Generic versus Brand-name drops

For a long time, I scoffed at other physicians comments regarding their preference for branded drops. I always felt that the generic drops contained the same compounds and therefore would not have any different effect than branded drops. I also did not give much credence to patients who claimed that they preferred one brand of drop to another. Recently, however, I have been made aware by a huge cohort of physicians that certain generic prednisolone acetate 1% drops have had a deleterious effect on vision after cataract surgery. Certainly, these effects are short-lived and totally reversible, but I hate the thought of affecting a perfectly good surgery with a drop that irritates eyes and decreases vision post-op! It has made me reconsider the use of these generic prednisolone acetate drops. Of course, even generic drops are made by certain companies, and there is only one specific company that has been implicated by this group of physicians as a manufacturer of prednisolone that is having adverse effects. Recently, my practice incorporated the use of a compounded drop that actually makes the cataract post-op drop regimen much easier for patients. The compounded drop contains a “generic” prednisolone, but that drug is not the drop that has been implicated. Now, we know that, in addition to making the regimen easier for our patients, we have the added bonus of avoiding the deleterious generic prednisolone in favor of a good generic prednisolone by using the compounded drops! It has been a great educational experience for me, and I really appreciate the patients and fellow physicians who helped me learn this lesson.