It's a common moment of confusion: a refill arrives and the tablets look nothing like the ones from last month, even though the label says the same drug and strength.
Generic competition means multiple manufacturers
Once a brand-name drug's patent expires, multiple generic manufacturers are approved to produce it. Each one formulates and shapes its own version independently, as long as it meets the FDA's bioequivalence requirements for the active ingredient.
Inactive ingredients can differ too
The active ingredient must match, but fillers, coatings, dyes and binders are not standardized between manufacturers. That's why size, colour, coating and even shape can vary between otherwise-identical prescriptions.
Pharmacies change suppliers
Pharmacies frequently switch which generic manufacturer they stock, often for cost or supply reasons, which is why your own refill of the same prescription can change appearance between pickups.
What to do if a refill looks different
A different appearance on a refill is usually normal, but it's always reasonable to ask your pharmacist to confirm the medication and strength match your prescription before you start taking it - especially if the change surprises you.