Coumadin: Generic Versus Brand Name

Deanne Stein Health Guide
  • It's been seven weeks since I had my baby. The time is really flying by and soon my maternity leave will be over. I've been slowly getting back to normal since pregnancy. My hormones are calming down, the nausea is gone and it's nice not to be waddling anymore. The baby weight is also coming off and I was so excited last week when I could actually get back into some of my pre-pregnancy clothes. However, I think the best part of not being pregnant is the fact I don't have to endure those belly shots anymore. That's right; I took my last Lovenox shot the other day and couldn't be happier. The shots helped to prevent a blood clot from forming during my pregnancy. The injectable blood thinner was safer for my baby, since the medication doesn't cross the placenta. But now, I say goodbye to those horrendous shots and hello to my old friend Coumadin.

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    During my last week of shots my doctor had me start the oral blood thinner, Coumadin, at the same time. It was a low dose of 5 milligrams a day just to get the medication back into my system. I need to have blood work done to see how much my doctor will have to adjust the dosage. For me, that's the only negative about taking the Coumadin. Sometimes it's hard to regulate and even the littlest thing you eat can really affect the medication's effectiveness. Also, having blood drawn once a month to check my pro-times isn't very pleasant. Although, compared to giving myself two shots of Lovenox everyday, blood work once a month is a walk in the park.


    Luckily, I have never had any side effects of taking Coumadin. Even the cost of the medication has never caused me any distress. I order my Coumadin through my insurance company's mail order pharmacy and a three-month supply has only cost me $50 in the past. However, when I ordered my first prescription post pregnancy that cost nearly tripled. I believe it's because my employer changed insurance companies during my pregnancy, and now my Coumadin is no longer a "preferred" drug. I told the lady on the phone that my doctor told me it was the preferred drug for me, but it didn't seem to make a difference. She did tell me that I could save one hundred dollars by using the generic drug, which cost only $20 for a 90-day supply. Knowing my doctor wouldn't approve, I just paid the $120 for my Coumadin. I do wonder why there is such a price difference if the generic is supposed to be just as safe and effective, and why can't I take it.


    I asked my neurologist about it. He told me Coumadin has a narrow "therapeutic window." That means any small change in my dosage could make a big difference in how it affects the blood. He also told me generic forms of the medication are not held to the stringent standards as the brand name is and thus why he didn't want me to take a generic form of Coumadin (Warfarin). But I also talked to a pharmacist about it. He told me generic prescriptions do have the same active ingredients but may have slightly different inactive ingredients than the name brand equivalent. However, generic drugs still have to pass strict Federal Drug Administration (FDA) regulations before being released to the market. In fact, generic drugs are required to be thoroughly tested the same as the name brand drugs. A generic drug has to be proven equal in both the benefits it provides and that it's safety before the FDA will approve it. As far as the price difference, I was simply told that it costs more for companies to come up with a drug than it is to manufacture a generic form of it.


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    The good news is that, generally, generic drugs are safe and effective, as well as affordable. Many people couldn't afford their prescriptions if it weren't for generic drugs. But staying healthy and clot free is my goal, so if my doctor wants me on the brand name Coumadin, I guess I'll continue to fork over the extra money. Always check with your doctor before switching to a generic drug.


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Published On: November 21, 2007