Switching between generic seizure meds

My husband has been on the same generic brand (Mylan) since his AVM removal. Now the pharmacy cannot get the Mylan generic and is giving him a different generic (not sure of the brand). Anyway I know some people had problems going from brand drugs to generic but has anyone had trouble going from a generic brand to a different generic brand. I just hate messing with something that is working for him. What do you guys think?

Thanks for you responses.


Our local neuro had Chari go on Tegretol, no generic. He said there was enough difference he wouldn't chance a generic.

I would not allow a pharmacist determine a change in medication for you--you should run it by your neuro. Also, whenever you switch seizure meds, you have to taper off one and taper onto the other. While you are taking both, the effects and side effects will be different still.

Unless the new med is exactly like the old one, I wouldn't do it.

Ron, KS

Thanks Ron, but he would be switching from one generic to another generic the same dosage. I just spoke to the pharmacy and it would be from manufacturer Mylan Lamotrigine 150 mg to manufacturer Cadista Lamotrigine 150 mg. Is anyone on Cadista Lamotrigine? I totally agree with you from going from the brand drug to a generic though, I have read horror stories on that. Thanks for your response.


Hi Marie,

Someone from the Epilepsy Foundation told me that the FDA gives generics a certain percentage of leeway in either direction...that is, a generic can have up to a certain percent MORE of the active ingredient or a certain percent LESS. I read that studies have shown differences up to about 15% between generic and brand name, when blood levels are taken, as you probably know.

Since the leeway works in both directions, there could theoretically be even more difference between two generics as there is between a generic and a brand: Generic 1 could be 15% MORE powerful than the brand, and Generic 2 could be 15% LESS powerful than the brand, causing a big gap between Generic 1 and Generic 2. That's an extreme case, but my feeling is that you're right to be cautious about this. Like Ron said, it shouldn't be up to the pharmacist to decide.

Have you called other pharmacies or checked whether your health insurance has a mail-order pharm?

If it turns out that he has to switch, I suggest that you both treat it as if it were a switch to a new drug--keep an eye on things for the first six weeks, and schedule a blood level test if there is one for Lamotrigine.



You make some great points and I had no idea the leeway that is given between generic and brand and like you said even more leeway could be possible between 2 generic manufacturers. I have called several pharmacies and will call his mail order tomorrow too. I did email his neuro/epilepsy doc this evening asking his expertise, so will let everyone know what the doc says as this could very well happen to someone else on this site. I know it all comes down to money, I'm sure CVS signed a new contract with this new manufacturer so Mylan is out for them. But still I think in this case and I'm sure other type of drugs it could really harm someone. Afterall we are not talking about something simple like cough med or antibiotics. thanks for your post and info!



Marie,I have seizures sometimes.I'm controling my with diet.Eating tomatoes or sauces made with tomatoes cause me to have seizures.Eating a plate of spaghetti is plan for raining days cause then I don't feel bad about laying in bed all day.Good Luck with your husband.Sylvia.

Thought I would update everyone on my topic. Our pharmacy stopped carrying the Mylan generic of Lamictal (lamotrigine) that my husband was taking and tried to give him another "generic brand". I would not take it and contacted his seizure doc and I'm so thankful I did. He stated that many have problems switching between different generics on the lamotrigine and could cause seizures. He has been blessed to be free of them for quite a while now that's why we did not want to mess with his meds. Fortunately I found another pharmacy after many days that will order the Mylan for him or the doc was going to put him on the brand drug. Anyway thought I would share, as you should watch when the pharmacy changes your generic to a different manufacturer it may prove to be a bad move for the patient. I really do not understand how pharmacies can do this without asking the patient first. We are not talking about ibuprofen or an antibiotic here, it is an important drug for the ones taking it.

Blessings and keep an eye on your pharmacy!