Kids and Generic Drugs

Medications are getting expensive.

Consider the retail price for a one month supply of some common brand name drugs at a national pharmacy:

• Omnicef for an ear infection $86.99
• Vigamox for pink eye $66.99
• Advair Diskus 100/50 for asthma $150.99
• Protopic ointment for eczema $164.99
• Adderall XR 30 for ADHD $117.99
• Tazorac cream for acne $117.99
• Clarinex 5mg Reditabs for allergies $105.99

This leads many parents to seek a generic alternative, which will hopefully be less expensive. Unfortunately, no one really makes it easy to find generic drugs. Even your insurance company likely lists generic drugs by an unfamiliar generic drug name, like fexofenadine, instead of the more familiar Allegra.

Your pharmacist, and hopefully your pediatrician, can help you figure out when a generic alternative will work for your child, but you have to ask first...

Keep in mind that because of the high incidence of resistance, many generic antibiotics have been replaced by newer medications. This is especially true for the ophthalmic or eye medications. Other older, generic drugs have been replaced by newer medications because newer ones are more convenient to take, work better, or cause less side effects.

Commonly used generic drugs which can save you money versus non-generic, brand name medicines, include:

Generic Antibiotics

In addition to Amoxicillin or 'the pink stuff,' there are quite a few generic antibiotics available these days. Unfortunately, not all of them are available in a suspension form for younger kids.

• Amoxicillin (Amoxil) for strep throat, ear infections, sinus infections, etc.
• Amoxicillin/Clavulanate Acid (Augmentin ES)
• Azithromycin (Zithromax)
• Cefadroxil (Duricef)
• Cefprozil (Cefzil)
• Cefuroxime (Ceftin) tablets only
• Cephalexin (Keflex)
• Cepodoxime (Vantin) tablets only
• Clarithromycin (Biaxin)
• Clindamycin (Cleocin)
• Erythromycin (E.E.S.)
• Minocycline (Minocin)
• Mupirocin (Bactroban) ointment only
• Penicillin VK for strep throat
• Trimethoprim and Sulfamethoxazole (Bactrim)

Suprisingly, two of these antibiotics, Cleocin and Bactrim, have made a comeback in recent years because they actually work better than newer antibiotics against MRSA.

Generic Eczema Medicines

Newer eczema medicines, such as Elidel and Protopic, aren't available as generics yet. Fortunately, most steroid medicines used to treat eczema flares are available as generics, including:

• Fluticasone 0.05% cream (Cutivate)
• Hydrocortisone cream
• Hydrocortizone Valerate 0.2% cream (Westcort)
• Mometasone Furoate 0.1% (Elocon)
• Triamcinolone cream and ointment 0.1%

Other Generic Medicines

Other drugs that are used in pediatrics include:

• Antipyrine, benzocaine ear drops for ear pain
• Bacitracin ophthalmic ointment
• Ciclopirox cream and susp (Loprox) antifungal
• Clonidine tablets
• Cyproheptadine (Periactin)
• Dexamethasone tablets for croup, asthma, poison ivy, etc.
• Econazole nitrate cream (Spectazole) antifungal
• Erythromycin ophthalmic ointment
• Fluconazole (Diflucan)
• Fluoxetine (Prozac) capsules for depression
• generic Polytrim ophthalmic solution
• Gentamicin ophthalmic solution
• Methylyprednisone tablets and dosepak
• Neosporin ophthalmic ointment
• Nystatin cream and ointment for yeast infections
• Ofloxacin 0.3% ophthalmic soln (Ocuflox)
• Polythylene Glycol (for constipation)
• Prednisolone (Prelone)
• Prednisone for croup, asthma, poison ivy, etc.
• Tobramycin ophthalmic solution

Generic Allergy and Asthma Medicines

Since kids typically have both allergies and asthma and need to be treated with multiple medications for good control of their symptoms, parents usually appreciate any help with the expense of these medications. Unfortunately, once Claritin went over-the-counter, many insurance companies stopped paying for prescription allergy medicines and there are few if any generic asthma medications, especially asthma controller medicines. Generic allergy and asthma medications do include:

• Albuterol 0.5% Neb Solution and Syrup
• Albuterol MDI
• Albuterol HFA
• Fexofenadine (Allegra)
• Fluticasone Nasal Spray (Flonase)
• Loratadine (Claritin), which is available over-the-counter

Generic Acne Medicines

Many teens are prescribed 2 or 3 medicines to help get their acne under control, which can get expensive. Although there are many newer medications, like Benzaclin, Differin, Tazorac, and Retin A Micro gel, you might ask your pediatrician if you could start your child's treatment with older medicines that are now generic, including:

• Erythromycin/Benzoyl Peroxide gel (Benzamycin)
• Tretinion cream (Retin A)

Minocycline (Minocin) is an oral generic antibiotic that is also typically used to treat children with acne.

Generic ADHD Medicines

The newer ADHD medicines, including Adderall XR, Concerta, Focalin XR, and Strattera, are good examples of when it can pay to go with a non-generic medication, since they offer a very real benefit of working for 10 to 12 hours versus the generics, which have to be taken at least twice a day:

• D-Amphetamine Salt Combo (Adderall)
• Dextroamphetamine (Dexedrine)
• Methylin ER (Ritalin SR)
• Methylphenidate (Ritalin)
• Methylphenidate CR

Non-Generic Drugs

More expensive, and sometimes newer, medicines that your pediatrician may be prescribing lately can include:

• Advair Diskus and Advair HFA
• Axid
• Astelin Nasal Spray
• Azmacort
• Ciprodex
• Clarinex
• Floxin Otic
• Flovent HFA
• Locoid Lipocream
• Nasonex
• Omnicef
• Prevacid
• Pulmicort
• Quixin
• Rhinocort Aqua
• Singulair
• Suprax
• Vigamox
• Xopenex and Xopenex HFA
• Zymar
• Zyrtec

In many cases, using some of these newer medications, even if they are more expensive, is justified. For example, Suprax and Omnicef are often used for urinary tract infections because the common bacteria that cause them are becoming resistant to Bactrim, the older medication that was used to treat UTIs. And in the case of asthma preventative medications, there really aren't generic alternative medications yet.

For other conditions, such as acne, allergies, eczema, and some infections, you might ask your doctor if a less expensive generic drug is available to treat your child.

Also consider that your pediatrician may have samples or coupons for many of these newer medications if a generic isn't available and you need help paying for your prescription.