Biotech Values

[rph_in_wi]

RE:Adderall takes roughly 3-4 days to reach steady state

While I agree with your facts, I would say that clinical efficacy doesn't always correspond. For instance, I have some patients who swear that generic Lasix (a common water pill) doesn't work as well for them as brand, and are more than willing to pay more for it. Both brand and generic lasix have such modest moderations in bioequivalence that there should be no clinical difference. So what explains the difference?

Remember that if there is no variation in the drug, then the variation must be attributed to the specific patient. The most common patient variations could be due to metabolism issues (kidney/liver), absorption issues (enviromental-stomach acidity or inactive ingredient incompatibility, mechanical-tablet compression as too hard or soft), and distribution issues (fluid volume). Greatly divergent patient variables are usually avoided in bioequivalence testing for FDA approval.

It's taken me years to not question a patient when they observe these differences. In fact, I have taken to tell all my patients to listen to their bodies. You'll be suprised at how much it's telling you!

I hope my pharmacology and therapeutics profs don't think my time was wasted in their classes!

RPh