To the Editor. —In the SPECIAL COMMUNICATION by Nightingale and Morrison1 concerning generic drugs, the subject of bioequivalence was discussed. However, no mention was made of bioavailability.In the past year, I have personally seen six patients who complained about the lack of effectiveness of oral estrogen therapy in alleviating their symptoms. Specific questioning revealed a difference between the control of their menopausal symptoms with the use of generic as opposed to brand name conjugated estrogens.In each instance, estradiol levels were below 37 pmol/L (10 pg/mL) or nondetectable. When these patients were switched to brand name conjugated estrogens, their menopausal symptoms were alleviated and their estradiol levels when rechecked were all above 165 pmol/L (45 pg/mL).The equine estrogens or synthetic estrogens are required by the United States Pharmacopeia to contain 50% to 63% estrone sodium sulfate, 22.5% to 32.5% equilin sodium sulfate, not more than 20% dihydroequilin,
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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