From Ms S. A. Patterson, MRPharmS
SIR,-I agree with Mrs Sheila Smith's suggestion that inhalers should be made exempt from generic prescribing (PJ, August 12, p222). However, there have been notes in the British National Formulary advising doctors to specify the brand to be dispensed, eg, nifedipine, diltiazem, theophylline. (Theophylline has a further note saying, in respect of modified release preparations, that it is essential that patients discharged from hospital be maintained on the same brand on which they were stabilised in hospital.) The supply of the wrong formulation in these instances could have more serious consequences than those described by Mrs Smith and yet all these items continue to be prescribed generically, as are lithium, sodium valproate, morphine preparations, oral contraceptives, etc.
Perhaps the computer companies responsible for prescribing software could take note and stop the automatic generic substitution of those products likely to cause problems.
S. Patterson
Woking, Surrey