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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can Change Of Brand Of The Medicine, Spironolactone HCTZ, Cause Decreased Urine Output?

I am a 56 year old, with history of idiopathic blood clots (later diagnosed with Factor V Liden); I also have a 34 year history of lymphatic dysfunction post DVT;s. I have had sleep apnea for 40 years but only treated the last 10 years. In Novemmber 2012, I fell at home and because on comadin, I was taken for CT of chest of bdomen.....no bleeding or broken bones, but found cancer on upper post of left kidney, sixe of large softball. This past Septmeber leading to Novemeber of 2013, i was having chest pain. Stress was abnormai, Atrialfib, flutter and V tach. but my cardiac cath was normal. I am currently on Demadex, Spironolactone HCTZ and Benicar for heart and fluid issues. Recently, Express Scripts changed my Spironolactone HCTZ has been changed from Mylan to Greenstone. My overall urine out put which I have been monitoring daily for ten years, has started to decline.....almost 40-60% overnight. What is the chance that the greenstone medications is ineffective as the original brand I have been on for 30 years? Thank, Tony
Mon, 20 Jan 2014
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Psychiatrist 's  Response
Dear Tony,
Thanks for using healthcare Magic.

There may be significant difference between branded and generic drug. As these drugs are regulated by FDA and before approving any generic drug FDA requires content of generic drug in range of 80-120% of the branded drug.

Having said this 60 % decrease in urine output can not be explained on the basis of change of the trade name of the drug.

My advice to you is first change back to origional drug for period of one week and monitor your urine output as you use to do.
If it returns to normal (previous level) than seek another consultation to your physician who will adjust the dose of generic medicine.


If it does not resume to previous level than there may be further deteriration in your renal function.
Thanks
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Can Change Of Brand Of The Medicine, Spironolactone HCTZ, Cause Decreased Urine Output?

Dear Tony, Thanks for using healthcare Magic. There may be significant difference between branded and generic drug. As these drugs are regulated by FDA and before approving any generic drug FDA requires content of generic drug in range of 80-120% of the branded drug. Having said this 60 % decrease in urine output can not be explained on the basis of change of the trade name of the drug. My advice to you is first change back to origional drug for period of one week and monitor your urine output as you use to do. If it returns to normal (previous level) than seek another consultation to your physician who will adjust the dose of generic medicine. If it does not resume to previous level than there may be further deteriration in your renal function. Thanks