Can switching Warfarin drug companies cause INR change?

[Natanni]

We switched to home delivery of hubby's meds, and he will be on a TARO product vs a BARR product (both being Warfarin, diff shape); They do look different, and I thought I did read that people had variability with their INRS when switching between Coumadin/Warfarin/Jantoven but am hoping the same won't apply here. Opinions?

 

[Ross]

There should be absolutely no difference. Every one of those companies MUST make the product to an exact minimum standard. I've used them all and there has never been any changes in my INR from doing so.

 

[dick0236]

Thanks Ross. I have wondered about switching manufacturers too. After finally getting a doc to agree to allow me to go "generic" and finding that the first Rx worked (Barr Lab), I intend to stay with Barr. It is good to know that I can expect the same with other manufacturers if I need to switch.

 

[Ross]

Just to clear the water---Some people insist that a specific brand does indeed give tighter control over their INR. I've found for myself for this to be hogwash, but nonetheless, there are still others who will disagree with me.

I've taken every brand there is and at times, even mixed them. Not once did my INR fluctuate one way or the other. The brands would be, Taro, Barr, Coumadin, Jantoven, in case there are more that I don't know of.

 

[ALCapshaw2]

I've gone from Coumadin to TARO to BARR with NO discernable difference.

FYI, TARO is made in Israel. Their tablets are easier to split than Coumadin. I had NO PROBLEMS with their product.

My insurance provider switched mail-order suppliers and the new one uses BARR which is an American manufacturer with a good reputation. I've had NO PROBLEMS with them either.

'AL Capshaw'

 

[Marty]

After many years sticking to brand Coumadin, Part D medicare made me switch to Barr generic. No problem with INR's ( use INRatio to test) However I no longer can get 100 pills at a time. Scrip apparently must be for one month only and not say " as directed" but must say " one tablet daily". Any one else have experience with this?

 

[geebee]

I sometimes am sent Taro and sometimes Barr. Have seen no difference in INR due to these changes.

 

[Ross]

After many years sticking to brand Coumadin, Part D medicare made me switch to Barr generic. No problem with INR's ( use INRatio to test) However I no longer can get 100 pills at a time. Scrip apparently must be for one month only and not say " as directed" but must say " one tablet daily". Any one else have experience with this?

Yeap Marty it's happened to me. The nurse taking the information wrote it down as 1 tablet a day instead of as needed and that's exactly how they called it in too. We had a small talk about that!

 

[catwoman]

I have used all 3 -- Coumadin and warfarin made by both Taro & Barr. No difference.

Marty:

I checked into prices at a Sam's Wholesale Club. Some sizes of warfarin are on their $4 month drug list, but not all. They did have very good prices on 100 tabs, about the same as what I'm getting from Medco Health (United Healthcare). If I wasn't able to get my Rxes via Medco, I'd be getting them from Sam's.
I did ask for quotes from Costco, but they wouldn't give them to me (even though I have gotten them via its website). Said the price changes according to supplier, sometimes it's Taro, sometimes Barr.

 

[Guest]

I have a page about this on my website

http://warfarinfo.com/generic.htm

 

[Christine]

Just to follow up on the Sam's club $4 warfarin.. I just switched my meds from a supermarket to Walmart and my warfarin is part of the $4 a mnth (ok $9 in PA) but I think it's great that you dont' need a script plan to participate. so it's not just the "clubs" but all walmarts participate in this program. many of their generics are covered by it.. they should have a list available.

 

[Natanni]

Thanks for everyones input! Al's article does mention that the Israel study did require the need to adjust a dose, but there is some lack of data also...


"Here is the latest episode. Everyone using the national health service of Israel was required to switch from branded to the same generic version of warfarin. Halkin et al studied the warfarin dosing requirements of 975 people. They found that after the switch people required warfarin doses that averaged 26.5% higher. But there were no excess hospital admissions for these people. What was not given in the abstract of this article that I read was whether or not the generic and the brand were manufactured under the same set of standards. If they were, was there actual testing of the tablets, as they were marketed, to prove that they were meeting those standards?"

Husband will be switching over about a week prior to leaving on a 2 wk vacation/cruise!! Overall, it sounds like it should be no problem and he will be bringing his INRatio with as well, but it is helpful to know that no one else ran into problems here. Thanks,

Ann

 

[ALCapshaw2]

After many years sticking to brand Coumadin, Part D medicare made me switch to Barr generic. No problem with INR's ( use INRatio to test) However I no longer can get 100 pills at a time. Scrip apparently must be for one month only and not say " as directed" but must say " one tablet daily". Any one else have experience with this?

Marty

If you do NOT take the same dose everyday, get your DR to Rx TWO different dose tablets with "one a day" for EACH, then fill the Rx's as needed, keeping some surplus for adjustments or in case you don't get the renewal in time. If you take a low dose, it can be useful to have a 'stash' of 1's for adjustments / backup. Maybe your DR could give you some 'samples' for backup. Note that as long as you only take ONE tablet per day, the cost is the same whether you have one or two doses on hand.

'AL Capshaw'