Can I switch from a brand name seizure medicine to its generic counterpart to save money?

Never make a change in your seizure medicine, either in brand name or dosage, without first checking with your doctor or nurse. There is a general trend in medicine toward the use of generic medicines because they are less expensive. For seizure medicines, however, the generics are often not the same as the brand-name medicines. The major differences are not the quality of the medicine itself, but rather the way in which it is made. The manufacturing process can affect how much of the medicine is absorbed and the rate at which it is absorbed. Switching to a less expensive medicine may reduce seizure control, so it is important not to switch from a brand name to a generic seizure medicine, or from one generic manufacturer to another, without supervision by your doctor.

The Epilepsy Foundation has published a statement expressing concern about insurance providers and institutions that require the use of generics and urging patients and physicians to report problems to the FDA. Nevertheless, a majority of people with epilepsy—especially those with excellent seizure control—probably can use generics safely and effectively as an alternative to more expensive brand-name seizure medicines.

What are safe ways to cut the cost of seizure medicines?

When applying for health insurance, ask if a prescription plan exists and how it works. It may be useful to compare the possible increased costs of a health care plan that includes partial or complete coverage for prescriptions to the costs of the your medicines. You also may be able to save money by comparing prices at different pharmacies. Large drug stores or chain stores often have lower prices, and some pharmacies offer discounts for the purchase of larger quantities. You also may be able to save money by using mail-order or Internet pharmacy services, or by taking advantage of programs sponsored by the manufacturers of many brand-name seizure medicines to help low-income patients afford their products. Your local Epilepsy Foundation affiliate can help you get information. The American Epilepsy Society website contains a directory of prescription drug assistance programs.

More money saving tips

• Ask your doctor to prescribe only one size tablet instead of two sizes. This will help you to avoid making two copayments, However, this will only work if your doctor thinks you do not need a special size tablet to adjust your dose.
• If your tablets have a line in the center, this indicates they can be split in half. Ask your doctor to prescribe a larger size tablet that you will split to get the correct dose. For example, ask for 500 mg tablets, cut them in half and take the correct 250 mg dose. This may cut your costs almost in half because many drugs are priced by tablet instead of by size.



*Please note:You can split the tablet in half either by using a pill cutter or by cracking in half with your fingers. You may purchase a pill-cutter at your local pharmacy. Don't try this with a knife. Also, do not try this with pills that are not marked with a line because unmarked pills can lose their potency if they are broken. When in doubt ask your pharmacist!

Couldn't I save money by taking my pills less often?

You might save money but you will pay the price in more seizures. Trying to stretch your medication by taking your pills less often or taking fewer of them is not safe. Look for a drug assistance program or talk to your doctor about whether you can use a less expensive medication.

Topic Editor:Steven C. Schachter, M.D.
Last Reviewed:12/15/06