Dr. Ritu Goel, MD, DFAACAP, explains that while generic drugs remain safe and effective for most children, parents must understand that generic does not mean identical. The FDA only requires generics to match the active ingredients of the original brand. For many basic antibiotics, this is perfectly fine. For sensitive medications like thyroid treatments or ADHD prescriptions, tiny variations in fillers and release technologies matter. These small changes can alter how the drug functions and cause side effects. If your child takes one of these sensitive medications, she advises asking the pharmacy to use the same generic manufacturer for every single refill. Trust your gut if old symptoms suddenly return after refills.