In generic substitution, what must be true for a pharmacist to substitute?

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Generic substitution hinges on matching the brand-name product in key ways and being allowed by law. For a pharmacist to substitute, the generic must be pharmaceutically equivalent to the brand-name product, meaning it contains the same active ingredient, the same strength, the same dosage form, and the same route of administration, and it meets established quality standards. It also must be bioequivalent, so it delivers the active ingredient into the bloodstream in the same way and to roughly the same extent. In practice, generics that meet these criteria are listed as therapeutically equivalent in references used for substitution, which is what allows a pharmacist to substitute without changing the therapy. Beyond the scientific match, state laws govern whether substitution is permitted at all and may require prescriber authorization, patient consent, or specific labeling. Price, color of the tablet, or whether the brand-name product is discontinued do not determine eligibility for substitution.