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.
The most reliable way to get the same version is to ask your doctor to write the brand name on your prescriptions. If the brand is written on your prescription, the pharmacist must give you that specific brand, by law.