The Pharmaceutical Journal
Vol 279 No 7469 p291
15 September 2007

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• The profession (3)
• NPC (3)
• Community pharmacy
• Prescription pricing
• Wholesaling
• Anticoagulation
• Dispensing
• The Society (3)
• Regulation
• Fees consultation (2)
• Retention fees (2)
• Listening friends
• The Journal

Letters to the Editor

Dispensing

Medicines use review might ease confusion over modified release preparations

From Mr N. J. Staunton, MRPharmS

I am a little confused as to which modified release preparations should be brand-prescribed and which should not.

In his letter (PJ, 11 August, p155), child psychiatrist David Coghill discussed the importance of ensuring patients receive the same formulation of methylphenidate MR. Dr Coghill discussed the launch of Medikinet XL with the result that there are now two MR methylphenidate brands available (Medikinet XL and Equasym XL). He then discussed the differences in release profile between these.

He concluded that methylphenidate MR should be prescribed by brand name to ensure patients receive the same preparation. This advice is entirely consistent with the BNF (number 53, March 2007) which states: “Avoid creating generic names for modified-release preparations”.

However, advice from the Royal Pharmaceutical Society in 2006 (PJ, 18 November 2006, p620) and Bandolier Extra in 2007 (May 2007) says that MR morphine preparations are interchangeable. The Society says that it no longer recommends routine brand name prescribing of MR morphine and fentanyl patches.

I wonder if there is a role for community pharmacists to use medicines use reviews (alongside primary care trust guidance) to ensure that methylphenidate MR, and other deserving MR preparations, are prescribed by brand while those undeserving are not.

I note that there are still few MURs being conducted compared with the 400 allowed per pharmacy in England and Wales (PJ, 21 July, p63).

Noel Staunton
Pharmaceutical Consultant
Binstead, Isle of Wight

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