Before I always got the standard generic 1 mg. sirolimus tablets- the unusual (bulging?) triangular shape. (looks quite different from any other tablet I have seen.) (From what I understand the brand name Rapamune tablets look like that as well.)
I was surprised then, when a recent fill was quite different- very small white ordinary-looking round tablets. Listed on the bottle: Glenmark Pharma.
Have others also got these small white round generic tablets? Are they identical in bioavailability, etc.? Are the triangular ones enteric coated? These round ones too?
Yes, they are fine. Remember, Sirolimus tablets are mostly used for organ transplant patients who might die if the drug had dramatically different characteristics. Glenmark is one of the major generics companies.
I usually advise people who are skeptical about generic drugs to stick to brand-name ones. The reason is simple: the nocebo effect. When patients believe that cheaper drugs are inferior to the originals, this negative psychological expectation can actually cause them to experience more side effects or reduced efficacy. I fall into this category myself, which is why I always try to buy brand-name medications. For those who don’t have this mental hurdle, you just need to make sure the generic has passed bioequivalence testing, because there are a lot of generics out there with pretty poor efficacy.