What’s Up With Generic Concerta?

Here at the ADHD Roller Coaster, I’ve long cautioned about generic medications for ADHD. Articles include 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? The answer: Yes. We know this because this particular Concerta generic is the brand; it is only marketed as a generic. That makes it an authorized-generic — not a standard generic.

You can read updated details about generic Concerta in this post- last updated 12/2022: Authorized Generic Concerta Update; 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 an FTC report on generic drugs, it is the same product (FTC Report Examines How Authorized Generics Affect the Pharmaceutical Market.

[advertising; not endorsement] [advertising; not endorsement]

Excerpt:

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 (no longer available online) 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.]

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

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. Ryan Stewart

    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. Ryan Stewart

      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.

  7. 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

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

  9. 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!

    1. HI Jeff,

      I’m happy to know that the ADHD Roller Coaster blog smoothed out your Rx ride!

      Good luck!
      g

  10. 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.

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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.

  18. 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

  19. Sorry for the misspellings I’m at work typing from my phone and it didn’t let me see all I was typing

  20. 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

  21. 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

  22. 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

  23. Ronnie Gibbs

    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

  24. 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

  25. 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!

  26. 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???

  27. 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?

  28. 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

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

  30. 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

  31. 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

  32. 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

  33. 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

  34. 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

  35. 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

  36. 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

  37. 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!

  38. 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

  39. 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

  40. 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

  41. 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

  42. 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!!!

  43. 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

  44. 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

  45. 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

  46. 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

  47. 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

  48. 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

  49. 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.

  50. 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.

  51. 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.

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