You’re Paying Too Much for These 10 Expensive Combination Drugs

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
Posted on

Drug companies often combine two cheap generic medications, sometimes slightly altering their doses, and market them as a “new” expensive brand name medication. Don’t let this fool you—in many cases your doctor can make those combinations by prescribing two or more inexpensive drugs, and help you save a ton of dough. Here’s how:

  1. Duexis. Approved in 2011, Duexis is used to treat arthritis pain. It’s expensive and guess what? Duexis is just ibuprofen (Advil) and famotidine (Pepcid) at a dose of 800 mg and 26.6 mg. You can buy ibuprofen anywhere over-the-counter, or get a prescription for 800 mg tablets of ibuprofen. Same for famotidine—you can buy it without a prescription in a 20 mg tablet. Both of these generics will cost pennies if you buy them separately. The point of the famotidine is to protect the stomach from the ibuprofen, and there is no evidence the Duexis combination pill works any better than taking ibuprofen 800 mg along with famotidine 20 mg.
  2. Treximet. Approved in 2008 for the treatment of migraine headache, Treximet is taken at the onset of migraine headache and may be repeated (though this has not been shown to be helpful) after 2 hours. Guess what? Treximet is just naproxen (Aleve) and sumatriptan (Imitrex) at a dose of 500 mg + 80 mg. Naproxen is available as a very cheap generic in 500 mg tablets. Sumatriptan comes in 25 mg, 50 mg, or 100 mg tablets, and it does require a prescription, but it is a relatively inexpensive generic. To make your own Treximet equivalent you can take 500 mg of naproxen and 1.5 tablets of generic cheap 50 mg Sumatriptan. Does swallowing one Treximet pill work better than taking a naproxen and a sumatriptan at the same time? There is no proof that it does—and why would it really?
  3. Acanya is a gel for acne that is very expensive. Acanya is just a mixture of clindamycin gel (1%) and benzoyl peroxide gel (2.5%), both of which are cheap generic prescriptions. Mix those two and you will have Acanya. Acanya may cost you hundreds for a tube, and may not be covered by your insurance, while you can fill a prescription for a tube of clindamycin 1% at as low as $4 – $10 through some generic discount programs, and a 30 gram tube of benzoyl peroxide 2.5% at as low as $15.
  4. Ziana is another expensive acne gel, and another case where you can make your own version by mixing two generic gels: clindamycin 1% gel and tretinoin 0.025% gel. Ziana costs hundreds of dollars for 30 grams, and similar to Acanya, mixing 30 grams of clindamycin gel and 45 grams of tretinoin 0.025% gel will total under $30 in most cases.
  5. Duac and Benzaclin, similar to Acanya, combine generic clindamycin and benzoyl peroxide. Both also have generic combinations available (clindamycin/benzoyl peroxide), but they still cost just under $100 per tube.
  6. Loestrin Fe (birth control with iron). This brand name oral contraceptive may cost you a ton. The difference between Loestrin Fe and less expensive options? Loestrin Fe includes iron in some of the pills in your pill packet—ferrous fumarate 75 mg on days 22 – 28. Please don’t pay extra money for this brand name oral contraceptive just because it includes a few pills when you can buy an equivalent over-the-counter iron supplement. If you do really want the added convenience, generic equivalents of Loestrin Fe include Gildess Fe and Junel Fe, and you’ll still save a ton of money by using the generic instead of the brand.
  7. Beyaz. There is no generic alternative to Beyaz but know this: Beyaz is 0.02 milligrams ethinyl estradiol + 3 milligrams of drospirenone (a type of progestin)—the exact same thing as Yaz and generic Gianvi. What’s different about Beyaz? It has folic acid in it (0.451 milligrams of levomefolate calcium, a metabolite of folic acid). You can buy a folic acid supplement over-the-counter for pennies, at at the dose recommended to prevent neural tube defects: 400 mcg a day.
  8. Contrave is the new weight loss medication, and it will cost you. Contrave is a mixture of naltrexone and bupropion at a dose of 8 mg / 90 mg. Now, I’ll be honest, this one isn’t as easy to replicate. Generic naltrexone comes in a 50 mg dose so you’ll be breaking that tablet into very small pieces. The bupropion part is easier as it comes as a generic 100 mg tablet—almost exactly the 90 mg in Contrave.
  9. Qsymia is another weight loss medication that mixes two existing generics, phentermine and topiramate (generic Topamax). Qsymia capsules come in several dosages: 7.5 mg phentermine with 6 mg topiramate, or 15 mg phentermine with 92 mg topiramate capsules. You can closely approximate these with cheap generic tablets: phentermine 15 mg and topiramate 50 mg or 100 mg.
  10. Solodyn. While not a technically combination drug, this is another case where taking more pills could save you a bunch. Minocycline is often prescribed for acne over doxycycline because it is less photosensitizing (less likely to cause a rash when in the sun) and is available as a cheap generic. Generic minocycline 50 mg or 100 mg capsules can be found for as low as $12 – $30 for a 30-day supply (60 capsules, in this case—it’s taken twice a day). Solodyn is an extended release version of minocycline, so it’s more convenient at once daily dosing, but it’s really expensive. Even the extended release generic minocycline ER is pricey. Regular minocycline capsules may be hundreds of dollars cheaper than Solodyn or minocycline ER, so know there are options before you pay the big bucks.

Hope this helps . . .

Dr O.

Filed under