This information is relevant to people who live in the UK.
The Medicines and Healthcare products Regulatory Agency is wanting to review its guidance on the need for getting the right version of your epilepsy medicine. So it is holding a consultation this year (2017). We will update our information once the guidance has been reviewed.
- Generic prescribing
- Parallel imports
- The problem with generic prescribing and parallel imports
- Advice for people who prescribe epilepsy medicine
- How to get the same version of your epilepsy medicine
- Reporting problems with epilepsy medicines
Epilepsy Action believes that it is important that you get the same version of your epilepsy medicine, every time you pick up a prescription.
Nearly all medicines have a generic name and a brand name. The generic name is usually the name of the main ingredient. The brand name is given by the company that makes the medicine.
In the first years that a medicine is available for patients, it is under licence. This means that only the company that developed it can sell it. They will give it their own brand name. Once the licence runs out, any company can make the medicine, giving it a different brand name. The generic name stays the same.
Here are the generic and some brand names of some commonly used epilepsy medicines.
If a doctor writes the generic name of your medicine on your prescription, a pharmacist can give you any brand of that medicine. This is called generic prescribing. To keep costs down, a pharmacist may choose to give you a cheaper version of a medicine.
Some companies make the same medicine at factories in the UK and in several other countries. An example of this is the epilepsy medicine Tegretol, which is made in Italy and the Netherlands, as well as in the UK. Some chemists in the UK carry supplies of Tegretol from all three countries. So, if a pharmacist gives you Tegretol, it could have been made in any of those countries.
When medicines that are made in the UK are also imported from other countries for use in the UK, they are called parallel imports. There are a number of signs that your epilepsy medicine is a parallel import. For example, the packet may look different or have wording in another language.
Generic prescribing and parallel imports mean there can be many different versions of one medicine.
Some people, who have switched to a different version of their epilepsy medicine, have noticed that they have had more, or different, seizures. Some people have also experienced side-effects that they have not had before.
For this reason, Epilepsy Action believes that people with epilepsy should always get the same version of their epilepsy medicine, wherever possible. This is called consistency of supply. However, not all doctors agree with this.
The National Institute for Health and Care Excellence (NICE) is an independent organisation. They provide guidelines for treatment and care for people using the NHS in England, Northern Ireland and Wales.
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 (MHRA) also gives guidance to people who prescribe medicine and to pharmacists. It is not official policy that must be followed, and Epilepsy Action does have some concerns about it.
The MHRA’s advice about prescribing epilepsy medicines
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.
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 or seizures 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. However, you can insist that your epilepsy medicine is given to you with a Patient Information Leaflet and packaging that is written in English.
If your epilepsy medicine is not made in the UK, it may be impossible to get exactly the same version every time. It is advisable to discuss this with your GP (family doctor).
If you think that you are getting side-effects from your epilepsy medicine, or they have caused your epilepsy to change, talk to your GP (family doctor). They can report these issues to the Medicines and Healthcare products Regulatory Agency (MHRA).
You can also report side-effects yourself by completing a Yellow Card. These are available from your GP (family doctor), pharmacist or the Yellow Card scheme:
Tel: 0808 100 3352
Epilepsy Action encourages you to use the Yellow Card scheme. This is especially important if you think that having the version of your epilepsy medicine changed might have caused any of the following:
- A breakthrough seizure
- Different seizures
- Worse or more frequent seizures or
- Worse side-effects
Please include details of the original version and the new version of your epilepsy medicine.
This is so the MHRA can make changes to their guidance about prescribing epilepsy medicines, if necessary.
If you would like to see this information with references, visit the Advice and Information references section of our website. If you are unable to access the internet, please contact our Epilepsy Action Helpline freephone on 0808 800 5050.
Epilepsy Action would like to thank Professor Markus Reuber, Professor of Clinical Neurology at the University of Sheffield and Honorary Consultant Neurologist at the Sheffield Teaching Hospitals NHS Foundation Trust for his help in producing this information.
This information has been produced under the terms of The Information Standard.
- Updated January 2014To be reviewed January 2017