The Pharmaceutical Journal
Vol 277 No 7428 p647
25 November 2006

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Why the latest edition of Martindale is a must-have for pharmacists

The 35th edition of ‘Martindale: the complete drug reference’ is published next week. The editor, Sean Sweetman, highlights its new features

Whenever a new printed edition of ‘Martindale: the complete drug reference’ appears one of the first questions asked is what is different about this edition. In the past, one could have been forgiven if, after a superficial glance, the conclusion was that little had changed between one edition and another but this would have ignored the immense amount of methodical work that goes into revalidating and updating the text. We try to keep major changes in the format to a minimum so that regular users do not have to relearn how to use a new edition. However, even without opening the publication one can see that the 35th edition is different as it is now produced as a two-volume set. So why the change?

Over a period of nearly 125 years, Martindale has grown from about 314 pages in the first edition to over 2,750 in the 34th edition. Many different techniques have been used to get more and more information on to each page but still the number of pages in each edition has grown. Even with advances in modern binding technology, and rumours of plans for suitable weight-lifting training for users, it was apparent that, if we wished to continue providing information on all drugs and medicines used throughout the world, we were not going to be able to pack everything into one easy-to-use volume any longer.

The time to consider publishing in two volumes had arrived: not completely uncharted territory for Martindale as it had been a two-volume work from the 15th to the 24th edition, but still a major change that required much consideration before its undertaking. In the end the advantages of publishing in two volumes appeared greatly to outweigh the disadvantages.

Familiar layout

Apart from the split into two volumes the layout of most of the content will be familiar to those who already use Martindale. Volume 1 now contains the chapters of drug monographs and volume 2 the section on proprietary preparations, the manufacturers’ index and the general index. Each volume is now of a more manageable size and each can be held comfortably in one hand. We have been told that copies of Martindale often suffer because of the punishment they get from constant use day-in day-out and we are hoping that easing the stress on the binding by dividing the work into two volumes will also make the publication more durable. (For those who require a more portable version, Martindale is also available on a CD-ROM, which can be purchased either separately or as a discounted package with the book. It is, of course, also available online.)

One of the criticisms of past editions has been the denseness of the text and the small type size we have had to use. Moving into a second volume has given us more working space and allowed us to increase the point size and add more white space. We hope that these typographical changes will make it easier for users to locate and read the information they need.

So apart from the improved presentation what other features are new to the 35th edition of Martindale?

Chemical structures

A plea from many users over the years has been to include graphical representations of the chemical structures of the various drugs and related substances in Martindale, a request we certainly could not entertain in a single volume. So I was particularly pleased to be able, finally, to fulfil this outstanding request. The graphics bring a new dimension to the book and help the reader to identify structural similarities between various drugs grouped together clinically in Martindale. Furthermore, including these graphics has also in itself added more white space and eased the perceived density of the publication.

Another of the more noticeable new features in this edition of Martindale is the inclusion of the Russian International Nonproprietary Names (INNs) in Cyrillic text. The user will quickly notice that these are fully covered in a separate Cyrillic section of the index in volume 2 that also includes entries for the Russian proprietary preparations. Martindale has long been an international publication sold around the world and we have always tried to include useful synonyms to help our users. Indeed, after only a short time working with our Spanish colleagues at PharmaEditores, who translate Martindale into Spanish, we realised the need to include INNs not only in English but also in all the INN official languages, namely, French, Russian, Spanish and Latin. We have finally managed to do so for this edition. We have also tried to improve our general coverage of synonyms, as it is always easier and safer for users to be able to locate information using their own native drug name rather than one from another language. For this edition we have included many more synonyms from Scandinavia and the Baltic and East European areas.

Hand-in-hand with the increase in the number of official synonyms we have also included many more “street names” used for various substances of abuse. Although these names cannot be used for definitive identification of a substance they nonetheless serve as a useful guide and a valuable alert where established and well recognised generic names or even herbal names have been misused as street names for completely unrelated substances, eg, belladonna is a street name for phencyclidine.

Drugs in sport

Another project that we have finally brought to fruition is to indicate where a particular drug or substance, or its preparations, might be restricted or banned by sports authorities. Besides individual named drugs referred to in the World Anti-Doping Agency regulations we have been able to use the Martindale classification to include those drugs that are prohibited on the basis that they belong to a restricted class or group of drugs in the regulations. Our interpretation of these regulations and the alerts we provide should be particularly helpful to those health care professionals who have to advise sportsmen and women about the medicines and supplements that they take.

We hope that the new features mentioned above will make the new book easier to use and further add to the usefulness of Martindale as a reliable and unbiased source of evaluated drug information.

On a final note it seems strange for me to be writing about the 35th and latest edition of Martindale in November 2006 because, editorially, we are already well into updating and revalidating the text for the 36th edition and by the time you read this we will have already finished the next quarterly update to the electronic versions of Martindale. Martindale is a work always in progress … always moving forward … never finished.