>While you are right that the active ingredient is the same in generic
>drugs, it is my understanding that there can be some differences which
>in some cases could be important...

>Pharmacists and physicians care to comment?

Here's a comment from a victim!  After some years of taking Dilantin, I
needed to switch to Tegretol (carbamazepine) and did so without problem.
Some time later, I changed pharmacies to keep the insurance coverage, and
in doing so switched from the name brand to a generic, also without
problem, though the neurologist had said there could be a difference in
effectiveness.

About a month after making the second switch, I developed an itchy rash on
the back of one wrist.  I cleared it up with a lactnet-suggested remedy,
and forgot about it.  Then I found myself scratching behind my knees...
then my elbows... then my neck.  My eyes were red and swollen.  My legs
bled.  Over time I became One Big Walking Itch and Rash.  (I'm sure the
rash was a result of the scratching, but I also learned that not scratching
a Compelling Itch only results in deep pain.  Not scratching was not an
option.  Hot showers *did* help.  I'd stand in the water and groan with
relief.)

The allergist suggested cortisone shots, which I postponed.  Could it be
the carbamazepine?  He didn't think so.  And indeed, the Itch had not
coincided with the switch from Dilantin.  Stopping all meds was not an
option anyway, and changing from one to another isn't simple.

Lactnet to the rescue again.  Natalie Shenk, who knew the whole story,
asked if the original rash had coincided with the change from name brand to
generic.  I checked the archives for my wrist rash post to get the date.
Yep!  I called the neurologist.  Could the Itch be a result of switching
from name brand to generic?  Yep!  Binders and fillers differ and can
occasionally trigger allergic responses.  Within days of changing back to
the brand name from the generic, the Itch had begun to subside, though it
was a good year before I stopped feeling like an itch waiting to happen.

Who would have thought that a little pinch of "inert" filler could wreak
such havoc?  Thank you, Lactnet, and thank you again, Natalie!

Diane Wiessinger, MS, IBCLC, no longer scratching in Ithaca, NY