic (which is the brand only marketed as a generic) and the Mallinckrodt.

      g

    2. Michelle Rogers

      Sorry I apparently didn’t follow directions. However, in your original post, I did not see any mention of Mallinckrodt, and really no discussion of anything other than the “authorized generic.” I was merely trying to reassure parents/patients that if circumstances arise that make it necessary for them to use generic, then maybe it might not be so bad.

    3. Sorry, Michelle, I was unclear.

      For one thing, Canada has long had a “generic” of Concerta that is nothing like the brand-name (which is, in fact, the Watson “generic” of Concerta). So, there’s that distinguishing point.

      For another, by writing “note that there is a difference between the Watson generic…and the Mallinckrodt,” I didn’t mean to imply that this information is in the post. That’s why I added it and wrote “note.” As I said, unclear!

      tx
      g

  42. Are there other companies besides Mallnkrodt which are poised to or have come out with Concerta generics.

    My pharmacy sometimes gives me the Watson and sometimes the Janssen/J&J. Sometimes it seems like I have not even taken my medication but for me it has not correlated with the generic vs name brand switch. Stress seems to be the major difference. My doctor prescribes a quantity of 140 18mg pills so I can take either 4 or 5 per day depending on what is going on in my life. If I take 5 consistently I get some unwanted side effects, but doing so periodically works for me.

    Ritalin didn’t work for me. Aderall made me feel very focused and I lost some weight, which was beneficial in my case, but I was irritable, bordering on mean, and my family said I was not as focused as I felt I was. I am on the lookout for my pharmacy to switch to another generic and wondering how I will be able to fight it.

    1. Hi Suzanne,

      I don’t know of any other upcoming generics for Concerta. It seems unlikely given that the Watson marketing agreement (to sell brand-name Concerta as generic) doesn’t run out for a while (I need to check the specifics). But who knows.

      You might want to stick with your pharmacy, since they aren’t yet filling your Rx with the Malinckrodt “generic.” You are getting brand either way with its current choices.

      g

  43. My son is 15 and diagnosed with ADHD with anger management issues at age 4. We have been through a series of drugs throughout the years (Vyvanse, Strattera, Adderall and Concerta). Growth spurts and hormonal changes made the journey challenging and frustrating. I, like most parents, want the best for my son. His pediatrician prescribed Concerta and we increased to 54mg over a year ago. Things were going better at school and at home. Our insurance company forced us into a 90-day mail order and subsequently the generic. I noticed immediately a a higher level of defiant behavior, impulsiveness and hyperactivity. In June the pediatrician submitted a letter to the insurance company to approve the brand Concerta. When the 30-day prescription was filled at our local pharmacy, we immediately saw improvements in behavior. What a blessing. Sadly, the insurance company rejected our request stating they “allowed the brand while it was under review”. We are back to the generic (Methylphenidate 54mg ER by Watson) and again saw immediate setbacks. I will continue to fight the insurance company and won’t back down on this battle. I don’t care what anyone says, I live with this child 24-7 and certainly know when something is working and when it doesn’t. Shame on the drug companies and insurance companies for putting the patient and their families through this battle over money.

    1. Hi Sandy,

      Thanks for relating your experience. I don’t know what to say; I’m flummoxed.

      If it’s not a case of “auto-suggestion” (that is, seeing that it’s a generic and expecting inferior results), that means something else is afoot. Yet, it is manufactured with the brand Concerta, as brand Concerta. The FDA is very strict about such things. I wish they were as strict in what they allow as a generic.

      g

  44. Thank you for this blog. This discrepency between generic brands indeed unwittingly put my husband on a daily roller coaster- after reading this section I checked his meds and he received a mix of alza’s and M’s. He went to discuss it with his pharmacy to get it put in his file to only receive generic alza’s and he was told “sorry, we can’t do that.” Alza producers ought to be the ones who lobby to get that loophole changed because otherwise people will simply switch brands all together. If my husband cant get the dr to specify alza’s then we are going to ask to switch to the new Quillievert XR- at least there wont be a generic discrepancy for a few years. and it is supposed to last 10-12 hours.

    1. Hi Lisa,

      Yes, most pharmacies won’t let you specify which generics you receive, but you can always specify the brand. That is, if you want Concerta, the doc writes the Rx for Concerta and checks the box that says “Do not substitute generic for brand.”

      As far as Alza producers lobbying to get the loophole changed, I’m sure that’s been tried.
      g

  45. Just wondering. I was just told I had ADHD, I was on Ritian as a child, taken off at probably age 12. Doctor says they are finding out that children don’t out grown hyperactive. ;0) Was put on Concerta and got the genetic. I looked at them and they are the M27. Being as I am only been on Concerta for 4 days now, how does one found a place that still sell the alza27 verison to see if this is the right pill to be on. I seem to notice that some of my systems seem to still be there but was thinking it was because I had just started with it and that I might be expecting too much from the pill in this early stage. I am not sure if I might need to go ahead and get the real Concerta or try to find places that still have the alza27. Any suggestions from someone new to Concerta.

    1. Hi Stephanie,

      Yes, it used to be thought that “hyperactive” kids outgrew it. Now we know that the physical hyperactivity might diminish with maturity but the “internal” hyperactivity (mental restlessness and the rest of ADHD symptoms) do not for most kids with ADHD. And, for a minority of these adults, the physical hyperactivity remains, too.

      You know, it’s very hard to say. Individual neurochemistry makes it hard to predict which medication will work best for someone. A medication that works best for the majority of people with ADHD might work horribly for the rest. And vice-versa.

      It could be that this Mallinckrodt generic will work okay for you. But the problem is, how will you know if you don’t try the real thing? You won’t know if you’re getting the full potential benefit unless you try.

      With any Rx for ADHD, it’s not immediately going to address all symptoms. Not to mention many of the poor coping strategies that many late-diagnosis adults develop over the years (procrastinating, staying up too late, etc.)
      Good luck!

  46. Thank you for your reply. Yes we were concerned that there might be something environmental going on as well. However he was doing so well at camp and then to have it change so suddenly. We are calorie packing and his mood is affected by what he eats so he’s had a good behavior plan in place for him to eat his snacks etc. But you are right it could be any number of changes in the environment.

    That is interesting about citric-acid products. He actually had a citrus intolerance (testing by an allergist) as a child and has grown out of it but as a result of avoiding for years doesn’t like orange juice or citrus. Good to know about it though!

    Camp Takoda is based from research of Dr. William Pelham University of Buffalo. (http://www.uafc.org/). Our nephew has enjoyed the camp for several years. This is our first year and we are seeing great success. Positive counselors and exceptional clinical director! Hopefully others can participate in Summer Treatment Programs nationwide

    1. Hi Christine,

      Thanks for your reply. Yes, I’ve heard of Pelham’s program.

      Please check back in when you try the “brand” Concerta.

      Also it’s important to remember that placebo can be very powerful; that is, if he thinks that he’s taking a generic and thus an inferior medication, that might have an effect in his behavior.

      Oh, and citric acid is in TONS of food products, including those fruit roll-ups. It’s used as a preservative. Perhaps some other food or drink at the camp, or perhaps even certain pollen that has come into bloom.

      Good luck!
      g

  47. Thank you everyone for your posts concerning Concerta vs Generic. My son is 8 years old and appears to metabolize medication differently. In 2011 upon his initial diagnosis we made the decision to have our pediatrician prescribe him Vyvanse brand name it seemed the meds were effective for a short time and then he continually needed an increase every few months to assist him with his classroom behavior.
    Our pediatrician referred us to a psychiatrist to manage his medication. In 2012 he was precribed Concerta. He was very stable on this medication 36mg for almost a year. Then in Jan 2013 his dosage was increased to 54 mg. Given his history, we felt it was important to pay the additional costs for the namebrand.
    My husband’s employment changed in June so due to our tight budget we decided to use the generic Watson. Although all of these threads mention that the Watson label is the same, we have noticed otherwise. He is currently in a therapeutic camp where he is working with CSW and LCSW counselors in a behavioral treatment program. (all day 8:30-4:30pm) The social worker camp counselors have noted a marked difference in his behavior since we are using the generic by Watson. Several times in consultation the counselors have asked “Did he take his medication today?” “Did you decide not to have him on medication for the summer?” My response is emphatic NO. The counselors note he has been irritable, but more often distracted, and at times hyper. Although he is also incredibly engaging and funny getting his fellow campers to laugh at jokes. This is not our son on medication. This is his behavior when he is home in the evening after the medication is wearing off.
    I have discussed this reaction with the pharmacy today and the technician was puzzled as to why he is reacting in this manner. The generic is labeled as Watson and our one remaining pill is labeled as alza 54. I had an appointment with the psychiatrist yesterday and we can only determine it’s his body’s reaction. We are filling the name brand Concerta today and hopefully we will see a difference in his behavior. We are looking forward to his counselors’ observations of his behavior as well.
    So interesting ….

    1. Hi Christine,

      I would first look at other variables, including his diet at camp and other environmental factors.

      Is he drinking orange juice or consuming other citric-acid products, for example? That can interfere with stimulant assimilation.

      Summertime is a big transition for kids with ADHD, and perhaps it is the behavioral-treatment program itself. Which camp is this, do you mind sharing?

      good luck,

      g

  48. George Hamrick, MD

    Gina,
    Thank you for the information you have researched and provided. It might also be helpful for folks to understand the differences between: “pharmaceutical equivalent”, “bioequivalent”, and “therapeutic equivalent”, especially in terms of the US FDA. There is a good synopsis of this in an article at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018179/

    The article is actually about medications for epilepsy, not ADHD, but is relevant. In brief, bioequivalence is determined by giving single doses of brand or generic medications to test subjects (who do not have the disease the drug is intended to treat). Blood concentrations of the drugs are measured by timed lab (blood) tests and plotted out in a curve. Averages of curves are then compared. The curves DO NOT have to be identical. The area under the curve (AUC) – a measure of drug availability in the blood – can potentially vary by +/- 20%. In addition, the testing does not reflect a true patient’s blood levels over time, as only a single test dose is given. There is no assessment of “steady state” levels in the blood. The result is there can be a significant difference in a specific patient’s response to a brand drug vs a bioequivalent generic. In other words, drugs do not have to be therapeutically equivalent to be sold as a bioequivalent generic substitution.

    I personally feel the FDA’s bioequivalence standards are inadequate, especially when dealing with certain medications such as those for cardiac arrhythmias, anticoagulation, those having central nervous system (CNS) effects, etc.

    I hope this is helpful to some of your readers. Keep up the good work!

    George

    1. Hi George,

      I had previously written about bioequivalence here:

      https://adhdrollercoaster.org/questions-about-adult-adhd/update-on-generic-rx-approach-with-caution/#.Ue6qVFNUjZo

      But I did not know about the information you have provided. It explains a lot about how Mallinckrodt was able to drive a Mack truck through the FDA guideline loopholes with its new generic Concerta. I just received a statement from the company but am trying to identify a policy expert who can shed light on how this product might effect consumers’ choices. Will post on that soon.

      Thanks so much.

      g

  49. I am thirty-nine years old and I take Methylphenidate ER 36 mg. I just came from the Urgent Care clinic, EKGs, Blood Tests, Hypotension tests… I said to the doctor, “you know that feeling you get when you just want something salty, like sour cream and onion chips. Thats how I think about Concerta. I just want the Concerta.” I’m a pretty tough dude (not motorcycle but 1940’s dad-type tough). I’ve been taking this crap against my better judgement for a few months. There’s a night and day difference between the ALZA stamp and the other. I keep my old bottles, for what had been, no apparent reason. I’ve been searching the internet all day and just lucked into your site. I looked on the new bottles, MalinKRAP. When I get the generic from Watson, which I now know is brand, I feel great and know that I made the right decision to go back to school-I could be anything that I want to be. On MalinKrap, I am dizzy, irritable, aggressive, hostile, faint, light headed, cold sensitive, tired and I just feel defeated.
    I used to take Ritalin when I was a kid and my mother said it worked but she felt it had too strong an effect on my personality so she stopped it. I consistently scored higher on tests than my peers but never turned in any homework. As a result I have had a life full of great experiences that unfortunately didn’t include success in academics. In January, prior to enrolling in Community College, I saw a psychiatrist and was prescribed Concerta (generic) and luckily, I received the Watson Lab version. During those months I felt like nothing could stop me. Not only was I doing well in school but also in relationships and the rest of my life. Then I was given the other. I have felt worse these past few months than I can remember. It is not just the side effects of the generic but the realization that something is terribly wrong. I haven’t told anybody or done anything about it until today when I went to the clinic. I am so happy to read your posts. I don’t feel better physically (side effects) but mentally-there’s hope again. Now I know the problem. Everything you people are saying fits with my experience.
    THANK YOU SO MUCH!
    Also, I’m 39 and it is hard for an adult to figure all of this out from the third person perspective. I feel so bad thinking of all the kids who don’t have the knowledge, confidence to stand up for themselves, and awareness that something is not normal. I applaud you for fighting for your children.

    1. N.M. — thank you for telling your story, sharing it with public here. It’s so very important.

      With each comment that comes in about this “MalinKRAP” (as you call it), I find myself outraged that this cynical manipulation of FDA guidelines is allowed.

      Here is the corporate contact info (I’m on hold right now); I suggest that folks give ’em a call:

      U.S. Headquarters Principal Executive Office

      675 McDonnell Blvd.
      St. Louis, MO 63042
      USA

      Ph. 314.654.2000

  50. My son is 6 almost 7 and has been on Concerta for almost 2 years. We have always received the Alza 36 mg pills (Watson brand) until last month. I took his script to Rite Aid and received the Mallinkrodt pill that has M with a square around it and 36. My sons behavior was out of control, almost like he hadnt took any medicine at all. It was an immediate change that everyone including his teachers noticed. The doctors and pharmacist tried to say they are exactly the same, but this month I made sure he had the Alza 36 (Watson brand) and he is back to normal and the outbursts and behavior issues have stopped. What I am having trouble doing now is actually finding a pharmacy that is still carrying the Alza 36 (Watson brand) When I call snd request the Watson brand Im treated like a criminal or an addict like I am trying to hunt down the drug for myself. But just know that there is a HUGE difference between the Watson and Mallinkrodt brand!!!

  51. I am so glad I found your site! My son has been on Concert 27 mg for over a year and all was going well. I recently filled a 90-day script via ExpressScripts. They filled with generic. I did not think much about it; I saved around $100. We are one week in and Wow, is there a difference! My happy son is become very angry and filled with anxiety. It has to be the medication. There has been no other changes with him. I am calling ExpressScripts tomorrow and then the pediatrician. He is 10 years old!

    1. Hi Kim,

      If the pill says “Alza,” you have the brand, even though it’s sold as a generic. If it says anything else, you have a generic.

      g

  52. I took brand Concerta 36 for over a year.
    Worked great.
    Took the Watson generic once – felt AWFUL ! If it’s the exact same ‘everything’ then I would not have noticed any difference.
    The manufacturing process may still be the same; the little sponge inside that pushs the drug out and a steady pace; but the ingredients are NOT .

    1. Ed, I don’t know what to tell you about your reaction. From all that we know, the “Watson generic” is, in fact, the brand-name. It’s just marketed under a different name. If you look at your pill and see that it says ALZA, that is the brand.

      g

  53. The difference between the generic and brand concerta is the codeine around the pill…. If you take a brand pill and generic pill and put it in water the brand releases into the body faster than the generic ….. The codeine on the pill is still patented till 2018…. So no it is not the same…. I received this information from the company itself. I have been taking it for over 12 years and they switched me to generic…. I almost lost my job over it… Due to my performance at work. If a doctor says it is the same by law you have the right to have them write you a letter how it is bio equivalent and what makes it the same …. It stated it in every insurance policy and if they can not respond with in 24 hrs
    They have to give you brand !…. I know this because I took the largest hmo insurance company to court over it ! You guys are not alone and since there is still a patent on it they have to give you brand if the generic is not helping.

    1. Hi Kristin,

      Do you mean the coating on the pill, because codeine is another medication altogether.

      And it’s not the coating that is patented, although that is part of Concerta’s delivery system. The primary component is the osmotic pump that delivers the medication to the GI system slowly and steadily. Here is an interesting video of how it works: http://www.youtube.com/watch?v=K6xIspSfo2U

      I know that, for most insurance companies, the generic is required first. Then, if it does not work, you can appeal (with a letter from the MD) and be allowed the brand. This probably varies by insurance company and state law. I’m not sure.

      Thanks for telling us about your experience.

      Gina

  54. I have information I’d like to share, I also have both pills with me and would like to submit pictures of both pills. How can I do that?

    Beth Milne

  55. My step-son is on Concerta36 (brand) for the past 4 years. He’s been doing excellent on his meds till about 2 months ago. He’s all of a sudden got hectic mood swings, aggressive, depressed, happy – it’s a total roller coaster. Can it be that the mg needs to be increased and not strong enough for him anymore? If yes, why all of a sudden the change?

    We’re staying in South Africa, and no generic is available here yet – thus I can’t even say that we’ve been given that.

    1. Hi Anina,

      There are many possible reasons why the medication might not seem to be working as well.

      You don’t mention his age or other lifestyle factors, which are part of the equation.

      But there are other factors. I write about medications for ADHD (which has many “traveling companions,” such as depression/anxiety) http://www.amazon.com/dp/B0050JCA7C/?tag=wwwginaperaco-20

      Best,
      g

  56. It took some work, but I did find a pharmacy that carries the Watson Generic Concerta that says alza 27. It was Walgreens that still had it. I tried a Kroger pharmacy, which was the place I used the very first time I filled the prescription, but apparently they too just changed to the M27. The technician or pharmacist that I spoke to at the counter was very helpful, yet not entirely helpful. He looked up on “facts and comparisons” information about the M27. He couldn’t actually figure out what the new delivery system is in this new pill. He couldn’t find anything about the osmotic pump. He did find a chart that showed a pharmokinetic curve nearly identical to what I found on Medscape for Concerta. That’s at least comforting, but I still wasn’t comfortable with going with that option yet. So I told him I would keep looking and fill the prescription somewhere else. I’m curious over the next month or so to see what else I can learn about this.

    1. Good for you, Roseann. I’m skeptical of that pharmokinetic curve. Everything I’ve been able to find out tells me this is basically Ritalin LA, which is not as sophisticated a delivery system as Concerta. Not at all.

      Stay tuned and subscribe to my blog. I’ll have a post about it soon, and maybe others will weigh in. tx

    2. Nicole Williams

      I just filled a prescription for my son at Target for Concerta – they said they gave me generic but it had the ALZA on it so according to Gina it should be the same as the brand. I homeschool him so I see him all day. Although I can see a slight difference, he isn’t as focused or motivated as he is when taking the brand and he’s very talkative – as in non-stop talkative, which is what I see on the one day a week that he doesn’t take the meds. I don’t know if it’s the generic issue or not. However, he took the last brand pill on a Monday and began the Watson generic on Tuesday.

    3. Hi Nicole,

      I don’t know what to tell you. If it says Alza, it is Concerta.

      Is it possible that your noticing the change (to a “generic”) led you to pay a little more attention to his behavior, noticing things you might not normally notice?

      g

  57. My son just started taking Concerta last month. Today I tried to refill for the first time, and the Costco pharmacy gave me half pills that say Alza 27, and half that say M27. They pharmacist said they are in the process of changing brands. The first time I filled the prescription they looked just like the Alza ones, but since they are gone now, I can’t remember what was imprinted on them. I felt really uncomfortable about the M27 ones. When these were prescribed, my doctor told me that the effectiveness of these pills were because of the pump, so to see the tablets that didn’t look like there could be any sort of pump in them, I felt extremely uncomfortable using these pills. I am not sure what to think of this. I didn’t get a chance to go to a different pharmacy tonight, but I hope that when I do go, that they will be the Alza ones. I am very confused on all this. Are pills marked Alza not generic? Are they sometimes? How can the medicine be just as effective as a tablet when supposedly the pump is what helps create the even dosing throughout the day? So frustrated and confused!!

    1. HI Roseann,
      Thanks so much for your report from the front lines. This is exactly what I’ve been fearing, this so-called “bioequivalent” substitute for Concerta that is really nothing more than Ritalin LA. It’s an outrage. I will be writing more details about this soon. If it were me, I’d take those M27 pills back to Costco and say that was a mistake; you need the Alza 27. And make a big stink.

      It is possible that your child will do okay on these Ritalin LA-like generics, but I sure would not bet on it.

      Frankly, I’m angry at this manufacturer’s cynical, craven exploitation of people with ADHD for their mining of FDA loopholes. Shameful. I’d like to mount a nationwide boycott.

      Stay tuned.

      g

    2. In response to Gina on May 17 (I can’t see how to respond to your comment)

      That’s actually what I did. My husband was the one who filled it, so when he brought them home and showed them to me, I immediately called the pharmacy. They tried to tell me it was fine. I took them straight to the doctors office, and they said to take them back. I did that, and the pharmacist was adamant they were fine, but finally said he would refund my money, but couldn’t take the pills back, but that I needed to take the pills to my doctors office and give it to them. He did reverse it on my insurance too, so I can still go get a new prescription of the correct stuff (in my opinion). I felt extremely stupid, but stuck to my guns because I really didn’t feel good about the M27 stuff. He even called my doctors office while I was there and got after them. He was apparently talking to someone different than I talked to, and he had that nurse talk to me. She was actually quite rude and made me feel even more stupid for not listening to the pharmacist, and that I was costing the pharmacy a lot of money, but in the end I was able to stick to my guns and say that I really wanted to take my prescription somewhere else. Once I left I felt so glad I stuck to my guns, but still felt stupid at the same time. I returned to the doctors office to give them the prescription and get a new written prescription, and the doctor and nurse there that I talked to reaffirmed that I was in the right. They made me feel better, which I was so thankful for!

    3. Woo-hoo Roseann – you’re my girl! And you’re not stupid — you’re smart. Very smart!

      Some day, we might not have a choice if we want generic Concerta; this poor M substitute might be our only choice, if we cannot afford the brand. In the meantime, the marketing agreement with Watson still holds to sell the brand as generic. So, if Costco is cutting corners already, I’d take my business elsewhere. That Costco pharmacy is simply buying the party line that the the M generic is just as good as brand — and want you to buy it, too. But consumer beware!

      We use a mail-order pharmacy, via our healthcare insurance. Might be worth looking into, if your policy features it.

  58. Hi Gina-

    I’m glad to have come across your info on generic v. brand or good generic v. bad generic. I have noticed the grades slipping from straight A’s to B’s with difficulty. Still, I am not complaining. I am hugely concerned with the shortage of the Meth 20mg ER. It appears to be a national shortage of raw materials. Any suggestions???

    I also want to ask how can I get a 90 day supply by mail when 1) it is a controlled substance and requires a script in person 2) my MD or my mail order pharm (can’t recall which) has said I can only have a Rx for 30 days at a time. I live near Chicago, IL. Am I getting bad info?

    1. Hi Tony,

      I haven’t kept up with the shortage controversy. Last I heard, it seems that the DEA has decided there will be limits on the “raw materials” for the stimulants, no matter how many people are diagnosed legitimately. Talk to your congressperson.

      re: 90-day supply, this might or might not be a feature of your insurance company’s prescription plan. Ask ’em. We send in my husband’s Rx to Arizona from California (previously, it was Texas, I think). Somehow, mail-order is different. You do have to send in a new script each time; no refills.

  59. Gina, sincere thank you for your quick response. Based on what you said, I’ll ask the doctor for another prescription and see what happens. Thank you so much once again.

    1. Good luck, Doug. I just don’t know what to make of these reports about the “Alza” generic not working. I’ve contacted the FDA and other sources to see about the chance of counterfeits. These things are tightly controlled, and the Alza OROS would be hard to duplicate with any kind of authentic look. So, I just don’t know.

      I do know that some of us will be in worse shape, when insurance companies start charging an even bigger premium for the brand and forcing people to take the “generic” — especially with this Malinkodt …..garbage…that is basically Ritalin LA. They’ve exploited the letter of the FDA law, it seems to me, in showing bioequivalence with Concerta. Shameful stuff, in my opinion.

  60. We got my 12 year old son his normal 30 day prescription of generic Concerta. Worked great last month. Got a 90 day prescription recently from Watson Pharma. It’s as if the medication no longer works. It’s as though he had stopped taking it. But, we’ve been adminstering it daily. The psychiatrist indicated that sometimes the dispensing mechanism(osmotic pump in the capsule) doesn’t work and providing a new prescription can solve the problem. Does anyone know which of the three generic manufacturers(Mallinkrodt/Methylin, Sandoz or Watson Pharmaceuticals) works the best?

    1. Doug, if you received the Watson “generic,” you received the brand. It’s “generic” only through a marketing agreement. You might want to read my posts on the subject.

      If it did not work, I would return it to the pharmacy and ask for another. But I’ve never heard of the osmotic pump not working. Could be true; just never heard of it.

      The Mallinkrodt “generic” is in no way anything like Concerta. It’s basically Ritalin LA. I am trying to get information so I can write up the details on this. Needless to say the companies aren’t forthcoming.

      I don’t know about Sandoz. If they make the generic Concerta in Canada, I’d avoid that one, too. It’s not anything like the brand.

    2. Four days ago, my pharmacy gave me a generic (Mallinkrodt ER 27mg) instead of Concerta for my 11 year old. It does not seem to be working, or working inconsistently.

      My child has become very forgetful, difficult to deal with and is unable to fall asleep at night. We did not experience any of these problems with the Concerta.

      Mallinkrodt’s ER 27mg tablet is a completely different shape from the Concerta tablet and may not be dissolving properly. I also suspect the formulation is different. I just did some searching on the internet and learned that Mallinkrodt just started manufacturing and selling this medication this year after receiving approval in December of 2012.

      I am going to call my pediatrician tomorrow and go back to Concerta.

    3. Thanks Jeanne. This is worrying, as many people will not be informed and will simply think that the medication doesn’t work (or worse, it’s not ADHD).

      If you can take the time to complain – to anyone and everyone – that might do some good.

      best,
      g

  61. Hi Gina,

    My son has been on Concerta 36 going on three years now and has been doing extremely well. He has diagnosed ADD with the major component being impulse control. He is an identified gifted child making A’s in all advanced classes, currently he is in the 7th grade. Last summer all of a sudden we noticed the impulse control issues were back. It was as if he needed a higher dose of Concerta. I became concerned that the pharmacy mistakenly gave us the wrong dosage so went to check the bottle. It was the generic… we had not known we were given the generic before I checked halfway into the month (I know, irresponsible on my part for not double checking) Anyway, I called the pharmacist who assured me it was the same med. I called the doctor who said it is supposed to be the same so she was also at a loss as to why. We got a new script written expressly for brand and things have been fine since… UNTIL…. this year my insurance is now making brand Concerta financially difficult for us. We asked for the generic this month, with immediate changes in behavior. This time I know its generic so some people might say its the placebo effect, but given our previous experience I truly believe the generic does not work as well as the brand for MY son. I don’t know why and definitely would never say its the same for everyone but for my child, the brand works better. With or without prior knowledge of generic, his behavior is different. I’m going back to brand Concerta even at $109 compared to $25 for generic… my sons future depends on it.

    Hope you find out something to help those of us who do notice a difference when nothing is supposed to be different….

    Donna

    1. Hi Donna,

      I don’t know what to tell you. If it says Alza and looks like the images of brand Concerta that you can find on the Internet, it IS the brand.

      There is apparently no way that could be copied and sold through a pharmacy.

      You sound emphatic, though, so I just have no idea what could explain this.

      There is another “generic” coming out….I’m still researching it, because I can’t see how the delivery system is anything close to Concerta. It’s just a pill. No osmotic pump. So, when insurance companies see that cost-savings, I’m afraid it will get worse for people who can afford only the (true) generic.

      I will post about it soon. Still waiting for info from the company.

    2. Donna could be describing my son exactly. He’s also 7th grade, gifted, A-student who has been doing well on Concerta Brand and also the Watson Generic. Last month our pharmacy switched to the Mallinkrodt manufactured brand and everything changed. His impulse control & focus issues were back with a vengeance. He noticed a marked difference in the effects of the medication throughout the day, and told me to PLEASE find the old medication.
      I’ve done some other research and according to the press release for the Mallinkrodt product, “the FDA found that our long-acting technology delivers a dose which is therapeutically equivalent to what is currently on the market.” I disagree completely with their statement. If you have found similar issues with their product, please notify the FDA here: https://www.accessdata.fda.gov/scripts/medwatch/. It is the only way we (as consumers) can have an impact.

    3. Our pharmacy gave us the generic and never said a word about it. The very first time my son took it, he was a completely different person! I knew something was wrong. It was the generic. He is allergic to methylphenditate and HAS to have the brand Concerta. As long as the doctor writes DAW on the script you can get approved by the insurance company for the brand.

    4. Hi Kathy,

      How can your son be allergic to methylphenidate yet have no problems with Concerta?

      Concerta contains methylphenidate. That is the active ingredient.

      g

    5. I have 3 kids with clinically significant ADHD symptoms. We have used both the generic methylphenidate and brand Concerta intermittently with 2 of them. Both white pills look identical with the alza 36 imprint. They are NOT the same. The brand is at least 20 percent more effective in managing symptoms every time we have switched due to cost. I don’t know how the pharmaceurical companies can get away with claiming they are bio identical. They are definitely not. My daughter fails on the generic and can teach her peers on the brand. We have tested three different times witth the same results.

    6. Thanks, Annelle. Stories such as yours make this topic even more confusing than it already is. Your children are lucky to have such an attentive mom.

      best,
      g

    7. My son is 7 and was giving the Kremers Urban generic concerta. He started hurting himself. His doctor and pharmacist agree it could be something in the medicine, a preservative he’s sensitive to. His therapist doesn’t understand how this generic concerta is being seen as time release without the capsule and that also may have played a factor. He’s getting too much at one time. I am ANGRY at my pharmacy because it is their job to know these things. I was even told today that Atavis was no longer making the meds. No news on Watson. I called another pharmacy and they have not heard. You really can’t trust companies. They will do anything they can to keep you and your money. 🙁 I hope your son is on the right thing.

    8. I’m sorry to hear this, Michelle. Poor little guy. 🙁

      I’m angry, too. How dare these inferior products be foisted on a naive public — and pharmacists who argue that the generics are “same as” are part of the problem. I guess they don’t take a hippocratic oath.

      My advice is, ask for “OROS, Watson or Actavis”

      good luck!
      g

    9. I find it funny that many parents love to share the fact that their child is identified as “gifted” almost as if they’re making it known their child is better than most. My child is gifted too!! Although he isn’t in “AG” classes he is an honor roll student, however HIS area of being gifted is in the area of respect, empathy, trustworthiness, and being humble…….which is a trait MOST identified “AG” kids lack.

    10. I understand what you mean, Keith.

      Actually, I find the whole nomenclature reprehensible. And I remember thinking that when I first heard the term used back in the 1980s?

      How dare they (teachers, parents, tests, etc.) decide which children are gifted and those who are …not?

      The very idea of it….of children being told that other children are gifted but not them? It’s an entirely crazy-wrong idea, imho, on so many levels.

      g

    11. What a nasty little comment you made at the end Keith.. hope that made you feel better. Meanwhile my son also possesses those same quality traits. Forgive me for using the term “identified gifted” to give Gina as much information about my son as possible. Its not something we “brag” about as you imply, and in fact my son will tell you “gifted” does not mean he is smarter or better than anyone else but just that some people feel he thinks about things a different way. If all you took away from this entire thread was the fact that I used the term gifted, perhaps you lost sight of what was truly important about the original article.

    12. Hi Donna,

      I’m sorry. I didn’t realize that Keith’s comment was following yours. (I’m speaking at a conference in Turkey, and my Internet connection is extremely slow; makes everything more difficult.)

      Of course you were right to include that information (“identified gifted”). It does provide a fuller picture and has nothing to do with the wisdom of a system that makes (or doesn’t) such designations.

      I would still be cautious about accepting the term “gifted” in the context of ADHD, though, because it often follows that the child will not be adequately treated, that the “giftedness” will be seen as contributory to their challenges.

      Sorry for the misunderstanding.
      g

    13. Gina this is precisely why I included the information. Before starting Concerta I frequently heard “Your son should be doing better, he is gifted and this is a core class”

      My comment was not meant for you but more for the derogatory way Keith implied because I used the term I was bragging about my sons accomplishments or academic status. Its amazing to me that Keith would comment about his child’s wonderful qualities and then show himself in a negative light with his accusation about “most gifted children lacking…”

    14. Yes, I understand completely.

      Sometimes people get carried away on the Internet.

      For example, you wouldn’t believe the names I’ve been called (and people even impersonating me and making comments under my name), all because I say ADHD is real. 🙂

      g

    15. PS… I am still paying out of pocket prices totaling more than $110 monthly for the brand because the “generic” just does not seem to work. Knowing that the generic comes from the same manufacturer and is supposed to be the exact same makes me feel crazy wondering WHY… why does it affect my son and so many others differently. If I had known I was given the generic the first time, I could understand…. thinking that perhaps it was the placebo effect. Frustrating.

    16. Donna, I honestly think that there’s something else going on. There is no reason to think that the Watson authorized generic is one iota different than the Janssen brand Concerta. They are the exact same. Indistinguishable. Perhaps something else has changed for your son. Growth spurts, hormones, changes in routine — all these can make a different in medication efficacy.

      best
      g

  62. A question for those who wrote to say that the “generic” is not working for them. If you missed my cautions elsewhere, it’s important to know that the brand-generic of Concerta will say “Alza” — just as depicted in this blog post.

    If you are in Canada, there is a generic Concerta that is NOT the same as the generic in the U.S.

    More recently, a new generic Concerta has entered the market. I am attempting to get more information on its appearance and the technology used (OROS or not?).

    Stay tuned….
    Gina

  63. My son has been on brand name Concerta for over two years (manufactured by Jenssen Pharm). His focus improved tremendously as did his grades. We are very happy with the product. In the last month my son has been telling me it isn’t working any longer. He is unable to focus and his mind wanders. It recently dawned on me that the only change in his life has been the switch from Concerta to generic Concerta (manufactured by Watson Labs) – no change in dosage. He is now back on Concerta, no longer using the generic version and his ability to focus has returned. I myself have taken generic versions of medications in the past with no problem so never thought twice about putting him on generic when the pharmacist asked if that would be okay. I assumed the generic would work exactly as Concerta had. I am at a loss to explain, but it appears the generic form is ineffective for my son, which is very unfortunate as Concerta is quite costly by comparison.

    1. Hi Shelley,

      Thanks for sharing your anecdote.

      I’m curious about a few things:

      1. Did you tell your son he was taking a “generic”? If you did, I would be tempted to try the medication again in the future, this time not telling him and see how it goes. As you say, the cost disparity is quite large.
      2. Could it be that something else had changed in his life temporarily, such as a big paper due, relationship issues, even a flu or cold or seasonal allergies?

      I’ve researched this issue as far as I can take it, unfortunately, and everything I’ve discovered confirms that there is NO difference between the “generic” and brand Concerta. It is a “generic” only by a marketing agreement and is, in fact, the exact same – meaning manufactured in the same plant under the same FDA standards, meaning, indistinguishable from brand because they are one in the same.

      thanks,
      g

  64. It is so interesting to read these posts as I have been on the generic Concerta go round for six months. My 14 year old daughter had no idea she changed to generic but her behavior was similar to many others, added anxiety, evening outbursts, etc. I switched a few times and even tried a new drug, but to no avail. So we are going back on Concerta non generic to a tune of $167.00 a month. I know this is still a good deal, but my co-pay used to be $25.00. Hard pill to swallow, so I wouldn’t be doing it if it wasn’t essential…

    1. Hi Nancy,

      I made another effort last week to go to the “horse’s mouth” on this topic, and everything I’ve learned confirms that the “generic Concerta” in the U.S. is EXACTLY the same. Because it IS the same medication. Made in the same plant. Under the same conditions. Undistinguishable from the brand.

      What might be happening with some of these comments it is perception bias OR other changes, such as hormones, development, dietary changes, or a host of other potential factors.

      What you’re not hearing from, in these posts, is people who’ve done as you say you will do — stop the generic and go back to brand — and are reporting that everything’s back to normal. (I don’t recall seeing that type of comment, but I will double-check when I get a chance.)

      If I were you, I’d be looking at other factors before spending that extra amount of money.

      Good luck,
      Gina

  65. My son was on the name brand Concerta for a few years and just recently switched to the generic (US-California). I could definitely tell a difference! He is was so sensitive and just wasn’t himself anymore :/ I couldn’t joke with him or play…he took everything so serious. All he wanted to do was play video games or watch TV. He was not like this before the generic came out. I argued and argued with the pharmacist who assured me it was the same. I eventually took him off of it and hes going un-medicated right now. But guess what….? I have my boy back…he jokes around and plays like a normal kid 🙂 He is having trouble in class and I’m really working with him at home to make up for that. We may have to eventually home school him, I’m not for sure. I just wanted to “side” with the other parents on here, there is a difference.

    1. Thanks for the feedback, Alysha. It is a mystery, these reports such as yours.

      I have made multiple queries with the FDA and various contacts among scientists who are familiar with FDA quality controls — but no response!

      I will keep pursuing it.

      In the meantime, please know that just because the generic supposedly had this effect (and there are variables, you know, including something else that might be going on with your son, such as a growth spurt or something happening at school), it doesn’t mean that it’s a great idea for him to go completely Rx-free if he needs it.

      There are many other options worth exploring.

      Also, you don’t make it clear as to whether he was benefiting from the brand Concerta — only that he became more serious after starting the generic.

      tx
      g

  66. My insurance will change in January 2013 to a straight 20% coinsurance for all covered expenses including drugs. We’ve been used to pharmacy by mail co-pays for 15+ years. I am taking Methylphenidate ER 36 mg 24 hr Tab (Concerta generic) and we currently pay a $10 co-pay for 180 pills which is a 90-day supply. My husband called the pharmacy to check on the actual cost for my 90-day supply and we were completely shocked to be told that it will cost us $908.00 for 180 pills. How can this be a generic? Why on earth would the cost be so high? Mind you, I’m not taking Concerta, I’m taking the GENERIC drug!

    1. Hi Nancy,
      I know. It’s a shocker, isn’t it?

      First thing, you ARE taking Concerta. It’s only technically, for marketing purposes, the generic.

      Second, it depends on the pharmacy. You might want to shop around.

      Third, we had that choice of policy for my husband’s health insurance and declined, opting for the one with better insurance coverage. It is a little more expensive, but it is the better policy for him. That other kind of policy is usually more advised for young people or people taking no Rx.

      If you can switch at open-enrollment time, that might be a better idea.

      Good luck,
      g

  67. g.

    Thanks for your timely reply.

    1) Family Health Care: We’ve not been eligible for coverage through work as my wife’s company only has 2 employee’s (boss and her) and the cost’s for a 2 employee company are too high. I work 2 part time jobs. A local public school and a bus company. The bus company only has coverage for me if I pay 100% of it and the school’s ‘family coverage’ would be $1100 per month, which is more than I make as a part time employee. So I’d end up paying the school district to permit me to be an employee if I went with their program. As for government assistance, since my wife and I both work and make ‘Too Much’, thus far we’ve not ‘qualified for any government health aid program. I too had opted to have health care insurance be coverage for catastrophic illness, not routine doctor visits. Hence we’ve paid out of pocket for the last 6 years all our health care costs. In the end, compared to the other ‘health care’ options we have we’ve copme out on the paying end. However, my son’s meds costs are crazy. If people who have insurance realized the ‘real costs’ they were paying there would be a revolution in the streets. Yet everything is masked by 3rd party payment systems. I’m a sceptic about the newest program … ACA. I’ll only believe in real change when I see it in my pocketbook.

    2) Concerta at less $: I found a coupon program at ‘GoodRx’ site for $78.73 at a local pharmacy (not Costco). I’ll call the direct numbers you listed for Watson. I’ll also check if Costco has the mail order program. My son’s Dr wrote three prescriptions each for 30 days for the next consecutive 90 day period. We’ll also check your other recommendations for the manufacturer’s $ assistance program as well as the pharmaceutical clearinghouse for financial-assistance programs too. As well as CONCERTA® phone number being 1-800-JANSSEN.

    I’ll update you on our results.

    Thanks
    -Bill

    1. Good luck, Bill! And it would be great if you could report back with anything useful you learn for others — from Watson, Costco, etc.

      As for people who have insurance failing to realize the “real costs,” co-pays have gone up, too, in the last 10 years. Even insured people have felt rising healthcare costs over that time. It was unsustainable.

      It’s been a crazy healthcare “system” for many years, with for-profit insurance companies, big healthcare chains/hospitals, pharma, big “Farma” (agricultural subsidies, etc.) the AMA, and more dictating the rules. It’s time we get down to what’s good for people’s health. 🙂

      g

  68. I have a question… as an uninsured parent, my family has been paying full price for my son’s Concerta 36 mg cr tablets. Obviously as being uninsured it means that my family cannot afford ‘family health coverage’ which would be over $1100 a month.

    So… my question is simply this. Where/what is the best resource for getting the “U.S. generic for Concerta methylphenidate hydrochloride extended-release tablets”? We’ve been going to Costco pharmacy and every month the cost goes up and the non-generic has been $180 for each 30 days supply ($540 for 90 days supply). My son needs these meds to be academically successful in school, but we can’t seem to get any local pharmacy to be forthcoming with anything other than name brand Concerta.

    My son’s Dr just rewrote a 90 day prescription for Concerta 36 mg and then told us to shop around and that a generic should be available for about $60.

    Where do I start? Calling random local pharmacies or some online mail-order site or what?

    I want’ my son to be successful, but not at the cost of not eating meals.

    -Bill

    1. Hi Bill,

      I appreciate your wanting to give your son the best opportunities for medical care. I’m sure your persistence will pay off!

      First, regarding healthcare coverage:

      In the past, I used to advise people to find a good healthcare insurance broker. Many consumers failed to realize that you could get a cheaper premium by opting for a higher-deductible plan. The money that you’d save could typically cover routine doctor visits throughout the year – and then some. Plus, having healthcare insurance gives you a negotiated discounted rate with care providers and Rx. For 20 years, I’ve held an individual policy with a high deductible. I’ve always seen insurance as something to cover catastrophic illness, not routine doctor visits.

      Now we have the Affordable Care Act (ACA), designed in part to help people in your situation and to reform the many problems with our spiraling out-of-control healthcare costs. You could check your state webpage, which I understand should be posting information regarding affordable insurance options. Some states have delayed in implementing the law, apparently waiting for the federal government to do it for them, so you might want to start your search at this U.S. federal government website, and check the pull-down menu for your state:

      http://www.healthcare.gov/

      Second, about finding Concerta at a discounted rate.

      First, see if you can get the generic version of Concerta. (Which, as I’ve noted in this blog post, is actually the exact same as brand name; it’s distributed by Watson via a marketing agreement with Concerta’s manufacturer.)

      Here is the customer-support number for Watson: (800) 272-5525 Ask if they can tell you who carries the generic Concerta in your area, or how you can avail yourself of it by mail order.

      In my experience, Costco usually has a competitive price. Check to see if Costco has a mail-order program. That’s how you can get a 90-day supply at a reduced price.

      Also, you might qualify for the manufacturer’s financial assistance program. Pharmaceutical companies have developed a clearinghouse for their financial-assistance programs: http://www.access2wellness.com or call 866-317-2775.

      You might be able to find out from Concerta’s manufacturer (Janssen) if you don’t find answers from the above website or phone.

      The CONCERTA® phone number is
      1-800-JANSSEN, and we are available from Monday through Friday, 9:00 am – 5:00 pm ET.

      I hope this helps, Bill.
      g

  69. I have been on concerta (generic) 36 for about 7 months and felt it working. I needed to increase my pill due to new changes in my life and started Concerta (generic) 54, this is the first month but I can not feel anything. Is it unusal that I can feel the 36 work right away and not even feel the 54?

    1. Hard to say, Rebecca. There are two variables that have been changed — the increased dosage and the generic version (which, in reality, should be the exact same as brand).

      Ideally, you don’t “feel” the medication work, in the sense that it makes you feel speeded up or other physical effects. You observe the results of the medication working in that you are able to focus on what you need to focus on, organize, and other tangible means of enjoying improved brain function. That’s how you judge medication efficacy.

  70. We are going to discuss her options with her doctor in the next two weeks. Right now, she remains off of the med, and is doing well.

  71. My daughter was on name brand Concerta for 10 years. The first day she was on the generic Concerta I noticed that she was cranky in the afternoon. During the past few months of daily generic Concerta, her anxiety level grew, and she has had angry outbursts, always in the evenings. It was like switching on a lightbulb, how quickly she became upset or angry. I asked her doctor if it could be the generic Concerta as the cause. He assured me that the two drugs were the same. After a particularly bad evening last month, I contacted him, and although he did not think it would make a difference, he agreed that she should go off of Concerta completely. Since then, she is calm, and it has been three weeks now, with no anxiety or angry outbursts. Reading this blog suggests to me that some people, like my daughter, are sensitive to some type of change in this drug when it became generic.

    1. Hi RW,

      Thanks for recounting your experience. It’s so hard to account for — the two are manufactured at the same plant, under the same protocols — but I don’t doubt your observations.

      I wonder why she didn’t go back to the name brand Concerta she’d used for 10 years (apparently, to good effect) instead of stopping medication entirely.

  72. 1) As a 42 year old diagnosed with ADHD in my mid-30’s, my experience is that the efficacy of the generic is virtually identical to that of the brand name. The only difference I’ve noted is that the side effects seem to have hit me a little differently and it may not last quite as long through the day.

    2) If a pharmicist tells you there is no approved generic for Concerta, go to the next pharmacy down the street. I was given the brand name at a big box store. When they charged me $45 (vs. $0 for the generic), I was told that there was no FDA approved generic for Concerta. The next day I drop my prescription off at another location of the same chain and get it filled with a generic.

  73. For what it’s worth, my doctor, who is a bit anal about “details”, also told me that the coating on Concerta is different than the generic. He talked about the holes drilled in the pill as well. The way he explained it to me is that the patent is for the coating. The coating has short-release ritalin which kicks in immediately; once the coating is dissolved, the inner part of the capsule starts taking effect. My doc said the manufacturer did that because it takes about 45 minutes for the drug itself to kick in. The coating was added to get more of an immediate effect. The patent also differs in terms of time-release. Same drug but the patent is for the time-release. So yes, a generic version will time-release differently.

    When I took generic ritalin, it felt like a sudden “burst”, then it would level out and I would “crash” when the medication was starting to wear off. 2nd dose during the day, same thing.

    I have taken concerta for over 10 years and it has been exceptional for me. My pharmacist changed it over the generic concerta about a year ago and I absolutely can tell a difference. Not necessarily bad but it does not feel AS effective as Concerta. Concerta was solid in terms of time release and it feels like the generic wears off much sooner. That has just been my experience but I know there are differences. I think it doesn’t effect some people and some people it does.

    1. Hi Lori,

      Thanks for sharing your experience. I don’t how to account for yours and others’ reported experiences, other than to say that the U.S. generic Concerta is the exact same as the brand. The patent, as I understand it, is on the osmotic pump.

  74. Pingback: ADHD Roller Coaster: "Is It You, Me, or Adult A.D.D.?" · A Pharmacist Explains Generics and More

  75. Hello Gina and everyone. I’m chiming in on behalf of the pharmacists out there. Just a little background on me, I live and work in Florida at a Walgreens pharmacy. I’ve been in the profession for 8 years now and have a large base of ADHD patient and we keep a large stock of every one in for a large population. After reading all of the posts here, I am sorry that everyone has experienced the problems they have put in here. I’m going to give a little bit more information that may help some people though some others may not accept it. The first thing is about the markings and the tablets found in the US. When a generic medication is approved by the FDA for distribution, if it is not made with the same exact process and ingredients, the manufacturers are required to change the markings on it and often the shape or colors are also changed. This is to signify who the manufacturer of it is for identification purposes. If they change one iota of the process or they change one ingredient such as a binder or filler or anything else, this holds true. Therefore, the medication that is being dispensed as the generic Concerta is in fact the brand because it looks exactly the same (assuming there aren’t any counterfit medications going around) and has the same exact markings. Now, to say that there is less medication in there or that it is being changed for the generic, every company has to follow strict quality control procedures and medications are a lot stricter than other types of manufacturing facility. The batches are all numbered and they have to give consistent results otherwise, we would get a notification of a recall due to whatever the problem was that they found. So, I do not believe that there are any problems with the generic medications before they get to the watson plant for packaging. That brings us to the bioequivelance part. For a generic to be approved, it has to expose the body to 80-125% of the same medicaion compared to the brand (not other generics) as referred to by Gina earlier. This is calculated as the AUC or area under the curve. This means that as the body breaks it down, you can measure blood levels of it every hour until it reaches clinically insignificant levels. Add all those levels up for the brand and then multiply it by 80% and 125% to give you the range of what you need to see. The medication can give exactly the same curve, higher at times and shorter length of effect, or longer effect and lower curves or whatever combination that gets it within that range. For most medications, this isn’t significant like ciprofloxacin whose dosages are 250 and 500mg. But medications like synthroid that have very small increments, this can give a very significant response. But, that’s not a reason to not use the generic medications either. That just means that you usually have to go up to the next higher dosage or sometimes 2 higher to get the same result.

    I do NOT claim to know all the laws in all other states, but florida does have what is called a negative formulary. On this formulary, medications that the generics do not show similar pharmacokineitcs are deemed to be NOT SUBSTITUTABLE based on the AB rating found in the orange book. Synthroid was on this list in the past, but has been removed. Some things on our list are conjugated estrogens and Extended release theophyline. There are 6 drugs on the list now for us, but other states can have these which would be possible as to why someone said their pharmacy told them that they needed the prescription wrote a certain way. Yes, Mail order is an effective way to get any of them cheaper for you if it is available. All mail order facilities have to comply with the laws of their state and the ones that they are distributing to. The controlled substance act (CSA) does not state an expiration date on any Schedule II medication or C-II medication, nor does it place limitations on the quantity that can be wrote for. Some states do put limitations on these, for example, in Florida, all C-II prescriptions expire one year after they are wrote. But all other prescriptions do that too, with the exception of C-III to V expire 6 months from the date that they’re wrote. So, your doctor could in theory write you one script for a years supply of the medication, but I doubt that anyone would fill it or an insurance company would pay for it. Good general practice guidlines would be that if it’s older than 3 months ago, contacting the doctor to see if it’s still appropriate and the current dosage should be done. Another thing that should be noted that people have commented about is that it is actually Illegal according to the DEA for a pharmacy to accept any controlled substance back from patients for ANY reason. I was at a conference that the DEA hosted and discussed this topic with us because there were many questions about it in March. Therefore, I always suggest before paying for your medications to ask to look at it and ask what it is and what it is for and if brand or generic was dispensed, etc. That way, you don’t get something incorrect and get stuck for a month without the medication. There was another commenter above that said something about getting methlyn ER and then being given Metadate CD instead one month. These are 2 very different formulations which should not have been interchanged unless the prescription states it. Methlyn ER is a tablet and Metadate CD is a capsule. This is not an acceptable interchange as they are different dosage forms and have some different pharmacokinetics and would have definitely seen a difference in effect. For that person, I’d suggest visiting that pharmacy and ask for a copy of the prescription. If it says a dosage form on it (like ER), I’d bring it up to the pharmacy manager and ask for a refund for a mistake that was made. Our policy is to make ammends for mistakes like that. We have an internal review process that protects us legally to errors because everyone can make a mistake, but as long as you learn from it, it shouldn’t happen again. Normally, we just refund your copayment so there would have been no cost to you, and even if there wasn’t a cost out of pocket, they need to know about the error so it doesn’t happen again.

    And the last topic that I’d like to talk about is switching and the response to which one is taken. When any study is performed to evaluate the patient’s response to a medication, they do what is called a double blinded study. That means that neither the person taking the medication nor the person distributing the medication know which one they are receiving. This is done to make sure that there isn’t a bias involved in the effects. When you are taking it or are giving it to your child, you know what you’re giving them so you are always biased on the effects. Whether good or bad. I do understand that there is inter patient variation and not everyone responds the same way. But to say that the same tablet manufactured by the same company coming out of 2 different bottles that are labeled differently is along the lines of the placebo effect. Another example of this is when I have patients come in and say that claritin doesn’t work for them, but alivert does or motrin works, but they get no relief from advil. It’s the same medication with a different brand name (loratidine and ibuprofen respectively), so if one doesn’t work, the other one can’t either. That’s also like saying you don’t get any nutrients from a granny smith apple but you do from red delicious ones. Yeah, they may taste and look different, but getting nothing from one just won’t happen. This again is something that the FDA wouldn’t allow to happen through regulations and monitoring. If it’s made to go into one bottle, it’s the same stuff to go into another bottle.

    I will say that I am open to all criticism and questions. I do have an open mind for most things, but with all of the regulations the FDA has in effect and the quality control measures in place to prevent changes to the formulation and process for the drug to be made and then distributed by the 2 different companies, I don’t think my view on the fact that there isn’t a difference in effectiveness will change.

  76. I just googled and found goodrx.com/concerta wow! I am really feeling deflated right now about the cost of this medication. I’m thinking that concerta must be in high demand for that price for a generic.

    1. Darn. You’re right. It’s barely cheaper than the name brand (which this “generic” is, of course).

      I’d still check to see if you have mail-order.

      Janssen’s website says this: For information on free or discounted prescription medications, visit access2wellness.com or call 866-317-2775.

  77. I have been requesting the generic concerta since it became available for my son in 2011. So far, nothing has changed, still the same positive results. The only that has changed this year: the cost. $157 for the generic. I realize this is because of our insurance, but this is the full cost we are having to pay since we no longer are able to have copays allowed (we have to reach a high deductible). At this point, I am considering stopping it. It has been the script that has worked the very best, but at $157 a month, more than $5.20/pill, along with another $150 every 3 months for a med check, I just don’t know if we can afford it anymore. That’s the cost of a high end coffee that I also stopped buying years ago because I couldn’t afford it.

    1. HI Mel,

      Is that $150/month?? That is expensive. Though, I tell you what, so is untreated ADHD. It has vast and long-lived repercussions.

      Have you tried getting a 90-day supply via mail order? That’s usually cheaper.

      Or try shopping around — maybe Wal-Mart or Costco.

      After trying all that, you might want to check with the company’s financial-aid program.

      good luck!
      g

  78. My 6 year old son has been on the Daytrana patch 15 mg for the past 9 months and it has worked great for him in school. However it’s been starting to get really hot here in Mississippi and the patch delivers more of the meds when it’s hot, and he’s been absolutely a zomby when trying to play baseball and this is 2 hours after removal of the patch. So his dr has changed him to Concerta 18 mg, which he started today, and I really can’t tell he’s even on meds now. His dr didn’t mark generic or namebrand when he wrote the prescription, but did explain to me that his reasoning for choosing Concerta was because of the advanced delivery system it has. The pharmacy have us the generic, and now after reading today, I’m wondering if this wonderful delivery system isn’t the same in the generic. Not sure what I should do. Wait, try to exchange at pharmacy (IF even a possiblity), or what. Any suggestions?

    1. Hi Kim,

      You should ask your physician, but there are many reasons why the Concerta might not work as well as the Daytrana patch for your son. The methylphenidate in the patch goes directly through the skin into the system; the pills must go through the GI tract. Much can happen there to mitigate the effectiveness of a medication.

      It might be that your son needs a higher dosage of the Concerta.

      I had not heard that about perspiration increasing Daytrana’s effectiveness (assuming that’s what you mean). I wonder if you can cut the patch, so as to make it smaller and perhaps the right dosage in the heat. It might be worth your calling the manufacturer. (Just Google “Daytrana”.)

      I’m 99% sure you cannot exchange the medication once opened.

      Good luck sorting this out.
      g

  79. Okay….I have taken concerta for several years I was off of it for the past year bc I was pregnant, etc…. when I filled my first scrip my copay had gone to $60.00….UGH!!!! So I talked w my pharmacist, who informed me that there was a “generic,” but my Dr would have to write a new scrip by that exact name, because…..the FDA does NOT recognize the “generic” as a generic so the pharmacies CANNOT fill a concerta scrip w the methylph…..whatever it is. Make sense?? So, the I paid my $60 and went on, the next two months I requested the generic from my Dr….went to my usual Target pharmacy, they weren’t stocking it???? So I drove to CVS, got it no prob, looked exactly the same….but only cost $30, I thought they screwed up, same thing the next month….then about two weeks ago I started to realize that I was so off task, not finishing things, remembering things, being impulsive w all kinds of things…..so I mentioned to my Dr, reminded her I have a 3 yr old and a newborn….maybe that’s it, she laughed and said let’s go back to the concerta…so ibid, headed to Target, discussed my feelings w the pharmacist again…..and she totally confirmed that the methylphenidate or whatever is NOT a generic.for concerta, the FDA has not Approved it…..hence why i cant fill my concerta scrip w the generic, its NOT a generic. Anywho….I have my $60 scrip and hope it works like it should…
    And I’m in the US….so confusing, but I will say they are NOT the same, wish they were…..

    1. Hi Susan, With a 3-year-old and a newborn, you have your hands full!

      I’m confused by parts of your report.

      1. “The FDA does not recognize the generic as a generic.”
      The generic would not be available if it weren’t recognized by the FDA.

      2. “My Dr would have to write a scrip by that exact name.”
      I wonder if the pharmacist was confusing the generic for Ritalin with the generic for Concerta. For both, the active medication is methylphenidate (MPH), but the delivery system is very different.

      Perhaps the pharmacist does not realize that there is an “authorized generic” for Concerta.

      My understanding is that the pharmacy can always substitute a generic unless the MD has expressly said “do not substitute with generic.”

      I hope that your new “brand” Concerta works for you. But really, it could be the newborn, eh? Pregnancy and delivery really changes your hormones and, as a result, your neurotransmitters.

      good luck sorting this out and thanks for sharing your experience.

  80. Stumbled across this board and thought I’d throw my two cents in. I’m in my forties and have been using Ritalin and/or Concerta for over ten years. I live in the US. Last summer, I noticed that the Concerta wasn’t working. I was hesitant to up the dosage and my MD advised that that I’d been using generics. I switched to Focalin with limited success and then back to Concerta – non-generic. The difference was immediate and noticeable. Now, unfortunately, I was given a generic brand again and, while I notice from above that there shouldn’t be any difference, I can’t help but notice that the drug isn’t working as well as it has when using the non-generics.

  81. I just switched back to Concerta fom the generic and did notice a difference in the Alza stamp size and the pill shape. The ends of the pill are not exactly the same so how can the generic be the same exact pill as the branded one if the stamp looks different and the shape is slightly different. I will keep you posted as to whether I notice a difference over the next two weeks. I just know that I felt great until about six months ago and that is when I was switched to the generic. I live in the U.S.

  82. Hi Gina,

    I my child is 21 now, and I find myself without coverage for his meds, which for asthma and ADD are expensive! I just had to pay $185.00 at CVS, in L.A., California for generic Concerta (Methylphenidate ER 36). All this year, each month we’ve been paying more and more for his prescription. I wish I could find the sort of savings you write of. Any source suggestions would be VERY appreciated.

    Thanks!

    1. Hi Beverly,

      You might want to shop around, even checking Wal-Mart and Costco.

      Also, your son might qualify for assistance from pharmaceutical manufacturer. Most have programs that help those who cannot afford the medications. Contact Concerta’s manufacturer (Jannsen Pharmaceuticals).

      For information on free or discounted prescription medications, visit access2wellness.com or call 866-317-2775.

  83. I bought the generic concerta a couple days ago because I have no insurance and the “real” would have cost $265 (36mg, 30 pills). So far I hate the effects I am feeling! I can’t focus or remember a thing! My brain is racing (opposite of real concerta!) so bad I’m combining words,can’t finish a sentence or grasp a thought! Physically I feel uncomfortably wired and my ears are ringing. Anybody else have this happen to them? Right now I wish I paid the extra $85 for Concerta. I can’t imagine taking this stuff for a month!!!

  84. Thanks so much for all of this voluminous information. My son was just diagnosed with ADHD (he is 8) and I live in USA. Just filled his first script for Concerta (18mg), and they gave me the generic. He’s been on it for only two days, and his impulsiveness seems to have decreased, however, his teacher still needs to redirect constantly. I’m hoping that with increased dosage (as his doctor suggested might be necessary after a trial period), we will have his issues under control, but after reading all of these posts, I may bite the bullet when his next script is due and pay the $120 for the brand name.

    1. Hi Deb,

      It took my son months to acclimate himself to ritalin/concerta. His brain needed to adjust to the drug. Now, for him, what a help it’s been! Give it a little time before changing it around. And good luck! Incidentally, my son now uses generic and doesn’t feel a difference.

      Best, Beverly

  85. My 7-year old son was diagnosed with Inattentive ADD a little while back, maybe in September. He has been on Concerta since about week after his diagnosis – the first med caused heart palpitations. He is now on 27mg Concerta. Recently, we went back to the psychologist for further testing (learning disabilties) and the psychologist told me that my son should NOT take the generic form of Concerta, that is an inferior product. (We are in California). He went on to say that the FDA does not set standards for generic medications like they do for the brand name medications, and that the generic form is substandard. We started my son out on Concerta, but then I read the generic was the same med so for the past few months I filled the Rx with the generic.

    That was a mistake. My son stops focusing about 8 hours in instead of the duration he was able to focus on the Concerta. My proof was that in his after-school martial arts class he had been able to focus, but on the generic he was not able to focus because that is later in the day.

    I just filled his Rx today and have a few of the generics left. I cannot tell one iota of difference in them in a side-by-side comparison, but I see the differences in my son when he takes both types.

    1. Hi RS,
      The FDA does, in fact, set standards for generic medications. The possible complications come from issues I wrote about in this blog post from 2009:

      Moreover, as any experienced physician can tell you, generics can wreak havoc with that narrow “therapeutic window” — the dose that works best with the least side effects. A few miligrams up or down can mean trouble, and the FDA allows a wide window of efficacy. In the U.S., the FDA requires the bioequivalence of the generic product to be between 80% and 125% of that of the original product. Bioequivalence, however, does not mean that generic drugs must be exactly the same (“pharmaceutical equivalent”) as their original product counterparts, as chemical differences may exist.

      Moreover, branded drugs and their generics almost always contain different dyes, fill materials and binding — ingredients to which many people are allergic or have other adverse reactions. (And while I have no proof that it’s true, abundant anecdotal reports indicate that people with ADHD seem more prone to these sensitivities.) Imagine what happens when your pharmacy changes suppliers on a regular basis (and this happens at many pharmacies). Imagine when your physician has no clue that it’s the filler that’s the problem and not the medication — or some “unmasked” co-existing disorder, like bi-polar. Talk about neurochemical roller coasters! Consumer Reports tests cars, so you should trust them that this is a safe ride? Not on your life.

      You can read the rest of the post here: https://adhdrollercoaster.org/the-basics/consumer-reports-on-vacuum-cleaners-maybe-on-adhd-medications-definitely-not/#more-96

  86. I just wanted to chime in on this, I was web surfing about this and found you all.

    I noticed I had received the generic’s about a couple months back at Walgreen’s when my script copay dropped in price from like 30 to 5 dollars. I asked if they made a mistake, and they replied no, so I let it slide figured they made a mistake in my favor. Later I did notice on the bottle it was not Concerta anymore this concerned me, after all this stuff does who knows what exactly??… and it does it in the brain! I don’t want any mess ups in there so I had compared to some older pills I had in the cabinet, and they looked identical but, I did notice it was not working as well. So on my next refill I requested Concerta instead of the generic, and I definitely noticed a difference. It did cost more but in my opinion they are different. If you have any doubts try switching back and see if you have the same results.

    It was funny when I requested the non generic Walgreen’s took like a week to get order filled.

    I live in the US near Chicago

  87. I, too, had a bad experience the first time I tried the identical generic. I went back on the name brand and it worked again. That was last summer. Now, due to the fact that I forgot to specify, I am taking the generic again, with no apparent difference in effect (and at a much lower copay, I might add).

    Could it be there is a QUALITY CONTROL problem with the Watson version? We have pretty much established they are the same drug, made on the same production line, with the same markings. So maybe the problem is with quality control during the Watson production runs, or with handling or temperature or humidity post-production?

    This is the only theory I can come up with that would explain the apparently random and occasional differences between the two sources.

    1. Gee. Thanks, DJ.

      This is worth further investigation.

      I know nothing about illegal pharma sales (counterfeit perhaps), but I wonder if something more than meets the eye is going on here.

      tx
      g

  88. Thanks, Gina, for believing me! – I’m in the US, btw.

    I agree it doesn’t seem logical. Maybe only some of them are bad. Maybe a bunch got overheated sitting on a loading dock in the sun … something accidental like that. All I know is, what I got isn’t working. So for now I’m having my Dr write the Rx so I don’t get the generic any more (tho my co-pay will more than double)

  89. I’ve been taking Concerta 54 (USA) for 10+ years with great success, until the generic came out. I’m usually happy to take generics because I can’t tell any difference, but not so with Concerta. I don’t care what they claim, generic Concerta is NOT the same. It’s not only weaker, but wears off much sooner. It should last 16 hrs but after 8 hrs it feels like I haven’t taken anything at all. This is not my imagination. I didn’t even know I was getting generic, or even that there WAS a generic, when I started noticing a difference. (My ins requires substituting generic if available).

    To those who insist it’s made by the same manufacturer as brand-name Concerta, ergo exactly the same: that’s only in theory. Think about this: If the same company is making thier own product AND their competitor’s product, might they not have a vested interest in NOT making their competitor’s product quite as good as their own, whether “accidentally on purpose” or not? It’s an absurd business arrangement, come to think of it. Technically they may follow the same procedures and use the same formulation, but probably cut corners by using cheaper, lower-quality ingredients, looser quality control, lower-skilled workers etc etc.

    Whatever the reason (and I’m sure we’ll find out – eventually), nothing will convince me that they are identical.

    1. I hear you, Cookie! 🙂

      And I believe you.

      But, again. you don’t mention if you are in the US or Canada. I assume you are in the U.S.

      I wouldn’t put anything past “commerce” but the FDA does have certain requirements, and I’m pretty sure the labeling cannot be exactly the same if the medication is not made exactly the same way.

      I guess time will tell…..

      Thanks for weighing in.

  90. The months of June and July were causing me to think to myself, “What is wrong with me?” In August I noticed on the Concerta bottle it was GENERIC!! No one told me. The pills are no different. What I went through to get the med changed to name brand was unbelievable. I don’t think anyone believed me that there was such a big difference. Finally in September, I took my first brand name Concerta. I thought it might take a few days to notice the difference. Then the same morning I took the correct pill it dawned on me, “I am doing more and feeling much sharper.” Who would have thought? I was on my way back to being productive and useful again. I might add the reason for taking Concerta is a TBI. I was going merrily on my way then….I had the script refilled. Sunday morning was the first time. I thought this day is a loss because I can’t get anything accomplished and am so tired. Oh well, it’s just one of those days I decided. But it wasn’t! The next day was worse and the next day even more so. I grabbed the bottle to see if it was generic. It wasn’t. This has gone on for a month feeling that I’m feeling like a dud, can’t think things through and so so tired. It’s odd this started when I started a new bottle of Concerta. What I would like to know is how can I tell if I am getting the brand name. They look exactly alike and who would ever know which is which? Also, it would be so easy to get them mixed up at the pharmacy. The pharmacy I called was a bit touchy that I would even think I was getting the generic instead of name brand. She came right out and said “They are not switching one for the other on me.” Yikes. They have assured me the brand name and generic are exactly the same. They are wrong. I’m the one taking the pills not them. There is a big difference. After a month of despair about this, I have analyzed everything I do, everything I eat, everyone I talk to and everything I do. Everything points back to the day I took one pill from the new bottle of brand name Concerta. What is your opinion of the sudden change and also of the difference between the brand name and generic.

    1. Hi Lucie,

      That is very curious! I wish I had an explanation. But all the best information I can find says that, in the U.S., the brand and generic of Concerta are exactly the same. The only difference is the price charged (and some people tell me that it’s not that different given their insurance policies; others report a big savings).

      If the pills you have look like the one depicted in this post, then they should be the brand (even if they’re called “generic”).

      I will repeat one more time: There IS a difference in CANADA between generic and brand Concerta. NOT in the U.S., though, it is reported.

      I’ll keep my ear to the ground on this issue, and if I hear anything will let you know.

      Gina

    2. Ian having the EXACT Same problem. My doctor the wrote for brand name only and last night when I filled my prescription they gave us the generic. Brougght it back, they said they switched the pills to the brand name but now in not sure. Took my morning dose today and feel anxious, almost speedy. Called the pharmacy back today and asked them if they have Concerta 36 mg in stock. They stated no they only have generic, they would have to order them. At 7 pm last night(2 minutes after closing time) they supposedly replaced our generic with name brand but after being open for 1 hour this morning they have no brand name? Something is Definitely fishy. I understand why the pharmacy insists they are the same pill, but my daughter and I take them and we both independently feel anxiety and headache and irritation after taking them. This is NOT in our heads. I am a nurse and have been on this medicine for years.

    3. Hi Tina,

      Thanks for sharing your experience.

      The thing is, you cannot be sure this isn’t psychosomatic, can you? You already knew it was a “generic” before you took it and so, given generics’ track records, you might have had some anxiety around that?

      I’m not discounting your experience, but the nature of scientific testing is having a “blind” control.

      And perhaps the pharmacy doesn’t quite know the language to communicate regarding a “generic” that isn’t really a generic but the name brand sold as a generic.

      Just a thought!

  91. No, Ky. From what I’ve read the concerta capsule and generic capsule are not the same, even if medicine inside are the same. This difference in capsules effects how the medicine is delivered into the child’s system.

    1. Actually, no, that’s not the case with the “generic” Concerta made in the U.S.. (But it is true for the one available in Canada.)

      The so-called “generic” Concerta in the U.S. is the exact same capsule in all ways. It is made by the brand manufacturer and distributed as a generic through a marketing agreement. It is called generic merely as a point of sales-marketing.

  92. My 8 year old duaghter’s teacher informed me that her behavior had turned defiant again, like before her concerta, and wanted to know if she had been forgetting to take it. After looking into it, I realized the last refill had been generic. I found out that, yes, the medicine may be the same in Concerta and the generic but the capsule is made different which causes different delivery amounts and times. Something as small as this made a big difference in my daughter’s behavior.

  93. I realize this is sort of an old post, but thought I would chime in in case someone (like me) is looking for info on generic Concerta. My 9 year old has been on Concerta for several years. We switched him to generic Concerta in June and I didn’t notice any change. Looking back now, I think this is because he was out of school and his days were just composed of fun activities and free time and he didn’t really have a lot of opportunities to get frustrated over work.

    When school started, we put him in a private school that specializes in kids with learning differences. At first we thought he was just taking a while to adjust to a new school, but his behaviors only increased in severity. He refused to do any work, would run out of the classroom, screaming/crying/fits, and eventually started attacking the other kids. He was asked to leave the school in November. I home schooled him for a month while I worked with our local elementary school to get his services back in place. He has been in this school since he was 3 and we’ve had a great team of aides and support people. Right before Christmas, he started going to school for just half of the day. We all agreed that since his behaviors had been so much more intense than they were in the past, that a half day was probably all he could manage.

    The team at the school has been documenting every outburst/whine/tantrum and keeping a detailed spreadsheet. We have probably 4-5 weeks worth of sheets now and every day he has an average of about 10-12 behaviors that require the team’s attention. (in four hours) He spends a lot of time by himself in the resource room, by choice.

    Last week, a friend gave me her son’s leftover name-brand Concerta that he was not going to take and it was the same dosage as normal for my son. (Yes, I know this is probably frowned upon, but we do what we can to save money.) He took the first one on Saturday. On Monday and again today (Tuesday) at school, he stayed in the regular classroom the entire time and did not have a SINGLE issue. This is a child who at times has three adults with him at school to help manage his behaviors and he made it through two days without a single whine, cry, anything. His team was amazed and asked about any changes in his routine. The ONLY thing different has been the name-brand Concerta. I realize that 2 days is not enough time to establish that this is a definite behavior change that can be attributed to switching meds, but after having every day at school be a disaster since August, getting kicked out of a school that specializes in helping kids like him, and reducing the length of his school day by 50%, this is truly miraculous for him.

    I’m sticking with name-brand and hoping that my gut instinct is correct. I had just brought up the possibility of the generic Concerta being part of the problem with his psychiatrist last week. She said that it “wouldn’t be unusual” and wrote a new script to be name brand. Hoping that when our freebie pills run out, our insurance will let us get the name brand again without too much of a hassle.

    1. Hi Beck,

      Thanks for sharing your story. It really hits home the point: The right medication can make a huge difference.

      I assume you are in Canada? Because the generic in the U.S. is actually the exact same as the brand (in fact, it IS the brand).

      thanks
      Gina

    2. Yes, the medication contained within each pill is exactly the same for the Concerta and the Generic. The DIFFERENCE is the time release coating/structure of the pill. This is the part of the medication that is under patent and cannot be copied by the Generic. This is what causes the drastic differences in the effects of the Concerta and it’s Generic. So those of you parents that are seeing the drastic change in your child… Name brand Concerta has a wax coat that has 22% of the medication contained in it and a hole is placed on the end by a laser to create an osmotic effect (water enters through the hole and releases the medication in a stable, balanced fashion). Because the generic is not designed in the same fashion, it releases differently and thus the difference in effect.

    3. Hi Jim,

      That information you share is counter to what I’ve determined otherwise. If it is made by the same manufacturer with the same standards, it is the same medication. It looks exactly the same. Exactly. Generics cannot look exactly the same as the brand. Can you please site any sources for your information? Thanks!

  94. Patricia Ongaro

    Hi Gina well yes I got the book and it is very interesting, but I have to read sentences over and over cause I have ADD and I just can’t comprehend what Im reading and not to mention I think of other things when Im reading…LOL…Due to no medical insurance I don’t take any meds for it, but I do take zoloft 200mg for depression….

    1. Hi Patricia,

      Yes, I know the book covers much complex material.

      You know, I strongly encourage you to tackle your own ADHD symptoms as you try to help your child. It’s like they say on the airplanes — put on your own oxygen mask first! 🙂

      You don’t need medical insurance to take medication for your ADHD; many of the medications are available at affordable prices, as affordable as zoloft surely.

      I should also point out that taking 200 mg of Zoloft could be WORSENING YOUR ADHD SYMPTOMS.

      Please talk to the physician who has prescribed the Zoloft and tell him/her that you want to talk about adding a stimulant.

      Good luck!
      g

      There are

  95. Patricia Ongaro

    > Hi thanks for your quick response and no nothing changed in November other
    > than him having to get rid of his puppy due to allergies. His pediatrician
    > had put him on Periactin to help with his appetite but I’m not sure if that
    > had anything to do with it. It was really scary to see him like that, he’s
    > never been a fan of the dark but this time he was seeing someone jump on my
    > porch at 3:00 am with the curtain closed, he was hearing screams in the
    > night and wouldn’t even go to the bathroom alone during the day, woldn’t go
    > to his room to play video games or watch tv, he stayed right next to me at
    > all times. I am really thinking that I need to take take him to a
    > neaurologist and have him tested and stuff, I don’t want to keep trying new
    > meds. Thank you so much for your input and advise…

    1. Patricia, I feel for you and your boy. It must be so hard to see a child go through these things and feel helpless.

      I would suggest, though, that there is much you can do to be pro-active — just as you are writing here and asking good questions. That is what people MUST do in order to get good medical care for their own or a loved one’s ADHD. No matter how good the doctor, we have to take this bull by the horns and be extremely pro-active.

      Did you stop the periactin? Of course, if the adverse symptoms started about the time he tried it, that could be the cause. it’s an antihistamine, and many people with ADHD have adverse, atypical reactions to antihistamines.

      But I do tend to think my previous response points to another obvious issue: the stimulant has backsuppressed serotonin. This can happen slowly over time, until one day it’s very clear. So you don’t often think it’s the stimulant medication causing the problem. Do read Dr. Parker’s book if you can. And also read through his website: http://www.corepsychblog.com

  96. I’m wondering if maybe there was something different in the generic brand concerta that made him feel paranoid.

  97. Hi my 9 year old son had been on concerta for the last 2 school years and this year he started out fine in October and November he started acting weird, he was always scared even in the day time he wouldn’t be in a room by himself and was always hearing things and seeing things and his Pediatrician told me to take him off for the holidays and it made a world of difference, he is still afraid to sleep alone but he is functioning like a normal 9 year old. He is now on Intuniv and all it does is make him tired he has only been on it for 3 days so Im hoping it will eventually work for him. He has been home sick this week and when Im helping him with makeup work he gets very depressed and says that he is stupid cause he can’t concentrate…

    1. Hi Patricia — Do you know what changed in November? Was that when you tried the generic? (This is assuming you are in CANADA; in the U.S. the generic Concerta is the same as brand.)

      If no external factors changed, many internal factors could be contributing to the problem. Perhaps taking a stimulant alone has increased his anxiety. Often stimulants are paired with an anti-depressant, because many people with ADHD (“dopamine issues”) also have trouble with “serotonin issues.”

      He might also benefit from some amino acid support for serotonin, such as 5-HTP. I recommend that you read Dr. Charles Parker’s book. Here is a link to it on Amazon.com, for the Kindle version: http://www.amazon.com/ADHD-Medication-Rules-ebook/dp/B005JZ932W/ref=sr_1_1?s=books&ie=UTF8&qid=1322707700&sr=1-1

  98. Thanks so much, I guess if I call the pharmacy about a week before hopefully that will be enough time to see if they might have Generic Concerta or not.

  99. Has anyone had any trouble filling either Brand name Concerta or Generic version. I was just curious as what to expect on my next prescription. Thanks

    1. Hi Casey,

      I haven’t heard of any Concerta shortages. Just to play it safe, don’t wait until the last minute! 🙂

  100. I’ll add another data point for not even noticing when I got switched to the “generic”. It’s so nice to pay less and not get screwed at the same time!

    1. Ha! Isn’t it great when that happens, Jay? Cuz it’s so rare!

      I was hitting the panic button when I checked the mail-order pharmacy status for my husband’s Concerta. I saw the “methylpheni….blah blah blah” and thought, damn! Another obstacle. Another hassle. They wear you down!

      I almost couldn’t believe that this change was a good one. lol!

  101. Hi Paul,

    Thanks so much.

    Sometimes we advocates get flak from all sides. Encouraging notes like yours, telling us we actually made a positive difference, are so very welcome. 🙂

    I’m glad you stuck to your guns. That is really what it takes sometimes.

  102. I met you at last years Atlanta Conference. I wish there were many many more people like you who have a good grasp on what it’s like to be
    ADHD and also how it relates to interactions with others.

    My past experiences with medications have been horrible. Through many “Professionals” I was constantly being told I was depressed, and went through the list of antidepressants, every few years, dealing with a frustration in life that I had no clue, as to the cause. Finally, after a nephew was diagnosed, I was encouraged to get tested (at age 52). Even after being diagnosed, I went through cartwheel inducing Adderall, followed by a dizzying drugged down feeling ending with my first and only panic attack under Wellbutrin.

    After reading more about ADHD, I suggested I try Ritalin. It was not immediately clear if it was working, but slowly I noticed that I was getting more done in less time, with less emotional effort. Much like I did when I was running 6-10 miles a day. (another story). I was on the short term (about 4-5 hours for me) generic Methylin. I later moved to the longer lasting generic Methylin ER. Both it worked great. Then the pharmacy switched over to the Metadate version. I found myself, struggling a bit more in the morning, ok near lunch, but in the afternoon, I found myself getting very talkative and often somewhat agitated. I went through about 20 days before I said “this isn’t right”. I explained what was going on and struggled to be believed. It was an awful feeling to be told that what I was saying couldn’t be happening, because it was the “same medication”. I firmly refused the Metadate version and even had to go out of state to get the Methylin ER when there was a shortage. I have now tried the Methylphenid ER version which seems to act identically to the Methylin ER. From your information and the conference last year, I now know so much more about myself and that how things affect me, may not affect others in the same way and that’s just the way it is.

    One of your best analogies, to help others understand how ADHD is for me, was from a video you did regarding cookie cutters. There is no one description or cookie cutter that fits us all.

  103. Thank you, Gina, for your reply.

    The pill says alza 18 and looks identical to the Concerta he was on last month. And we’re in the U.S.

    So it’s sounding like what I need to do, is go ahead and fill the “real” Concerta (even though it’s the same) – and then we can rule out that his issues at school are not “generic” related but rather dosage related. Hopefully in a couple weeks we can get him on the right track.

    Thankfully my insurance company has no problem with me refilling it, and my co-pay is the same.

    It’s never easy, is it? Thank you for your thoughts, even though your primary focus is adults. I truly appreciate it.

    1. Hi Sally,

      Yes, it sounds like you have the brand-name Concerta.

      And yes, it sounds like a wise idea to look at other issues, including dosage, potential side effects (sometimes these appear over time, not right away), and any other change in routine that can affect brain function.

      While I do primarily focus on adults (because adults have been historically, woefully under-served), many of the issues are the same, no matter the age.

      best,
      g

  104. I’m happy to find someone talking about this on-line.

    My 8 year old was on Concerta 18 MG for one month for ADHD and the second month the pharmacy gave me the generic and assured me I would see no difference.

    Day 3 and 4 of the generic meds (after the weekend) and he’s having issues in school. Not getting along with friends, crying over spilled water, not having as much self control, etc.

    It’s so hard to know if this is a blip in his treatment, if he needs a higher dosage or if it has to do with the generic.

    I called his doctor and she’s writing him a new prescription for Concerta (the real deal) but after reading this, I feel like we’re in a loophole of sorts Can you give me any perspective on how to advocate for my son?

    1. HI Sally,
      Did you check the label on the pill? Does it say “Alza?” (The 18 mg should look like the one in the photo above, but white, I think.)

      If so, that is the brand-name.

      If you’re in Canada, however, my understanding is that’s a different type of Concerta-generic.

      Generally speaking, when dealing with insurance companies in the U.S., you often have to try the cheaper alternative first. Then, if it doesn’t work for you or has unreasonable side effects, you can have the doctor document that for the insurance company. Often, they will then allow the brand-name. Just depends on your insurance plan.

      But in this case, the generic Concerta should be the same as the brand-name.

    2. sally,
      I had the same problem with my 9 year old boy. He was on concerta and we tryed the generic. He didn’t like it, said he could tell the difference and it didn’t work as well. Now his insurance said they wont cover anything other than the generic. Now I need to find another medication to put him on. I hate to do that because concerta works so well for him.

    3. Hi Sally,

      Thanks for sharing your experience. Does the capsule look like the brand Concerta? Does it say “Alza” and does it have a little hole drilled in one end? In other words, are there any clues that this isn’t the real thing?

      If not, then I would ask, Did you tell your son he was taking a generic and thus plant the idea to expect inferior performance?

      g

  105. I gladly went to the generic as soon as it was available (MA). Saved $30 a month in copay, and no apparent difference in effectivity!

  106. The All-Purpose Guru

    The generic, in this case, is only different in classification. The generic “Methylphenidate ER capsules” sold by Walgreens in California are the identical drug to the name-brand– they both carry the Alza brand, and my pharmacist assures me they are identical. (He knows about the differences between generics and name-brand due to an unfortunate issue my wife had with generic Allegra)

    Unfortunately, even though the generic is a tenth the price, we still pay the non-generic copay on it because the drug is still “non-formulary”. Feh.

    1. Thanks for weighing in, AP Guru. I thought that was the case but, geez, so many tricky wordings these days. 😉

      Bummer about your co-pay. Sometimes if you can document that the formulary choices don’t work for you, the insurance companies allow non-formulary at formulary prices.

      I’m thinking it might be worth checking out Costco Pharmacy, especially online. You don’t need to be a member to use the pharmacy (but members get slightly better prices). It might be that Costco’s generic Concerta is cheaper than your co-pay.

      g

  107. What’s up with stimulants?

    Good article, and important too. I need to get my Rx changed from Adderall (generics OK) to Concerta. I haven’t been able to get my “amphetamine salt combo” prescriptions filled at any local pharmacies in Raleigh, NC since last Spring. Without the Adderall I feel like I’m swimming in peanut butter! My pharmacist said “the manufacturers didn’t make enough pills to satisfy the demand” and “the raw materials to make the medicine is are in very short supply, across the country, hence the shortage”.

    I’m not blaming my pharmacist, but I wonder if you know anything about a nation wide shortage of stimulants, and also drugs for several other categories of health issues, like cancer/chemo drugs.

    PS – I’m in the Triangle Adult ADHD MeetUp Group, the largest Adult ADHD MeetUp in the world, and everybody I’ve talked to has this problem.

    1. Hi Michael,

      Thanks for your comment. And hello to the Research Triangle Adult ADHD Meetup group! I love that part of NC — even attended NC State my freshman year.

      To your question: Yes, it’s true. There has been a nationwide shortage of certain stimulants.

      Tim McGeorge, of the National Resource Center for ADHD, covered the issue on a CHADD blog:

      http://chaddleadershipblog.blogspot.com/2011/04/shortages-of-adhd-medications.html

      excerpt: It is expected that these shortages, which are the result of quotas imposed by the U.S. Drug Enforcement Administration (DEA) on the manufacturers, should be resolved within the next six to eight weeks. [note from Gina: this was written 4/13/11]

      What to do? If you experience difficulty in filling an ADHD prescription due to this shortage, here’s what you can do:
      • Ask your pharmacist if the medication is available from another location, especially if you use a large chain pharmacy.
      • Contact the manufacturer to help locate a pharmacy that has your medication in stock (see the customer service numbers below).
      • Contact the doctor who prescribed the medication to see if he/she has any samples you can use.
      • Ask your pharmacist about the availability of other medications used to treat ADHD.
      • As a last resort, discuss with your prescribing physician whether or not any of these available medications might be appropriate for you or your child.

      Finally, if you’ve exhausted all avenues and still can’t get a prescription filled due to a medication shortage:
      1. Tell the FDA: Send an email to drugshortages@fda.hhs.gov or call 888-INFOFDA or 888-463-6332.
      2. Tell CHADD: 800-233-4050.

      I hope this helps!
      Gina

    1. Glad to hear that your husband is doing well, Lisa. Sorry to have confused you with the photo; I’ll add a caption.

      Some people have said that the authorized generic still looks like the original; you might have to check the bottle to see what it’s called.

  108. My husband has been on the exact pill, same dosage and everything, and I haven’t noticed any changes. He seems to have not noticed that he’s taking anything different either, he didn’t know it was a generic. So I don’t know when it changed. He’s doing really well and has been working very hard as of late.

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