The principal reasons for advocating the habitual use of nonproprietary (generic) names in prescribing are:
Clarity: because it gives information of the class of drug e.g. nortriptyline and amitriptyline are plainly related, but their proprietary names Allegron and Lentizol are not. It is not unknown for prescribers, when one drug has failed, unwittingly to add or substitute another drug of the same group (or even the same drug) thinking that different proprietary names must mean different classes of drugs. Such occurrences underline the wisdom of prescribing generically, so group similarities are immediately apparent, but point up the requirement of brand names to be as distinct from each other as possible. Relationships cannot and should not be shown by brand names.
Economy: drugs sold under nonproprietary names are usually, but not always, cheaper than those sold under proprietary names.
Convenience: pharmacists may supply whatever version they stock5 whereas if a proprietary name is used they are obliged to supply that preparation alone. They may have to buy in the preparation named even though they have an equivalent in stock. Mixtures of drugs are sometimes given nonproprietary names, having the prefix co- to indicate more than one active ingredient, e.g. co-amoxiclav for Augmentin, but many are not because they exist for commercial advantage rather than for therapeutic need.6 No prescriber can be expected to write out
5 This can result in supply of a formulation of appearance different from that previously used. Patients naturally find this disturbing.
6 This is a practice largely confined to the UK. It is unknown in Europe, and not widely practised in the USA.
the ingredients, so proprietary names are used in many cases, there being no alternative.
International travellers with chronic illnesses will be grateful for recommended International Nonproprietary Names (above) as proprietary names often differ from country to country. The reasons are linguistic as well as commercial (see below).
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