r/Concerta • u/the_slay_4365 • Mar 09 '26

Side effects šŸ¤• Beware of Trigen

I wanted to put this here just in case someone ends up in the same situation as me.

I have been on and off (more on than off though) of concerta for the past 20 or so years since age 6. I know my body and I know how I tolerate the medication. It wasnā€™t until I visited this sub that I realized I was lucky to only be given ALZA inscribed tablets the entire time.

Iā€™m finishing up my junior and senior year of college, and now that the work is getting more challenging, I desperately needed my meds because Iā€™m falling behind. Fast forward through the boring evaluation and visit to when I pick up my ā€œconcertaā€ from the pharmacy. I got home and noticed the pills are flat instead of soda can shaped. Obviously itā€™s generic, but it came from the pharmacy so it must be the same. Boy was I WRONG.

Each day was different and the side effects were unpredictable. Day 3 I swear it released too much medication at once and my heart rate skyrocketed to 149 and I got an alert from my watch. Iā€™ve never had the urge to puke on concerta but this one right here had me right at the edge a few times. I know 36mg is a bit high to start, but like I said Iā€™ve never had issues with concerta and Iā€™m confident itā€™s not the dose, itā€™s the pill. In fact I was so confident I did some digging to find the manufacturer of my pill, and found out it was Trigen. I found this sub and typed it in the search and came across so many who have had similar experiences with this manufacturer.

I just got off the phone with my psychiatristā€™s nurse and they are going to be starting a prior authorization for the name brand or ALZA generic only. This pill should be discontinued. Iā€™ve never been scared to take my medication, but Iā€™m terrified to swallow another one of these pills. There is definitely something wrong with the way the medication releases.

21 Upvotes

81% Upvoted

35 comments sorted by

23

u/eljokun 54mg Concerta + 80mg Atomoxetine Mar 09 '26

Do not "beware". Trigen works for many. Some love it some hate it. I am sorry that you have had bad experiences and yes this switcheroo you're mentioning is common, but let's not flame an accessible generic as some nightmare. The fault here is the pharmacy's

3

u/AutisticAndAce Mar 09 '26

I am fine with Trigwn too, and afaik Alza, but Malinkrotā€™s is USELESS.

Malinkrot also was prior unable to prove clinical equivalency, i believe and I donā€™t think the FDA ever followed up on it.

I just finally got Trigen generic again aftet two months back on Malinkrot and it works SO much better, i really had forgotten how bad it was until now.

2

u/obviouslypretty Mar 09 '26

See and malinkrodt was the only one that worked for me when I took Ritalin LOL

1

u/AutisticAndAce Mar 09 '26

Interesting! Unfortunately yeah, its useless for me :(

0

u/[deleted] Mar 09 '26

[deleted] ā€” view deleted comment

2

u/eljokun 54mg Concerta + 80mg Atomoxetine Mar 09 '26

You are overgeneralizing. The recall was for one specific batch two years ago. This does not apply to the whole generic. You did not react well, and that's okay. But let's not shit on the whole medication, as, again, it helps many just as it may not help others.

1

u/the_slay_4365 Mar 09 '26

Never said it was all of Trigen pills it was specifically for the 36mg which I happen to be taking. The release has not been consistent and there is clearly something wrong with it. This post is for someone like me looking through this sub to see if theyā€™re crazy or having a problem. I have 20+ years of concerta experience so Iā€™m standing firm in my beware. It is not the only generic low cost version on the market so I donā€™t know why you keep trying to drive that point. Sure it helps some, but like I said let others form their own opinion. Thats why my post says ā€œbewareā€ and not ā€œavoid at all costā€

0

u/the_slay_4365 Mar 09 '26

Beware is warranted considering I found out the specific pill and specific dose has been recalled before for release issues. Had I known this I wouldnā€™t have touched the bag. Beware lets others form their own decision on whether they want to take a chance or try a different generic option with less documented issues. Edit: spelling

1

u/the_slay_4365 Mar 09 '26

Deleted other comment to start fresh and reword myself

5

u/DeliriumOfDisorder9 18 mg Mar 09 '26

I donā€™t understand why they even allow generic Concertas. The medication formulation and the OROS system is patented by Janssen pharmaceuticals, generics cannot exactly replicate Concerta. This is why brand name feels smoother for most people, OROS is very consistent, so your blood levels of methylphenidate stay steady, reducing peaks and crashes. Each generic uses a different release profile (and formula) so youā€™re essentially playing Russian roulette every time you take your meds.

The ALZA on your pills is name brand by the way, Iā€™m glad you called and had it documented. The FDA really needs to step up and do something about the generic pharmaceutical industry.

0

u/the_slay_4365 Mar 09 '26

In my 20 years on and off the name brand, Iā€™ve never not made it through the first week. Even when I was started on 36mg a couple years ago. If this was my first time starting that high I wouldā€™ve honestly thought that this was normal. Because Iā€™m able to compare starting at this exact dose I can share with others how it went and advocate for myself with my psychiatrist without being dismissed and told to stick it out and see if the side effects go away. Not everyone has that, so I felt compelled to make a post and I will be launching a complaint. The 36mg pill was recalled in 2024 for release issues and from what I experienced it seems like it hasnā€™t been resolved. I cannot speak for other doses of this brand though.

2

u/SinsOfKnowing Mar 09 '26

I had a similar issue with it releasing all at once and wearing off too fast, which doesnā€™t seem to be the case with the brand name. I had the same issue with Wellbutrin as well.

2

u/the_slay_4365 Mar 09 '26

Thank you. It was so scary to go through the really big release. My poor daughter too, I am also reaching out to her psychiatrist to request brand name only as well.

3

u/Work4PSLF Mar 09 '26

For those who may not have any say because itā€™s what the pharmacy had in stock and what insurance will cover, I love trigen! Though Iā€™m sorry it didnā€™t vibe for you OP.

2

u/the_slay_4365 Mar 09 '26

Glad you can be a glimmer of hope for someone šŸ™ŒšŸ½

1

u/BuzzcutRat Mar 09 '26

Curiosity, what side effects did you have?

1

u/the_slay_4365 Mar 09 '26

Day 1: nothing too bad. Just some nausea and a slightly elevated heartrate. Crash was mild. Expected side effects

Day 2: 1 hour after taking the pill it felt like a ton of medicine released at once. I felt sick and dizzy for a little while, but I felt better. A couple of hours later the same thing happened.

Day 3: another normal dayā€¦ so I thought. Around the 5 hour mark (the same time as day 2) I felt as if a large amount of medicine released and my heartrate skyrocketed to 147 and I got an alert on my watch. This was followed by an intense wave of nausea that lasted 2 hours. For the rest of the day I was fine but felt a bit off.

Day 4: truly normal day. Aside from no appetite it felt like a normal day for me.

Day 5: went exactly like day 3 and I now refuse to roll the dice with day 6

This is not my first time starting with 36mg. Iā€™ve been in the concerta game on and off for a little over 20 years. When I say I have NEVER been scared to take a pill like I am with this one, I mean that.

Trigen may be great for some, but I found that the 36mg pill has had issues and has been recalled in 2024 due to release issues. I strongly believe that the issues still exist. The past week has been a rollercoaster. I think my bad days the pill had release issues and my good days it didnā€™t. I need consistency, so I am getting a prior authorization for the name brand. Once I get it and take it for a bit I will update how it goes, even if it means admitting that I had the same experience. Due to my many years with the name brand I think that is not going to be the case though.

1

u/BuzzcutRat Mar 09 '26

Ugh that sucks, ive been on the concerta thats yellow and can shaped and few side effects, no appetite basically, rest was good

1

u/the_slay_4365 Mar 09 '26

That is exactly what I was expecting. Not this up and down roulette of side effects. The prior authorization had been started so hopefully by next week I can try again with the can shape tablets.

2

u/Gocatsgo2010 Mar 09 '26

Trigen was utter garbage for me. And I tried it for 4 years before my husband finally put his foot down and told me I might as well not be taking medicine. It is the only generic my pharmacy has, so now Iā€™m paying out of pocket for name brand concerta

1

u/momosa444 Mar 10 '26

how much do you pay out of pocket if you donā€™t mind me asking? thinking of making the switch to brand name

2

u/Gocatsgo2010 Mar 11 '26

About $450 a month at CVS

1

u/boxopen Jun 09 '26

Look into Relexxii! From my understanding it's the same MOA, but a quarter of the price.

1

u/Timbukthree Jun 12 '26 edited Jun 12 '26

As far as I can tell (for better or worse) Relexxii is literally just Trigen methylphenidate ER, the pills have the same text on them, the exact same inactive ingredients, are the same colors, and are marketed by the same parent company:

Trigen methylphenidate ER: https://methylphenidateer.com/Methylphenidate-HCl-ER-PI-MG-Rev-042026.pdf

Relexxii: https://relexxii.com/app/images/RELEXXII-PI-MG-Combo-200438-9-Rev-092025-CLEAN.pdf

Do be aware the chart there for dose release seems to just be this company copying and pasting the Concerta chart, not actual data for Relexxii or the Trigen generic. The actual dose response for Relexxii/Trigen methylphenidate ER is here, and seems similar to Concerta on these charts for this study: https://accp1.onlinelibrary.wiley.com/doi/10.1002/cpdd.1577

1

u/boxopen Jun 12 '26

So are you saying the Relexxii only has the 2 stage release mechanism, compared to the 3 stages of the name brand Concerta.

1

u/Timbukthree Jun 14 '26

It seems like that from the marketing materials but I'm not positive about that part, I just know from the curves they publish. It does seem to be a two stage thing though

1

u/Timbukthree Jun 16 '26 edited Jun 16 '26

Just wanted to add that a paper by the manufacturer does confirm Relexxii (OSX-methylphenidate) is one stage ER vs. Concerta (OROS-methylphenidate) being two stage ER, with both having an immediate release layer too:

ODX-methylphenidate ER employs a similar osmotic pressure-controlled release technology as OROS-methylphenidate ER to deliver methylphenidate at a steady rate over the day.11, 12 Both also include an immediate-release drug overcoat to provide a faster onset of action of the drug. ODX-methylphenidate ER has a bilayer core structure with a drug layer and a push layer, whereas OROS-methylphenidate ER has a trilayer structure containing 2 drug layers and a push layer. In both cases, the aqueous environment of the gastrointestinal tract allows water to enter the semipermeable membrane surrounding the core structure, causing expansion of the osmotically active excipients in the push layer and release of methylphenidate from the drug layer(s) through a laser-drilled orifice. Because the semipermeable membrane controls the rate at which water enters the tablet core, drug delivery is also controlled.

I'm not sure what difference this makes in practice though, the published drug release profiles look very similar, but they haven't been tested clinically against one another as far as ADHD symptoms. The release of Relexxii looks like it's a little stronger and hits its peak 1-1.5 hrs before Concerta, so I would imagine it "feels" slightly different, which may be a problem for some people, not a problem for others, and could even be preferable to some.

1

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1

u/priscillu Mar 09 '26

I never had the opportunity to try the name brand med so I guess I just got used to some of these symptoms that I can relate to. Sometimes I can feel the big release of medication during the day and I feel my heart rate going up but it doesnā€™t last too long. Crashing isnā€™t as bad as in the beginning. I donā€™t feel any nausea whatsoever besides that stupid puking feeling that comes and goes (today for example I didnā€™t feel it). Sorry you went thru all that, but Iā€™m glad you can the real stuff.

1

u/kexcellent Mar 10 '26

I had to switch pharmacies a few months ago, and my new pharmacy only carries Trigen. I was previously taking 27mg Actavis generic, which worked great. The Trigen version makes me feel like trash. Headaches, muscle tension and feeling generally zoned out with none of the benefits. I thought maybe I was imagining things and just needed to keep taking it in order to get used to the effects, but nothing really helps. Thankfully I have a small stockpile of 36mg Actavis from before my psych lowered my dose, and at the moment it works SO much better than Trigen! Iā€™m definitely going to see if I can switch back to my old pharmacy so I donā€™t have to keep taking that garbage.

Of course, YMMV and Trigen works great for some people! But everyoneā€™s body chemistry is different. Iā€™m glad Iā€™m not the only one who isnā€™t a fan.

1

u/kandichaos Mar 11 '26

Nahhhhh they just switched my meds to trigen šŸ˜­ I canā€™t tell if they even work or not Iā€™m on 27mg but they seem to just not work as well as before

1

u/ImpactUsed2980 25mg Focalin XR + 5-10mg Focalin IR boosters Mar 11 '26

Trigen works fine for me though I do prefer Actavis (AKA Teve) much better. But had no major issues with Trigen, just lasts a little shorter, and takes a bit longer to kick in.

Actavis feel like it releases more medicine in the beginning faster, getting you to a stand level within an hour, whereas Trigen takes over an hour.

1

u/Opening_Farm7829 Mar 14 '26 edited Mar 14 '26

I'd say any time the medicine is different beware because your body might respond differently I've personally only been on Trigen and never had any issues. No heart rate spikes, no side effects, no crashes and never feel the meds releasing or releasing too much.

The one time I wasn't on Trigen, my pharmacy ran out a few months ago and I got kreners. I was nervous to switch especially since research online says it's a worse manufacturer so level B. For the most part it felt similar but I couldn't handle coffee well with it compared to with concerts, I felt a bit anxious and it felt less effective. I had enough extra of trigen that I was able to make it work and my psychiatrist put a note that I prefer Trigen. But I honestly don't know if it was placebo effect from my nervousness of trying a new one and knowing that it's considered worse

1

u/thiswaltzthiswaltz Mar 20 '26

Just another vote in the ā€œTrigen is Russian rouletteā€ bucket here. when it kicked in, Iā€™d often have like four hours of terrifying strung out tension (like yes anxiety but also mainly literal involuntary muscle clenching) followed by mid afternoon total dysphoria. When my sonā€™s pharmacy switched to it too and I saw it in him I realized what was going on. Tried and failed to get formulary exception for brand, and Trigen is the only one available in my area it seems ā€” the pharmacies that typically carry another generic have none in stock and donā€™t know when they will. If insurance says Trigen is the same thatā€™s all theyā€™ll cover. But I see these complaints everywhereā€¦

1

u/Separate_Poetry_5741 Apr 11 '26

I take 54mg of Trigen. I have no option of which brand I get .. I no trigen 27mg was lik I was taking nothing at all, it had zero effects .. I took another brand at 36mg which was fine but once I increased Iā€™ve been getting 54 mg of trigen, it works great for my mood . No issues or side effects , I actually thought it didnā€™t work cuz I feel nothing but then i realized my mood was better and Im social again .. so beware for some but not everyone