Should I Switch to the Generic of Lamictal?
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Q:  Should I Switch to the Generic of Lamictal?


I have been stable for 4 yrs. on 75mg. of Lamictal. My insurance company wants to  switch me to a newly released generic. I have read that the generic varies between 80% - 125% strength of the same brand name dose and, the generic has caused problems in dosage resulting in serious consequences for some patients. Cost is not a problem for me. Should I switch to the generic? The only medicine I take is the 75mg. of Lamictal.

Thank you

Dear Matilda --
You could wait six months to a year until we physicians have had more experience switching people from trade name to generic.  By that time, it should become clear whether the generic can be relied upon at the same doses.

Right now, I am switching people to the generic who stand to save a lot of money and need to do so.  For those who can afford to wait, especially if they are in the middle of a very touchy process of symptom control, where we need to minimize the variables, I'm usually recommending that we hold off on switching.

Someone who has been stable for four years is in a good position to be able to detect a shift if it occurs.  If you wanted to be very cautious, you could buy both the trade name and the generic versions in a 25 mg pill, and switch one third at a time

Because the generic lamotrigine has only been out for a few months, even though I have switched a fair number of people already, I don't think we can yet say with confidence that the generic is equivalent.  The longer you wait to switch, the more confidence we will have in that call.  However, the majority of medications work fine in the generic form, so I don't think there is a need to wait for years.

Dr. Phelps

Published November, 2008

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