Fentanyl patches

[Linnear]

Hi there!

Anyone out there know why everyone's got so twitchy over generic prescribing of fentanyl patches!

I was always told that Lithium, Insulin, Diltiazem, Aminophylline etc. should never be generically prescribed as different presentations have different profiles and can cause toxicity/low serum level difficulties.

Any ideas why Fentanyl has been singled out for preferential treatment?

Backhanders somewhere perhaps? Or am I just getting cynical?

[Zoggite]

what do you mean? Has someone High Up in the NHS said that all fentanyl patches were to be considered as bioequivalent and therefore to be p'bed generically, or have they said the opposite?

[admin]

Hi there!

Anyone out there know why everyone's got so twitchy over generic prescribing of fentanyl patches!

I was always told that Lithium, Insulin, Diltiazem, Aminophylline etc. should never be generically prescribed as different presentations have different profiles and can cause toxicity/low serum level difficulties.

Any ideas why Fentanyl has been singled out for preferential treatment?

Backhanders somewhere perhaps? Or am I just getting cynical?

Linnear

I believe what you say about the above list of drugs, along with epilespy medication, is true. However fentanyl is a pain killer so I don't understand what the problem could be (if there is one). The drug release profiles of these patches must be similiar, or else they wouldn't get a licence? I can't really see any real problems from one brand to the other (like dose dumping etc) so I don't understand why someone needs to be brand loyal on this one.

You are always cynical by the way.........

[Linnear]

what do you mean? Has someone High Up in the NHS said that all fentanyl patches were to be considered as bioequivalent and therefore to be p'bed generically, or have they said the opposite?

There was a big hoo hah that different brands of fentanyl patches have such different release profiles that anyone on the patches should always be given the same brand.

I really can't believe it's more dangerous than giving a different brand of lithium etc.

But then what do I know?

[Linnear]

Looks like the back hadners really dried up on this one!

http://www.rpsgb.org.uk/pdfs/pr061114.pdf

This bit seems a bit contradictory though.

In the case
of modified-release oral morphine preparations, the BNF states that dosage requirements
should be reviewed if the brand is changed.

[Zoggite]

Looks like our darling RPSGB is still deeply in love with its "sitting on the fence" position!
"In short,the Practice Committee does not recommend routine brandname
prescribing of modified-release morphine preparations ", it says;BUT, it continues:
"The Practice Committee agreed some good practice points that it commends to the profession.
• Pharmacists should take steps to prevent unintentional changes of the brand supplied to patients"
How hypocritical is that?
Surely the first step to preventing unintentional changes of brand supplied is to insist on brand-name prescribing!