A Common Poison Center Call: My Prescription Looks Different

I just picked up my prescription. The pills look different from my last refill. What should I do?

To be sure you have the right medicine, you can do any one of the following:

• Go online to www.drugs.com, click on “pill identifier”, and identify the pills you received by typing in the letters and numbers that appear on the pill.

• Call the pharmacy that filled your prescription, or bring your medicine back to the pharmacy, and ask the pharmacist why it looks different.

• Call your poison center at 800-222-1222 for help identifying the pills you received.

Probably, the medicine is a generic medicine. Generic medicines have the same active ingredients as brand name medicines. They have the same effects as brand name drugs. But, they may be a different color, shape, or size. And, they are less expensive than brand name drugs.

Many different drug companies may make versions of the same medicine. For example, the drug Prozac® is a brand name. Its generic name is fluoxetine. There are more than 30 different generic types of fluoxetine in the 20 milligram dose alone!  Medicine may look different each time you refill a prescription, if the pharmacy orders from different drug companies.

For many years, U.S. law has required that generic drugs look different from brand names. This was to prevent drug makers from selling counterfeit drugs. If the drugs looked too much alike, patients and doctors could be confused. And, many states did not allow generic drugs to be sold. This was to prevent pharmacies from cheating people by charging brand-name prices for look-alike generic drugs.

The world of generic drugs has changed a lot since then. The Food and Drug Administration (FDA) requires that generic drugs contain the same active ingredients as brand name drugs. They must be absorbed into the body at the same rate. They must be as effective as the brand name drugs. But usually, they do look different from brand name drugs.

There are some times when brand name drugs are the right choice – or even the only choice.

• A brand name drug may be sold for seventeen years without generic competition. This is to allow drug makers to earn back the money they spent on researching, developing, and gaining federal approval for the drug.

• Brand name drugs and generic drugs may have different inactive ingredients. This could matter if a patient is allergic to an ingredient.

• Some medical conditions can be managed well only if there is no change at all in the patient’s drugs, even the very minor changes that could occur with some generic drugs.

When picking up medication from the pharmacy, don't be afraid to open up the bottle and look at the medication.  If it looks different, ask the pharmacist why. Review the strength of the medicine and the dose with the pharmacist. Make sure nothing else has changed.

If you think you took the wrong drug by mistake, call the poison center right away. The expert staff of pharmacists, nurses, and physicians will help you, 24 hours a day. Call 1-800-222-1222.

References

U.S. Food and Drug Administration Center for Drug Evaluation of Research. Facts about generic drugs. [Internet]. Rockville (MD): U.S. Food and Drug Administration; [cited 2011 Dec 4]; [2 screens].

Green JA, Kesselheim AS. Why do the same drugs look different? Pills, trade dress, and public health. NEJM. 2011;365:83-89.