NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Anti-epileptic drug prescribing

The MHRA issued advice in November 2013 on the appropriateness of generic prescribing of antiepileptic drugs (AEDs) and when a patient should stay on a particular manufacturer / brand. This advice is only for the management of epilepsy. Patients on AEDs for neuropathic pain do not require specific brand / manufacturer prescribing.

 

NHSGGC has developed good practice guidance for GPs and community pharmacists (CPs) in the prescribing and supply of AEDs for the treatment of epilepsy. This guidance is based on effective communication between GPs, pharmacists and patients and robust documentation. A patient information leaflet is also available.

 

This guidance does not endorse the wholesale switching of patients on AEDs for epilepsy / seizures onto branded medication but the maintenance of the patient’s current AED manufacturer / brand where appropriate.

 

Actions for prescribers

GPs are required to identify patients on category 1 AEDs (all category 1 drugs require maintenance of a particular AED supply) and category 2 where relevant (those patients on drugs where individual reasons may make maintenance on a particular AED appropriate) for an indication of epilepsy / seizures. The prescribing record should be annotated with “maintain on the same manufacturer’s product” within the dosage instructions. A tool has been developed to aid identification of these patients. Further information is available in the GP good practice guide.  GP record searches should be re-run 6 monthly to ensure all patients have been identified.

Actions for pharmacy

On receipt of an AED prescription with the above statement, community pharmacists should confirm with the patient or carer their usual brand / manufacturer. Once confirmed this should be recorded on the Patient Medication Record (PMR). In cases where the brand / manufacturer is not known or has varied, the opportunity to set the brand / manufacturer should be made and recorded in the PMR. Continuity of supply of the same AED brand / manufacturer should be maintained. Any supply issues should be discussed with the prescriber and patient. Further information is available in the CP good practice guide.