My rant of the day, generic drugs.

I have just opened my pharmacist's package in order to remove the various medications that I take and it was a case of "What the devil is that?". I know this happens in the UK and it happens here, the doctor has to prescribe a drug by its generic name, it is then up to the pharmacist to supply it generically if they can or by trade name if that is all they have. Sounds fine but the packaging differs with each manufacturer as does the colour and shape of the actual tablet.

Is this not dangerous? I am not quite in my dotage but if I get used to taking a diamond shaped orange tablet it confuses me to then be presented with oval white ones. Occasionally the pharmacist will make an error and dispense the incorrect drug, they are human, if you are expecting to find round yellow tablets you will question square blue ones but when the shape and colour changes almost month to month are you really going to check the dosage of the drug?

This isn't far-fetched, I have certainly been given incorrect medication and have questioned it immediately when it is a branded one which I am familiar with, to be honest I don't know if I have been dispensed incorrect generic drugs as I can't remember exactly what I am supposed to take.

A further problem with generic medication, that is when you have been given a couple of packets of medication 'just in case' which have different dosages to each other, one might be twice a day and the other three times a day, but you only have to take them when required... Help, which do I take, which is which? For instance I was prescribed some Stemetil recently (anti-nausea) and some anti-spasmodic drugs (see kidney stones in another forum), the Stemetil turned out to be generic and not called that at all.

My mother is 87 and she knows her drugs generically, she is much better than I, but I don't know if she checks the size of the drugs prescribed each time, perhaps she does. I bet there are many people like me who don't check. How many elderly people mix up their medication because it keeps changing colour and shape? Perhaps there ought to be a ruling that says all tablets of a certain medication must be the same shape and colour regardless of manufacturer so that your special tablet will always be a blue triangle and you don't end up taking an aspirin by mistake.

Am I the only person who gets annoyed with the ever changing colour and shape of medication?

In England , my M in Law, used to get herself a copy of M.I.M.S. which gave out full details of all drugs on the market each month. (In fact, with her it was bedtime reading, neurotic old bag) Maybe you can get that still.

In the US, most doctors prescribe drugs based on brand names. The pharmaceutical companies have "special relationships" with physicians, and the physicians do a large part of their advertising for them.

Pharmacies (drugists) can always dispense your drug to you in a generic form, but it must match identically with dosage to what your doctor has prescribed so your doctor's instructions to you remain the same. Generic is cheaper, and I always get the generic of whatever my doctor prescribes. On the few occasions I've been told that my pharmacy was out of what I wanted, they called around to other branches of their store and found the nearest that DID have it, and I only had to go another 5 minutes or so.

It sounds like there is a big difference between buying drugs in the US and the UK, which I suppose we could have guessed. But, the rant I could go into about pharmaceutical companies is really better left to a board that no longer exists.

There has been an occasion when the generic version of my regular prescription changed packaging, but all the NEW packaging came with notes attached stating that it was, indeed, the same pill even though the package had changed, just for those people who might think their pharmacist had given them the wrong thing.

Here in Australia, when I fill my prescriptions I am always asked by the Chemist if I want what was prescribed or a cheaper generic brand. This way I know why a tablet is differntly shaped or coloured.

We are not given a choice with presciption only medicines, we take what we are given. We pay a fixed sum for each item medication regardless of what is prescribed/dispensed, currently £2.10 per item (not UK where each item is about £6).

My main point is that the drug could be made by a number of companies and although the content is the same the shape and colour differs, surely that must make it confusing for an elderly person who knows s/he take a little round yellow three times each day and a triangular white one four times each day - then s/he is given drugs made by another company and suddenly the white is pink and the yellow is white. Mistakes must happen. Is it beyond the manufacturers to agree to conform to a colour/shape code?

Edited to add that doctors don't get MIMS now, they all use the BNF which is an inch thick and yes I have an old copy, got one off my doctor. That doesn't help when it comes to colour and shape.

Pity. MIMS used to give you colour and shape.

You can see where I am coming from though. Once my pharmacist made a mistake and dispensed .125mg tablets instead of .0625mg, the colour of the ones I should have had was maroon, the ones he gave me were yellow so immediately I knew there was a mistake. Had I taken the larger ones it really wouldn't have mattered too much as they were HRT but if they had been heart tablets it might have been a different story.

I suppose the answer is for me to actually compare the medication against the prescription to ensure no mistake has been made, but who actually does that? Mistakes are not made often but once could be TOO often.

Edited to add MIMS was published by the manufacturers and was basically massive advertising, virtually all brand names. The British National Formulary (BNF) is published by the BMA as doctors are now supposed to prescribe generically where possible to keep the costs down.

I have multiple health issues and take about 5 drugs daily. I always get the same stuff when I go to the same pharmacy, so I know what they look like. They never change. When I went to school, I went to a new pharmacy. One of the drugs was not availible in the same generic I was taking, so the pharmacist explained to me that it looked different, but was the same thing. I know my drugs pretty well.

None of this is to say that I have not had problems with prescriptions. I have, but they have not been related to generics.

I agree there needs to be some standard though. I believe that the simple answer to the problem is to place both generic and brand name labels on the containers.