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Question: I really enjoy your newsletter. My question concerns Hydergine. What are the advantages/disadvantages between generic and non-generic forms? The price premium for the Sandoz Hydergine is more than two times the price for generic ergoloid mesylates. I’d like to know your opinion before I make a purchase. ——TWB

Answer: In the 80s, there were a number of non-standardized formulations of ergoloid mesylates which used various proportions of the three drugs which compromise Hydergine. Since that time, however, the formulations have been standardized, and now all forms of Hydergine have the same ratio of active ingredients. The bioavailability of the generics may be slightly less (10-20%?), however, taking a bit more of the generic is still much more economical considering the substantial cost differential. I use generic Hydergine. For those for whom price is no object, I recommend Hydergine Liquid Capsules (liquid Hydergine). The liquid capsules have even higher bioavailability than the sublingual tablets (which are themselves better than the oral tablets). ——WD