The Pharmaceutical Journal
Vol 279 No 7474 p437
20 October 2007

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Letters to the Editor

Prescribing

Brand name prescribing and Movicol

From Mr P. Jerram, MRPharmS

A letter by Bruce Burnett and Uttamlal M. Chouhan in the PJ of 22 September 2007 (p326) called for brand name prescribing of a number of drugs, including the Movicol range, to avoid confusion. I thought this an interesting point and one to which I would like to add my support.

There is now considerable confusion as to what should or should not be prescribed by brand name. The Royal Pharmaceutical Society says that it no longer recommends routine brand-name prescribing of modified-release morphine and fentanyl patches since MR morphine preparations are interchangeable (PDF 130K).

However, the BNF 53 seems to say the opposite: “Avoid creating generic names for modified-release preparations”. The National Patient Safety Agency has issued an alert over confusion with differing amphotericin formulations (PJ, 8 September 2007, p249). Even the authors of the PJ letter of 22 September have become slightly confused and have stated that Idrolax is a member of the Movicol family — this is not the case.

Locally we have a high percentage of patients over the age of 75 years. We advocate and use Movicol in care homes on the Isle of Wight as the evidence and local experience suggest that it is more effective, easier to administer and more cost effective than lactulose. We also advocate brand-name prescribing to avoid confusion with prescribers and pharmacists.

I should say that I have no financial or other affiliation with the manufacturers.

I wonder if it possible for the Society, National Prescribing Centre, BNF, NPSA or another body routinely (every year or so) to produce a list of those products that, to avoid confusion, should be written as a brand name.

Paul Jerram
Head of Medicines Management
Isle of Wight Primary Care Trust

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