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Q: I have been reading that there are conflicting views on whether it is as effective to take a generic form of Aldactone. What is your opinion on this? I am on Spironolactone. Is the generic form as effective as the name brand for women's hair loss?

A: This is an important matter because the generic is much cheaper than the brand name. There are FDA standards for manufacturing all medications which the companies have to follow. However, it is hard to be certain that all are really identical. I know of some generic companies with excellent quality control. But others may not be as good. When you get your prescription filled generically, neither you nor the pharmacist knows anything about how it was manufactured. When tablets are made by cheaper processes, they may not disintegrate properly in the stomach and so not be absorbed. Or there may be too much variation in how much medication they contain.

With some medications, it may not make much difference. With an allergy medication for example, the worst is that you might sneeze a little more. With hair loss, it takes months for Aldactone to start working so it is hard to tell if you have a batch which is not as good. No one with alopecia wants to take a chance on taking less effective medication.

In general, I suggest the brand name unless the person cannot afford it. Generic spiro is better than none at all.

The big chain pharmacies like you to use generics because they make a much bigger profit on them than they do on the brand name -- though they don't tell you that.

Hope this is helpful.


Geoffrey Redmond, MD

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