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Specialist recommends caution with generic glaucoma medications
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PARIS — Generic glaucoma medications are an option for treatment, but specialists should discuss the choice with their patients, evaluate tolerance and return to brand-name drops if necessary, according to one speaker.
Almost the entire range of glaucoma medications is available as generics. The price is about 50% less than equivalent brand-name drugs, and some of them, such as latanoprost, have gained rapid acceptance in France, covering 50% of the total sales of the drug in less than 1 year.
However, studies on the efficacy of generic vs. brand-name latanoprost show controversial results, Jean-Philippe Nordmann, MD, said at the meeting of the French Society of Ophthalmology.
"Though generics are supposed to contain the same active principle in the same quantity, there are other variables that may determine a substantial difference," he said.
The first issue is excipients, which affect viscosity, osmolarity, stability and other important parameters related to the quality and efficacy of a drug.
"All together, these parameters are crucial to determine bioequivalence. While with systemic drugs we can measure bioequivalence by plasma concentration data, this is not possible with topical medications," Nordmann said.
Other variables are related to the containers of the drug. Changes in shape, suppleness and size of the orifice may lead to substantial variations in the volume of drops and quantity of active principle administered with each drop, besides affecting ease of administration.
"Due to all these factors, tolerance may not be identical and needs surveillance," he said.
Disclosure: Nordmann is a consultant for Allergan, Alcon, Théa and MSD.