Not sure whether to worry or not

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Koda1021

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Hi Everyone!
I was diagnosed with epilepsy in June of 2010 caused by Grey Matter Heterotopia. I did a few rounds of some meds, then when Keppra XR came out, my doctor gave me samples and I did great on it. Last month, the insurance company told me that with the generic now out, I'd either have to switch, or pay a higher price. At first, I kept the brand, then decided to give the generic a shot.
To say this has been the worst month of my life is an understatement. All I want to do is sleep (and can sleep all day given the opportunity). I'm dizzy most of the time, irritable, no energy...just every hideous feeling imaginable. Now, one interesting thing..the generic med showed dosage as 2 tablets twice a day (my dosage is 2000 a day). On the brand name, it was 4/500mg pills every morning. So, I asked the pharmacist who said it may have been a mistake, and to take four each day. I tried both ways, two and two, then four in one day. Nothing worked, and I kept feeling worse.
Yesterday, I called my neurologist's office. Normally, the people there are nice, but this one woman I've dealt with a few times..she is just nasty on the phone. I asked why when they called in my prescription, they changed the dosing, shouldn't generic be the same? She puts me on hold..comes back, and says that because it's "not the same" the dosage was changed. I was like, how can it NOT be the same? Doesn't that negate the Extended Release aspect of the drug?? I couldn't get anywhere with her, so finally she says "well, since it seems you are having side effects, I'm assuming you want to go back to the brand name?" I finally just screamed yes.
Luckily, when I switched to the generic, I still had brand name left as a backup, so I started back on 2000mg of Keppra XR brand yesterday. I feel horrid though. I have been having non-stop naseau, panic attacks, ears ringing...I honestly feel a little bit like I'm going crazy. But, I don't know if that's just my body getting re-used to the brand name? Is this common?
Thanks in advance!
 
Hello Koda1021,

They messing with your meds and this can be serious for the sensitive ....thank goodness u back on the brand and same dosage? ...hopefully this settles your seizures

We know not so simple with E meds...My Son has E and one med so far and far from perfect and its brand and hate to think they could switch him and up the dosage to boot (pretty strict my neck of woods on E meds)


Trusting some of the CWE folk have some brand change input to give you.
Well, your call to miss friendly seemed to work so keep battling as you are (good job there!) :-) they listened...
 
I know with Dilantin, the generic form (Phenytoin) breaks down differently and thus doesn't have the same time release effect as the brand. Perhaps the same is true for brand-name Keppra XR vs. the generic Levetiracetam, which would account for having to take it spread out over the course of the day. Keppra also has a relatively short half-life, meaning that it can be harder to maintain a constant amount in the blood.

I think transitions of any kind with the E meds can be stressful to the system, and result in side effects. Hopefully in your case they are temporary. Since it's only been one day since the latest transition, I hope you can hang in there until things even out. (Of course if they don't get better, call your doc -- bypassing the nasty lady -- and let them know what's going on).
 
Ive been taking Keppra XR since 11/2010. In May of last year, I was asked if I wanted to switch to the generic? They did talk it over with me and explained the differences that can come about, but I chose not to go with the generic. The way the drs nurse explained it to me was that I would have possible side effects, and the manufacter could change, causing changes in the pill. So, I decided to stick with the name brand. In 2010, I was paying $100 for a 6 month supply. But now they raised it to $150 for a 6 month supply. But I wouldnt want to risk going cheaper that could cause bad side effects or seizures to occur. I hope you get to feeling better soon!
 
Thanks for the advice everyone! Well, I'm feeling better as the time passes. Still a bit stressed and tense but trying to suppress it and remind myself it's just temporary. I gave it a shot, but obviously it just wasn't going to work (the generic). In my case, the prescription will run me $200 a month, but I'd rather pay that and remain more stable as I did with the brand. So oh well, hopefully the bad effects wane in the next few days! Fingers crossed!
 
I know with Dilantin, the generic form (Phenytoin) breaks down differently and thus doesn't have the same time release effect as the brand. Perhaps the same is true for brand-name Keppra XR vs. the generic Levetiracetam, which would account for having to take it spread out over the course of the day. Keppra also has a relatively short half-life, meaning that it can be harder to maintain a constant amount in the blood.

I think transitions of any kind with the E meds can be stressful to the system, and result in side effects. Hopefully in your case they are temporary. Since it's only been one day since the latest transition, I hope you can hang in there until things even out. (Of course if they don't get better, call your doc -- bypassing the nasty lady -- and let them know what's going on).

Well, what you said makes sense..and sort of what got me thinking in the first place that the generic might be the problem. But, what doesn't make sense, is if the original is a time release, shouldn't the generic be the same time release? I know it seems like a simple question, but that is what got me thinking.

Originally when I was first diagnosed in 2010, my doctor put me on regular Levetiracetam in generic form, and oh geez, it was horrid! That is when my doc told me to try the Keppra XR. At the time, there was no generic, so she gave me sample packs. She also gave me Lamictal in case I didn't do well on the Keppra XR. I did also start taking a low dosage of Zoloft, and that combination worked beautifully (the Zoloft and Keppra XR).

So, I guess I'm wondering how a generic can supposedly be the same but "not be", in which case, that may be why I didn't react well (since I didn't react well on the generic regular all those years ago).
 
Technically the brand and the generic should be identical, but the amount of active ingredient is allowed to vary (within a small range). In addition, the fillers can be different, and the generics can vary from batch to batch and manufacturer to manufacturer. So if you're at all sensitive to small dose changes, the generics can be problematic. As to why the generic extended release might need to be taken differently than the brand -- perhaps they're still getting the bugs out! The Keppra XR generic's only been approved since January...

You might be interested in this article about problems with generic keppra:
http://www.allvoices.com/contribute...uting-to-more-seizures-side-effects-and-death
 
Yeah I agree with Nakamova. It was all that she said is what the doctors nurse went over with me to inform me of the differences. Since I had gone through seizures a couple of months prior with my VEEG, the last thing I wanted to have was more seizures. So I opt'd to stay with the brand name and not switch. Im sure it will come up again at my next visit. Which reminds me, I need to check back with them since its been a couple of weeks since I left my message. I guess the dude is busy!
 
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