Prescribing medicines by generic rather than brand name can improve cost-effectiveness and is encouraged. However, there are some circumstances in which continuity of the same product is important for patient safety and prescribing a specific manufacturer’s product (brand or generic) is preferred. This Medicines Q&A describes such situations and lists medicines that may be considered for brand-name prescribing in primary care.
- Where there is a difference in bioavailability between brands of the same medicine, particularly if the medicine has a narrow therapeutic index.
- Where modified-release preparations are not interchangeable.
- Where there are important differences in formulation between brands of the same medicine.
- Where administration devices (e.g. inhaler or self-injection) have different instructions for use and patient familiarity with one product is important.
- Where the product is a biological rather than chemical entity.
- Where products contain multiple ingredients and brand-name prescribing aids identification.
- Where there are differences in licensed indications.
Adrenaline pre-filled syringes, aminophylline, buprenorphine patches, carbamazepine, ciclosporin, fentanyl patches, lithium, methylphenidate MR, morphine MR, mycophenolate, phenytoin, tacrolimus and theophylline.
Senior Medicines Information Pharmacist, North West Medicines Information Centre