Have you ever visited the pharmacy to pick up your refill and noticed that the pills look different than last time? There are several reasons why this may happen, and it is not something that should concern you.
When a company develops a new drug, they can apply for a patent to gain exclusive rights to the drug. When the patent expires, other companies are allowed to manufacture and sell the generic version of the product, leading to more competition among producers and reduced prices for patients. But this also results in some drugs having multiple different manufacturers and appearances, as different companies may produce their own version of the generic medication with a specific size, shape, color, etc. For example, the generic medication lisinopril (used for high blood pressure) is manufactured by more than 10 different companies!
Lisinopril 20 mg, manufactured by Lupin Lisinopril 20 mg, manufactured by Ivax Pharmaceuticals
The tablets shown in the images above are both lisinopril 20 mg but they look completely different, potentially leading to some patient confusion about whether they received the right medication.
Why does this happen?
As a pharmacy, we prioritize the health of our patients, and we accomplish this by ensuring we have adequate levels of medication inventory in order to fill prescriptions. When we order medications through our distributor, they often have several different manufacturers providing them with medication. If Kelley-Ross pharmacy has a low supply of lisinopril 20 mg, we would order more from our distributor, but we may receive a manufacturer different than what we had last time. This results in the lisinopril possibly looking different for the patient than the last time they got it.
Will this change in appearance affect how the medication works?
Will a different generic medication change how the drug will work on me? The short answer is – it shouldn’t. For companies to create the generic, they must have the same Active Pharmaceutical Ingredient (API) as the brand name product, meaning the therapeutic effect of the generic drug is identical to the brand name. So, different generic lisinopril 20 mg tablets are proven bioequivalents to the original brand name medication, but they are not exactly alike.
Companies are allowed to change the inactive ingredients in their generic drug, including fillers, binders, coloring, or flavoring. These differences are usually minor and likely do not impact how the medication impacts the patient.
What if this happens to my prescription?
At Kelley-Ross we place a label or sticker on the medication to note a manufacture change and the potential that the drug may look different from last time. With the same active ingredient as the brand name medication, the generic has demonstrated identical safety and efficacy as the brand name but may contain different inactive ingredients. This should not change how it affects you, but it is good to keep in mind! While it is unlikely, if you are experiencing abnormal side effects after a manufacture change, please reach out to the pharmacy or a health care provider. If your medication looks different than last time but does not have a label or sticker noting a manufacture change, please contact the pharmacy so we can provide further assistance.
Prepared by Matthew Hohenwalter PharmD Candidate 2026
