Recently, a new generic of Concerta, manufactured by Mallinckrodt, has come to market and patients may be getting this substitute for their prescription. I have  two patients who, having been on the previous generic manufactured by Watson, now say this new generic is clearly not working as well. One of my patients took the pills back to the local pharmacist who is reported to have said “I have several people who have come back complaining ‘It’s not working.’”.

Background: Brand Concerta pill contains a mechanism called “OROS” to deliver the methylphenidate over several hours at an increasing dose over time. The benefit of this specific delivery was established in sophisticated research. The Mallinckrodt generic does not and can not use this technology because of patents. This is not to say that an equivalently effective medication can’t be developed without OROS. It just appears that the Mallinckrodt formulation may not be equally effective to the Watson formulation in some patients.

I bring this to clinicians’ and peoples’ attention for two clinical reasons:

1. If you have been on other preparations of Concerta and now find the medication is not working well for you. Check the manufacturer with your pharmacist. He/she will want to know.

2. If you are prescribed Concerta for the first time, receive a generic, and you find it doesn’t work well, even at higher doses, check the manufacturer. Don’t rule out Concerta as an effective medication because of this experience. See if you can specifically request the Watson formulation from the pharmacist.

Hope this is helpful. I’ll be watchful and interested to see how this develops. Please leave comments for me. Thanks.