Some
worrying new guidelines have been recently given by Medicines and
Healthcare Products Regulatory Agency which are not in line with the NICE
guidelines which state:
“Consistent
supply to the child, young person or adult with epilepsy of a particular
manufacturer’s AED [epilepsy medicine] preparation is recommended, unless the
prescriber, in consultation with the child, young person, adult and their
family and/or carers as appropriate, considers that this is not a concern.”
The Medicines
and Healthcare Products Regulatory Agency have put AEDs into 3 categories
as to the importance of having the same brand each time…
Category 1 – Phenytoin, carbamazepine, phenobarbital, primidone
For these drugs, doctors are advised to ensure that their patient is maintained on a specific manufacturer’s product.
Category 2 – Valproate, lamotrigine, perampanel, retigabine, rufinamide, clobazam, clonazepam, oxcarbazepine, eslicarbazepine, zonisamide, topiramate
For these drugs the need for continued supply of a particular manufacturer’s product should be based on clinical judgement and consultation with patient and/or carer taking into account factors such as seizure frequency and treatment history.
Category 3 – Levetiracetam, lacosamide, tiagabine, gabapentin, pregabalin, ethosuximide, vigabatrin
For these drugs it is usually unnecessary to ensure that patients are maintained on a specific manufacturer’s product unless there are specific concerns such as patient anxiety, and risk of confusion or dosing errors.
If your take
an epilepsy medicine that is in category 2 or 3 of the MHRA guidelines, your
doctor might not want to prescribe you the same brand. However, you could ask
your doctor if you could stay on the same version if:
- The thought of changing makes you feel anxious or confused, or
- You think you have had side-effects eizures because you have been prescribed a different version of your epilepsy medicine
You can ask
your doctor to write ‘no parallel imports’ on your prescription, but the
pharmacist doesn’t have to take any notice of this.
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