Reply To: Change in Manufacturing of Adderall XR

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Jessy
Participant

I work in biopharmaceuticals testing and formulating drugs being produced. Prior to this, worked in various areas of medicine for 18 years. I also have been on the Prasco manufactured Adderall XR 30 for 2 years. My insurance company switched and name brand isn’t covered. I’ve experienced the same issues you all have described. In addition, I’ve developed weird health problems, like hypertension. My BP has ALWAYS been 112/64 or in that realm. No family history of hypertension. Yes, I’m aware of all the factors that can contribute to health issUes weight gain, salt intake, etc. I have heard all the possible causes for the change in efficacy, such as tolerance. I tried switching to 20 mg for awhile and then going back up and no improvement. It’s definitely the drug itself. I noticed it immediately the first time I was accidentally written an rx that wasn’t “dispense as written” (prior to being forced to switch due to insurance). Heart palpitations observed at 6 hr mark made me feel like the R-enantiomer and S-enantiomer proportions weren’t shifting at the same rate as the brand drug. I’m going to look into this further. Contrary to efficacy claims, generics don’t have to adhere to as the same documentation stringency as the innovator drug had to go through. Things in the formulation can differ and the molecule has been seen to having varying aggregation or stability issues across manufacturers. Look into this, there’s data out there demonstrating. Even if the structure change isn’t at the active site of the molecule, there’s been noted changes in efficacy. For example pseudoephedrine in Sudafed that was altered very slightly to prevent misuse of the drug. Blind studies showed a difference in effect. Insurance companies want to save money (I’ve written many appeal letters on behalf of patients, trying desperately to get their drug approved rather than have them try/fail 8 other drugs first). It’s very sad that doctors cannot often use a tried and tested (ie shown to work well) drug without a patient being put on another type. I’ll stop rambling. I just want you all to know it’s not imagined. 🙂