Safety and efficacy of generic drugs with respect to brand formulation
A 72-year-old woman has been brought to her GP's attention for the development of an acute bacterial bronchitis. History revealed the presence of blood hypertension in treatment with calcium blocker (amlodipine 10 mg daily) and a beta-blocker (atenolol 100 mg/day).\nOn examination, blood pressure was 120/85 mm Hg, body temperature was 38.6°C and no lymphadenomegaly/lymphadenopathy was observed. Cardiovascular and abdominal relieves were normal.\nClinical evaluation documented the presence of wheezing, coughing with green mucus and shortness of breath. Therefore, paracetamol (500 mg as need) and levofloxacin (Tavanic, sanofi-aventis® 500 mg tablet once daily for 10 days) were prescribed, but 4 days later the patient returned to the GP for the persistence of symptoms. A detailed pharmacological evaluation revealed that the patient was taking generic levofloxacin (Ranbaxy®, 500 mg once daily) instead of the branded ones because in agreement with Italian law, the pharmacist advised that a bioequivalent drug with a lower price was available.\nGeneric levofloxacin was changed to Tavanic® with a complete improvement of symptoms in 2 days and without the development of side-effects.