Sitagliptin Generic?

[JaxHog]

I've recently been issued with something called 'Sitagliptin Grindeks' instead of the prescribed Sitagliptin. The pharmacy (not my usual one) swears blind it is a known generic version. It doesn't appear on the NICE medicines database, and my blood sugar has gone back up. I'm trying to get my usual Januvia by re-ordering my prescription from my usual pharmacy - fingers crossed.

Has anyone else had this problem?

 

[Robin]

Have you read the patient information leaflet about what the medicine contains? And in what dose strength?
The only references for Sitagliptin Grindeks that come up on line are for a Sitagliptin/Metformin combination, which isn’t what you usually have, I assume. But there may be a plain Sitagliptin versions as well.
Check whether the amount of active ingredient it says it contains is the same dose as you usually get with your Januvia, and if it isn’t, complain to the pharmacy immediately, as they shouldn’t be substituting something that is slightly different.

 

[JaxHog]

Yes, I read the leaflet. It says it contains sitagliptin hydrochloride monohydrate which is 'equivalent' to the same dose of Sitagliptin. I will make a formal complaint to the pharmacy. Fortunately, my doctor has reissued the prescription to my usual pharmacy who, I hope, will prescribe it correctly.

 

[Robin]

Yes, I read the leaflet. It says it contains sitagliptin hydrochloride monohydrate which is 'equivalent' to the same dose of Sitagliptin. I will make a formal complaint to the pharmacy. Fortunately, my doctor has reissued the prescription to my usual pharmacy who, I hope, will prescribe it correctly.

Ah, good, I was afraid they’d given you the sitagliptin/ Metformin combo, which wouldn’t be the same.
It seems Januvia is Sitagliptin Phosphate Monohydrate, according to its PIL

JANUVIA 100mg film-coated tablets - Patient Information Leaflet (PIL) - (emc) | 7887

JANUVIA 100mg film-coated tablets - Patient Information Leaflet (PIL) by Merck Sharp & Dohme (UK) Limited

www.medicines.org.uk

This 'should' mean that the Grindeks stuff is equivalent, but as many people in here have discovered, different formulations of the same drug don’t always have the same effect on different people, and pharmacies should try and dispense exactly what has been prescribed. However, I think they are allowed to substitute if they can’t get hold of the exact brand, and they may argue that if the dose and the active ingredient have the same effect,, then they are within their remit to substitute it.
Glad you’re getting your usual prescription issued, anyway.

 

[JaxHog]

I wish they'd told me when they'd dispensed it, as I believe they are supposed to. I already have a history of problems with some generics e.g. the TEVA version of Metformin. It's a family thing, as my Mum went into anaphylactic shock with an unfamiliar formulation of ibuprofen. Very scary.

 

[Nick Cliff]

I believe I have only ever been on generic Sitagliptin, and have had at least 4 different brands... ..the latest one, not yet started, being Sitagliptin Krka from Slovenia. So far I have not noticed any difference between the brands via my ad hoc finger-prick testing. I've always understood that generic medicines were as good as the original brand-named medicine, just cheaper for the NHS. Perhaps I should have less faith in my pharmacy in this world of declining standards?

 

[Proud to be erratic]

I wish they'd told me when they'd dispensed it, as I believe they are supposed to. I already have a history of problems with some generics e.g. the TEVA version of Metformin. It's a family thing, as my Mum went into anaphylactic shock with an unfamiliar formulation of ibuprofen. Very scary.

It is possible that prescriptions become increasingly generic as part of the continuous drive to keep all NHS costs down. I moved from Bucks to Berks in late July and I've noticed that a couple of my meds were quite specific and are now generic.

That change occurred in my new Medical Practice and would have arisen specifically as the official Pharmacist for the Surgery was updating the carry across repeat prescriptions from my former Surgery. In practice if Berks traditionally used a generic descriptor they will naturally continue with that term. I have found that a dialogue with the Practice's Pharmacist resolves most things. It's really not the fault of the Dispensing Pharmacist - unless they have unilaterally changed something - which would be most unusual. Have a look on your copy of the prescription and establish if the problem really does sit with the Dispensing point, before embarrassingly raising a complaint against the wrong place. 🙂

 

[JaxHog]

I double-checked my prescription, as did my Doctor.

There is no actual generic Sitagliptin, as it's still under licence as Januvia. There are similar products that contain Sitagliptin, but in a different formulation and they have names other than just 'Sitagliptin'. For most people this may not matter, but it may not work as well (or at all) for some other of us. My concern was that the pharmacy dispensed a different formulation to what was prescribed, and to what I've always had before, and then didn't tell me. I was also concerned that I could not report the side effects because this formulation is not listed in the NHS medicines database.

I don't have a problem with taking generics, provided I (and my Doctor) know what I'm taking.

 

[Nick Cliff]

Thanks @JaxHog , that's very useful to know. Your experience is rather worrying, I agree. Nick