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Branded and generic medicines
=============================
Written by Helen Marshall, pharmacist

Why do medicines sometimes have more than one name?
---------------------------------------------------
Medicines will often have more than one name:

a generic name, which is the active ingredient of the medicine
a brand name, which is the trade name the manufacturer gives to
 the medicine.

The generic name is the official medical name for the active
ingredient of the medicine.
The brand name is chosen by the manufacturer, usually on the basis
that it can be recognised, pronounced and remembered by health
professionals and members of the public. An example would be Viagra -
this is the well-known brand name given by Pfizer to the generic
medicine sildenafil. (Brand names are capitalised; generic names are
not.)

The naming process
------------------
When a pharmaceutical company discovers a new generic drug to treat or
prevent a condition, they put it through a series of clinical trials
in order to gain approval for marketing from the Medicines and
Healthcare products Regulatory Agency (MHRA). The MHRA is a government
body responsible for ensuring that all medicines that reach the UK
market meet appropriate standards of safety, quality and efficacy. If
the clinical trial results show the new drug to be safe and effective
for the condition in question, the MHRA approves the drug and gives it
a licence.

Once the licence has been granted by the MHRA, the pharmaceutical
company can then market the generic medicine under a brand name. The
company then has exclusive rights to market the medicine for the
licensed uses for a certain period of time, usually about 10 to 12
years. This is known as a patent, and allows the drug company to
recoup the costs of research and development of the new medicine,
before other drug companies are allowed to produce it as well. Other
drug companies are likely to be able to produce and sell the medicine
at a cheaper rate, because the research and development has already
been done.
Once a patent expires, other drug companies then have the right to
manufacture and market the generic drug. However, they must market it
under a different brand name, or under its generic name.

For example, sildenafil (Viagra) is still under patent and so can
currently only be marketed by Pfizer to treat impotence. Once the
patent expires, we can expect to see other other pharmaceutical
companies marketing potentially cheaper versions of the generic
medicine sildenafil, either under different brand names, or simply as
the generic sildenafil.
Ibuprofen on the other hand is a much older medicine and can already
be bought under various different brand names, eg Nurofen (made by
Reckitt Benckiser), Brufen (made by Abbott) and Anadin ultra (made by
Wyeth Consumer Healthcare), to name but a few. All of these contain
ibuprofen as the generic medicine. Ibuprofen can also be bought simply
as ibuprofen tablets, made by various different manufacturers who
market it without a brand name.

How does this affect me?
------------------------
When a doctor is writing a prescription, or a consumer is buying an
over-the-counter medicine, they may have a choice between a branded
medicine and the generic version of that medicine. Generic medicines
are sometimes cheaper than brand-name medicines, but the active
ingredient (the ingredient that produces the therapeutic effect of the
medicine) is the same in both.

Medicines also contain inactive ingredients, which are used to
formulate the active ingredient into a tablet, liquid, cream or other
preparation. These inactive ingredients are called excipients, and
different manufacturers do not always use the same ones when
formulating their product. This is why medicines containing the same
active ingredient, but made by different manufacturers, may vary in
appearance. The excipients used may create small differences between
them, such as in colour, or the amount of time it takes for a tablet
to dissolve in the gut and be absorbed into the bloodstream, but these
differences are rarely significant, which is why generic and branded
medicines are (with a few exceptions) interchangeable.
Prescription medicines

All high-street pharmacists are obliged by law to dispense whatever
the doctor has written on the prescription. If your doctor has
prescribed a medicine by its brand name, your pharmacist must dispense
that brand. However, if a medicine has been prescribed by its generic
name, your pharmacist can dispense whatever version of the medicine
they have available, because each version will have the same
therapeutic effect, regardless of whether one manufacturer makes the
tablets a different shape or colour. As a result your regular
medicines may vary in appearance each time you renew your
prescription. Generic prescribing like this is one of the ways in
which the NHS can save money that can be better spent elsewhere.
There are a few exceptions to this. There are a handful of medicines
that your doctor must prescribe by the brand name because the inactive
ingredients do affect the action of the medicine. These include:

modified-release theophylline for asthma, eg Nuelin SA,
 Slo-phyllin, Uniphyllin continus
modified-release aminophylline for asthma, eg Norphyllin SR,
 Phyllocontin continus

modified-release diltiazem for angina and high blood pressure, eg
 Adizem-XL, Slozem, Tildiem retard
modified-release nifedipine for angina and high blood pressure, eg
 Adalat retard, Coracten XL

the immunosuppressant ciclosporin, eg Neoral
lithium, which is a mood stabiliser for manic depression, eg
 Camcolit, Liskonum, Priadel

fentanyl patches, eg Durogesic DTrans
carbamazepine, phenytoin and sodium valproate for epilepsy.

If you take any of the above medicines it is important that you always
take the same brand, because different brands of these medicines may
differ significantly in the way they are absorbed. If a different
brand than usual is taken, the blood levels of the active ingredient
could stray outside the required therapeutic range. If the amount in
the blood becomes too low, the effect of the medicine may be lost; if
the amount in the blood becomes too high, there may an increased
chance of side effects.
Your pharmacist will always make sure you receive the correct
medicine, but if you are taking any of the above medicines it is also
wise for you to know which brand you normally take.

If you are ever concerned that the medicine you have been given is
different to what you normally take, always check with your
pharmacist, who will be happy to explain any discrepancies.
Although generic prescribing is an important cost-saving mechanism for
the NHS, do remember that if you have a particular reason for wanting
a particular version of a medicine, for example because you find that
size and shape of tablet easier to swallow, or because it is a
different colour from your other medicines and stops you getting
confused between them, that your pharmacist should normally be happy
to always give you that version.

Over-the-counter medicines
When you buy medicines without a prescription to treat minor ailments
you can usually be sure that generic or own-brand medicines will be
cheaper than their branded equivalents. As long as both medicines
contain exactly the same active ingredients at the same strength
(always check the packaging), the generic or own-brand medicine will
ultimately have exactly the same effect as the branded one and thus
could save you money.

If you have any questions about buying branded or generic medicines
over-the-counter you should ask your pharmacist for advice.
Last updated 15.01.2009

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