Generic drugs are safest when not needed

Generic drugs have long held an unusual place in the world of medicine. They have the same ingredients, the same power to treat and the same potential to harm as brand-name prescription drugs. But they’re sold under different names at bargain-rate prices. They’re often manufactured overseas, making them visitors that live under their own set of rules.

Now the U.S. Supreme Court has given these drugs a sort of diplomatic immunity. In a 5-4 split -- with the conservative wing on the winning side -- the court ruled that patients can’t sue makers of generic drugs for complications or side effects not listed on labels. The labels are also essentially copies and, the reasoning goes, the burden lies with the brand-name firms.

The case involved two patients who developed tardive dyskinesias -- a condition that causes involuntary movements of the tongue, lips, hands, feet and other parts of the body -- after taking a generic version (metoclopramide) of the heartburn drug Reglan.

When you can get your antidepressants or your blood-pressure medication for the price of a latte, you just might forget that you’re taking actual medicine. But generics are the real deal. Studies suggest that, on the whole, they have the same effects -- good and bad -- as brand-name medicines.

For example, a review article of 47 studies published in the Journal of the American Medical Assn. in 2008 found no meaningful differences between brand-name heart drugs (such as the blood-thinner Coumadin, the diuretic Lasix and the beta-blocker Toprol) and their generic copies.

But acting like a prescription drug isn’t always a good thing. As another study, published as a JAMA letter in 2006 found, switching from Coumadin to warfarin, the generic version, didn’t seem to lower the risk of major bleeding, including hemorrhagic strokes.

Now that the Supreme Court has made its decision to protect manufacturers of generic drugs, it’s a good time to remember: Whether it’s a brand name or a generic, medications can be risky. The Agency for Healthcare Quality and Research estimates that “adverse drug events” seriously injure or kill more than 770,000 Americans each year -- and that’s just in the hospital.

If you suffer a complication from a generic drug, obviously you shouldn’t expect much help from the courts.

Your best alternative is to avoid trouble in the first place. If your doctor prescribes a medication, ask about possible serious side effects, including those that aren’t listed on the label. Know the early symptoms of a bad reaction. And check with your doctor to make sure that you aren’t taking more medications than necessary.

Generic or no, the safest pill is the one you don’t have to take.