Lorazepam Habit Forming

Margaret Says:

I think most people who take lorazepam are familiar with side effects like any other script, however we also know what works and what doesn't. And I for one am tired of hearing the same explanation that you build up a tolerance. I only have encountered that problem when different mfg merge or deviated from what the formula calls for.

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Leebs Says:

Agreed. Been on Lorazepam long term and have never seen more mfgr chances in the last 6-8 months, between Actavis/Teva, Leading & Aurobindo, just as my body adjusts, there’s a change. My dosage has always stayed the same.

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VerFree Says:

Hello, Margaret, and Leebs! How are you both doing?

If you are referring to posts on a site such as this, where side effect references are regularly posted for medications, as well as warnings about long-term use, such as tolerance, and addiction, the reason for that is because not everyone is aware of these details. Most websites are open for use to anyone in the world, and while the U.S. requires that everyone receive information about potential side effects, and dangers of any medication they are prescribed, that is not universally true, for example, someone from Africa may not be aware of these details. By including the information in each post, when possible, it helps to broaden the dissemination of the relevant information, especially if someone may be doing a search, and you can't know if they will click on the first result, or the 10th.

Sometimes, I am still stunned by how often some foreign doctors tell their patients that any given medication has no side effects, to avoid scaring them away from taking it, rather than simply taking a couple more minutes to address their concerns.

Regarding a tolerance to a medication, such as Lorazepam, not everyone experiences it, there are people who can effectively take the same dose for years, without issue, but that doesn't apply to everyone, since we are all different.

Leebs, there have been a lot of price changes, due to supply chain issues, so many pharmacies are ending up with different generics whenever they have to restock their supply. It all depends on which manufacturer is offering the cheapest price through their distributor at the time they order. However, if your dosage remains the same, then there really shouldn't be any adjustment period.

As to knowing what works, and what doesn't, that is true of most people, but doctors also have to worry about those who are drug seeking, so they can't always just take a patient's word for it, and thus may require prior medical, and pharmacy records.

Ref: Medline Plus Lorazepam

Is there anything I can help with?

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Margaret Says:

Re: VerFree (# 2) Expand Referenced Message

I read your lengthy message that covered many topics regarding lorazepam. What caught my interest was the cheapest price" When pharmacy's buy in bulk and are able to sell cheaper, however, that does not mean that their product falls within the guidelines of the required formula. I have spoken to pharmacist and they have told me that they noticed the difference in the ingredients. Ex: when you put a pill in your mouth and it melts before you reach for a glass of water and you find that you are not getting the same results that tells me that they are deviating from the correct ingredients that the pill calls for. I call it a cost savings for big pharma and I would like to add some pills don't work at all. We should be making our medicine in this country with our products and following strict guidelines. Because pills from all different countries are not the same and we can't be sure under what conditions they are being formulate. Furthermore, how does the mfg. warrant thousands of dollars for the real drug which most people can't afford only to sell the public a poorly substituted formula and lable it a generic. Less formula more money for big pharma and that's what it's all about.

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Margaret Says:

Re: VerFree (# 2) Expand Referenced Message

Myself and many others would be doing better if we weren't put in a position to deal. with these hurdles that big pharma is making for us. Bottom line put the correct formula for what the drug calls for and stop making people's lives more difficult than they are.

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VerFree Says:

Re: Margaret (# 3) Expand Referenced Message

All very good questions Margaret, and I will provide whatever additional information that I can, however, I will also acknowledge that this likely won't help, because it does not change anything.

When it came to generic drugs becoming more readily available, there were other people that thought as you did, they raised concerns about quality, and therapeutic efficacy. This led to the inception of the Hatch-Waxman Act of 1984.

Under this act, to be approved for use in the U.S., all manufacturers must prove that their generics active ingredients are biologically equivalent to the active ingredient in the name brands, and the amount of the active ingredient must be within in plus, or minus 20% of the amount in the name brand.

Ref: FDA Hatch-Waxman

Now, from the way I've worded my statement, and the details provided in the FDA reference link, I am sure you can see where issues might arise...

Requiring an ingredient to be 'proven to be biologically equivalent' does not mean that it has to be completely identical to the original active ingredient, that only means that they have to show that it is sourced from the same substance, and works in the body in the same manner.

Additionally, that plus, or minus 20% allowable difference from the name brand, which the FDA considers to be a 'therapeutically equivalent amount', gives a window of 40% in which they can actually differ.

Breaking this down for those who may not want to do the math, this means that if the original product contained 100mgs of the actual ingredient, an acceptable, approved generic could feasibly contain anywhere from 80 to 120mgs of the active ingredient.

Now, there are some medications in which these variations don't really matter, small fluctuations do not change much about their overall efficacy.

There are also people whose bodies do not suffer any ill effects from these variations, so they never notice any difference.

However, as we all know, there are exceptions to every rule, which means that the efficacy of some medications may be altered by these fluctuations, and some people are more sensitive than others, so they may notice the differences immediately, and experience ill effects from them.

Moving on to you mentioning tablets that may dissolve very fast, before you even get a chance to swallow them.... this is another matter entirely.

The inactive ingredients do not have to be the same, at all, from the name brand to a generic, and from one generic to another. They only have to make sure the inactive ingredients they use are taken from the FDA list of items that are considered to be generally safe, and inactive.

Again, this can create problems for some people, especially if they are very sensitive to medications, or suffer allergies to some products that the FDA considers inactive. I'm very sensitive to medications, and have a lot of allergies, so I've experienced both problems myself, sometimes at the same time.

Another thing to note is that generics are not required to measure the amount of the active ingredient, or its biological equivalence against each other, they only measure against the name brand. This means that there could also be significant differences when being suddenly switched from one generic to another.

The same is also true of the inactive ingredients, each generic manufacturer can use whatever they see fit, they do not all have to agree, and use the same ones.

Even time release formulations are allowed to use different mechanisms of action from one product to another.

So yes, there are reasons for the issues some people experience, but they are all considered legal and acceptable, since they wanted to create more competition in the pharmaceutical market, and help bring generic medications to market faster for those that do not have insurance, and/or have a low income.

As I said, I know this doesn't help, it doesn't fix the problems, I am just filling you in on why such issues happen.

Many generic manufacturers are very careful, and don't allow much variation in their product from the name brand, but some aren't as careful.

Please let me know if there are any other questions I can help you with.

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Richard H Says:

Margaret...... I've been taking the same dose of lorazepam for 40 years (2mg 3x day) for GAD, agoraphobia and panic disorder. Before that, 13 years of valium. Benzos saved my life. Yes, of course I'm addicted but no more so than a friend who must take heart medication or another on Metformin for a severe case of diabetes. But it's downright scary reading that 'tolerance' is not only expected but guaranteed. Somewhere I read a while ago about 5% of patients taking benzos DO NOT build up a tolerance to them. For me, they generally work as well as when I first started them. Like others here, the only time they didn't is when mfgs changed the formula for their generics.....and unfortunately that's always in the 'less effective' direction. For me, Watson was the most dependable. Early Teva was pretty good until it started being made in the Czech Republic. Unfortunately now Teva is the only lorazepam available in every pharmacy within 10 miles of my home. I guess it's better than nothing but I sure would like to see some competition.

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