If you find your personal menopause symptoms require addressing with your health care provider, it’s important to give special thought to the subject of prescription medications. They may be a valuable tool that is best used when well thought out and monitored closely.
Laura Borgelt, Pharm.D., a professor in the department of clinical pharmacy and family medicine at the University of Colorado Skaggs School of Pharmacy, encourages women to view their menopause symptoms as belonging in one of three buckets: hot flashes, psychological, and urogenital. She says placing symptoms into categories can help patients identify which are most bothersome. This not only steers the conversation with health care providers, but it can help make it clearer which medications are most appropriate.
“There are some drugs that can cover two of the buckets, or in some cases all three,” Borgelt explains. “It helps to create the most effective treatment plan.”
Once a medication has been decided upon with your provider, there are two simple steps to take at the pharmacy to ensure you are receiving what you were prescribed. First, Borgelt suggests having a conversation with your pharmacist to ensure what you’re receiving is what you left the provider’s office understanding you’d be taking, such as a hormone patch to be placed in a specific location and at what interval.
“Sometimes, because there are so many different medications available there may be some confusion around dose or formulation,” Borgelt says. “I think sometimes mistakes can be made at a quick glance.” For example, she explains that one brand of a hormone that comes to mind is offered in a cream and a pill.
Second, once you feel everyone is on the same page with what medication is being dispensed, make sure that’s what’s in the bag before you leave. As with all medications, check for your name, address, medication name, dosage, and use instructions.
On the subject of generic versus branded drugs, professionals agree the differences are subtle, but medical professionals, like their lay patients, may have preferences. “I don’t really go with a generic,” says Diane Pace, Ph.D., APRN, FNP/BC, NCMP, FAANP, a past president of the North American Menopause Society, and an associate professor and director of nursing science for the University of Tennessee Health Science Center College of Nursing in Memphis. “I usually write for the branded name, and that’s when I get the call from the pharmacist if insurance will only pay for generic.”
“That’s when the generic is fine if they want to do that,” she adds. “I write for those drugs that anecdotally in my practice have been effective.”
Fillers, the materials other than the active ingredient that manufacturers use to fill the tablet or capsule, are one example of what may differ from a branded drug to a generic.
Registered Pharmacist Sophia De Monte practices retail pharmacy in Long Island, NY. She says the appearance of the tablet itself or the packaging may be more pleasing in the branded drug, as may the flavor.
In a prescribed drug, such as a patch to be worn on the skin, some patients may find the adhesive works better in the branded product versus the generic De Monte says. She says a majority of the medications for hormone therapy she works with don’t have a generic. “But it’s not really a good savings over the brand,” she adds.
Borgelt says generic versus branded medications are not usually of much concern in the categories of drugs used to treat menopause symptoms, but she does explain there is a negligible difference allowed in the amount of an active ingredient in a generic compared to its branded counterpart. She says the window of allowable difference is very small and would not have a significant clinical outcome.
“I’m all for trying to start with a generic if it’s available,” Borgelt adds.
Diane Pace, Ph.D, APRN, FNP/BC, NCMP,FAANP, via phone interview January 28, 2016. https://www.uthsc.edu/nursing/faculty-and-staff/pace.php
Sophia De Monte, RPh, via phone interview February 1, 2016.
Laura Borgelt, Pharm.D., via phone interview February 1, 2016. http://www.ucdenver.edu/academics/colleges/pharmacy/Departments/ClinicalPharmacy/DOCPFaculty/Pages/BorgeltLauraPharmD.aspx
Reviewed February 2, 2016
By Philip Sarrel, M.D. and Lorna Sarrel, M.S.