glossary

bioequivalence

the standard a generic must meet — releasing the same drug into the blood at the same rate and extent as the brand. usually true; famously, once, not.

generics are one of the great bargains in medicine, and the rule that makes them safe was once proven enforceable by patients who refused to stop reporting.

what it is

Generics are approved by demonstrating bioequivalence: the same active ingredient reaching the blood at the same rate and extent as the brand, within tight statistical bounds. For almost all generics, almost all the time, this works.

the famous exception

Budeprion XL 300 — a generic of Wellbutrin XL — was approved by extrapolating from tests of the 150 mg strength. Patients who switched reported for years that the copy was different; in 2012 the FDA's own study confirmed it, and the approval was withdrawn. The honest generalization: equivalence is the enforced rule, and the one documented psychiatric failure was caught because patients kept saying something the paperwork denied.

somewhere to put it

free. anonymous. people who’ve been where you are 🤍

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want the deeper story? read prescribed to fail

questions

are generic antidepressants as good as brand?

As a rule, yes — bioequivalence is tested and enforced. The Budeprion episode is the documented exception, not the pattern.

what if I feel different after a generic switch?

Report it — to your prescriber and FDA MedWatch. 'Generics are identical' is a strong presumption, not a law of physics.

more from the glossary

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