DEAR DR. DONOHUE: I would like your opinion on generic drugs. Are they as good as the brand-name ones? My monthly drug bill is quite high, and I don’t have any insurance. My pharmacist suggested I switch to generic drugs to save some money. I have some reservations about them. Are they reliable substitutes? – J.C.

ANSWER: Many people have reservations about generic drugs, but those reservations spring from misunderstanding.

When a drug company develops a new drug, it applies for a patent, which gives the company the exclusive right to manufacture that drug for the next 20 years. The manufacturer doesn’t actually have 20 years of drug marketing, because by the time the drug is ready for the public, there are only 12 to 15 years left on the patent’s protection. Because only one company makes the drug, the costs can be quite high. The company gives the drug a brand name.

When the patent expires, other pharmaceutical companies can make the drug and market it as a generic. The generic name is the name of the active ingredient.

The Food and Drug Administration requires that generic drugs match the brand-name drugs in strength, quality, stability and absorption. Generics can have different inactive ingredients, and they can look different from the original drug but, in all important aspects, they are equivalent to the brand name.

If a doctor wants a patient to have only the brand name – and that can happen with a few drugs – then the doctor writes on the prescription that a generic substitution is not acceptable.

You don’t need to have any reservations about generic drugs. You’ll find that the cost is one-half to one-tenth the cost of the brand-name variety. In a few instances, that is not true, but those instances are few indeed.

DEAR DR. DONOHUE: My doctor heard a heart murmur during my exam, and he thought I had a leaky heart valve. I had an echocardiogram. I don’t have a leaky valve; I have a heart tumor. No one believes me when I say I have a heart tumor. Are they rare? I have an appointment with a heart surgeon. Do you think I will have to have surgery? – D.W.

ANSWER: Heart tumors are rare, and most people have never heard of them. However, they are not so rare that they make headline news.

The most common heart tumor is a myxoma. It’s usually located in the left upper heart chamber, the left atrium. Small myxomas often produce no symptoms. But they grow and can cause serious problems. They can interfere with normal heart rhythm. They can impede the pumping of blood out of the heart. Bits of the tumor can break loose and be carried to distant body locations – like the brain, where they can block blood flow and cause a stroke. They can bring on chest pain, cough, trouble breathing and blood-tinged sputum.

I do think you will have to have surgery. Even though you might not have a single symptom now, most likely you will in the not too distant future if the myxoma isn’t removed.

DEAR DR. DONOHUE: I’m 34. I was taken to the ER because I had bad stomach pain. A CT scan didn’t show anything wrong, and the pain got better on its own. I got a copy of the scan report. It says I have a liver cyst. No doctor mentioned this to me. Should I be concerned? – P.P.

ANSWER: Liver cysts are usually harmless unless they are so large that they disturb liver function or cause pain. If yours does neither, then you don’t have to be concerned. Your cyst did not cause your stomach pain.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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