| Active Ingredient Name | Principle | Notes |
|---|---|---|
| Abiraterone acetate 125mg tablet and methylprednisolone 4 mg tablet | Similarity in active ingredient name | Availability of the single and composite pack may cause confusion |
Adrenaline (epinephrine) injection, pre-filled autoinject pen device; available as:
| Differences in administration/delivery device | Even though brands are interchangeable, there are differences in Anapen’s delivery device. Non-Anapen and Anapen products should not be prescribed to same patient without training in their use |
| Agalsidase alfa 3.5 mg/3.5 mL injection | Similarity in active ingredient names | Availability of alfa and beta formulations may cause confusion and selection errors |
| Agalsidase beta 35 mg injection | Similarity in active ingredient names | Availability of alfa and beta formulations may cause confusion and selection errors |
| Amphotericin B (as liposomal) 50 mg powder for injection | Differences in dosing regime and/or rates of administration | Different formulations (e.g. liposomal) have the same chemical name, but different dosing and/or rates of administration |
| Antithymocyte immunoglobulin equine 250 mg/5 mL injection ampoule | Similarity in active ingredient names | Availability of equine and rabbit formulations may cause confusion and selection errors |
| Antithymocyte immunoglobulin rabbit 25 mg powder for solution for infusion vial | Similarity in active ingredient names | Availability of equine and rabbit formulations may cause confusion and selection errors |
| Aripiprazole prolonged release suspension for intramuscular injection; all available strengths | Differences in release characteristics High-risk medicine (antipsychotic) | |
| Atropine sulfate monohydrate 0.01% eye drops | Differences in dosing for different indications | Different formulations for different indications, however the similarity in the strength may lead to confusion between products |
| Atropine sulfate monohydrate 1% eye drops | Differences in dosing for different indications | Different formulations for different indications, however the similarity in the strength may lead to confusion between products |
Beclometasone dipropionate; in all available strengths and formulations 50mcg/actuation nasal spray | Same active ingredient and strength for different indications | Same active ingredient and strength is used for a different indication as a nasal spray. |
| Betamethasone dipropionate | Differences in release characteristics | Different formulations “optimised vehicle” cream/ointment and regular cream/ointment have different release characteristics. |
| Bifidobacterium bifidum, bifidobacterium infantis and lactobacillus acidophilus | Differences in dosing and/or rates of administration | Drops and capsules are available |
| Bimatoprost 0.03% + timolol 0.5% eye drops | Similarity of active ingredient names | Availability of different formulations and combination may cause confusion and selection error The ‘PF’ formulation indicates ‘preservative free’ and is available in single use dose units. |
| Bimatoprost 0.03% eye drops | Similarity of active ingredient names | Availability of different formulations and combination may cause confusion and selection error The ‘PF’ formulation indicates ‘preservative free’ and is available in single use dose units. |
Botulinum toxin type A purified neurotoxin complex injection vial; all available strengths | Brands are not therapeutically equivalent Differences in dosing regimens for the same indications Differences administration/delivery device | There is no therapeutic equivalence between different brands of botulinum toxin and the different brands are not interchangeable. Different brands have different dose regimens for the same indications. Different administration (subcutaneous or intradermal) |
| Brimonidine tartrate eye drops; all available strengths | Similarity of active ingredient names | Availability of different formulations and combination may cause confusion and selection error |
| Brimonidine tartrate 0.2% + timolol 0.5% eye drops | Similarity of active ingredient names | Availability of different formulations and combination may cause confusion and selection error |
| Brinzolamide 1% + brimonidine tartrate 0.2% eye drops | Similarity of active ingredient names | Availability of different formulations and combination may cause confusion and selection error |
| Brinzolamide 1% + timolol 0.5% eye drops | Similarity of active ingredient names | Availability of different formulations and combination may cause confusion and selection error |
| Brinzolamide 1% eye drops | Similarity of active ingredient names | Availability of different formulations and combination may cause confusion and selection error |
Budesonide + formoterol (eformoterol) fumarate dihydrate inhalation available as:
| Differences in administration/ delivery device | Same active ingredients and same strength available as pressurised metered dose inhaler and a dry powder inhaler. Delivery device continuity is required. |
| Budesonide 3 mg modified release capsule | Brands are not therapeutically equivalent Differences in dosing regime and/or rates of administration. Differences in release characteristics | Budenofalk and Entocort have not been assessed as being therapeutically equivalent and similar dose forms are a potential source of confusion |
| Buprenorphine; all available strengths in all available formulations | Differences in dosing regimens and/or rate of administration Differences in dosing regiments for same indications Differences in administration/delivery devices Differences in release characteristics Medicines are not therapeutically equivalent Highrisk medicine (opioid) | Buprenorphine sublingual or injection formulations are available for opiate dependence, while transdermal formulations are generally used for pain relief. All doses of buprenorphine should have brand specified to ensure selection error does not occur |
| C1 esterase inhibitor 500 units injection vial with diluent vial | Brands are not therapeutically equivalent Differences in dosing regimens for different indications | |
Carbamazepine
| Narrow therapeutic index Differences in release characteristics | When prescribing carbamazepine 200 mg, you may specify brand to eliminate confusion between immediate release and modified release tablets. |
| Ciclosporin 100 mg/mL oral liquid | Narrow therapeutic index Differences in administration/delivery device | Switching between brands once patient has been stabilised on one brand of ciclosporin, may lead to clinically important changes in blood ciclosporin concentration |
| Ciclosporin capsule; all available strengths | Narrow therapeutic index Differences in administration/delivery device | Switching between brands once patient has been stabilised on one brand of ciclosporin, may lead to clinically important changes in blood ciclosporin concentration |
Ciclosporin eye drop ampoule available as:
| Similarity of active ingredient names | |
Clostridium botulinum type A toxin – haemagglutinin complex Injection vial; all available strengths | Brands are not therapeutically equivalent Differences in dosing regimens for the same indications Differences administration/delivery device | There is no therapeutic equivalence between different brands of botulinum toxin and the different brands are not interchangeable. Different brands have different dose regimens for the same indications. Different administration (subcutaneous or intradermal) |
| Clozapine; all available strengths in all available formulations | Narrow therapeutic index Highly Specialised Drug Brands are not therapeutically equivalent | Different brands are not a’ flagged on the PBS. There are specific brand patient monitoring systems. |
| Dorzolamide 2% + timolol 0.5% eye drops, bottle | Similarity of active ingredient names | Availability of different combinations may cause confusion and selection error |
| Dorzolamide 2% eye drops, bottle | Similarity of active ingredient names | Availability of different combinations may cause confusion and selection error |
| Epoetin alfa injection; all available strengths | Similarity of active ingredient names | Similar names and similar looking strengths are a potential source of confusion and selection error |
| Epoetin beta injection; all available strengths | Similarity of active ingredient names | Similar names and similar looking strengths are a potential source of confusion and selection error |
| Epoetin lambda injection; all available strengths | Similarity of active ingredient names | Similar names and similar looking strengths are a potential source of confusion and selection error |
| Estradiol and progesterone; all available strengths | Similarity of active ingredient names | |
| Estradiol + dydrogesterone; all available strengths | Similarity of active ingredient name | |
| Estradiol + norethisterone; all available strengths | Similarity of active ingredient names | |
| Estradiol transdermal gel with progesterone 100 mg capsule | Similarity of active ingredient names | |
| Estradiol transdermal patches; all available strengths | Different brands of the same active ingredient have different dosing regimens for the same indications | No ‘a’ flagging across brands. |
| Everolimus tablet; all available strengths and formulations | Narrow therapeutic index. Differences in dosing regimens for different indications | The dispersible tablets are not interchangeable with the regular tablets as they have a lower bioavailability. Switching formulations should only be done under specialist advice, with therapeutic drug monitoring required. |
| Fentanyl; all available strengths in all available formulations | Narrow therapeutic index High-risk medicine (opioid analgesic) | Fentanyl patches are available as matrix and reservoir formulations. Reservoir patches must not be cut because damage to the rate-limiting membrane can lead to rapid release of fentanyl resulting in overdose. Risk of abuse with reservoir patches. |
| Fluorometholone 0.1 % eye drops | Brands are not therapeutically equivalent | Brands are not interchangeable |
| Flupentixol decanoate injection; all available strengths | Differences in release characteristics High-risk medicine (antipsychotic) Differences in administration/ delivery device | |
Fluticasone furoate powder for inhalation available as:
| Similarity of active ingredient names | Similarity in active ingredient name, and the availability of overlapping strengths may cause confusion and selection error. Arnuity is not interchangeable with Flixotide/Axotide. They have different inhalation devices. |
Fluticasone propionate powder for inhalation available as:
| Similarity of active ingredient names | Similarity in active ingredient name, and the availability of overlapping strengths may cause confusion and selection error. Arnuity is not interchangeable with Flixotide/Axotide. They have different inhalation devices. |
| Follitropin alfa injection cartridge, all available strengths in all available formulations | Differences in dosing regime and/ or rate of administration. Differences in administration/delivery device | These are biosimilar medicines but have different dosing and/or rates of administration. Use of biosimilar name only may lead to selection and administration error. Delivery device continuity required Patient familiarity with one brand is important, as instructions for use vary between preparations. Pen devices are different and not interchangeable. User training is required. Use of the biosimilar name alone could lead to prescribing, dispensing and administration errors. These items are not ‘a’ flagged. |
| Formoterol fumarate dihydrate 12 microgram/ actuation powder for inhalation | Medicines are not therapeutically equivalent Differences in administration/delivery devices | Administration delivery devices have different instructions for use and consumer familiarity with one product is an important contributor to consumer compliance and safety |
| Haloperidol | Differences in release characteristics High-risk medicine (antipsychotic) | There may be confusion between the liquid formulation and injections, additional brand specification is appropriate. |
| Hydromorphone hydrochloride; all available strengths in all available formulations | Different formulation release characteristics High-risk medicine (opioid analgesic) Differences in administration/delivery device Narrow therapeutic index Narrow therapeutic index | Hydromorphone immediate release and modified release tablets have overlapping strengths which may cause selection error. There may also be confusion between hydromorphone and other morphine salt injections. Formulations are not interchangeable Switching between brand and generic formulations or between generic formulations should only be initiated by a transplant specialist |
IncobotulinumtoxinA purified neurotoxin, free from complexing proteins Injection vial
| Brands are not therapeutically equivalent Differences in dosing regimens for the same indications Differences administration/delivery device | There is no therapeutic equivalence between different brands of botulinum toxin and the different brands are not interchangeable. Different brands have different dose regimens for the same indications. Different administration (subcutaneous or intradermal) |
Insulin (All insulin products) | Narrow therapeutic index – High-risk medicine (insulin). Similarity in active ingredient names Differences in dosing regimens for same indications Differences in administration/ delivery device | Delivery device continuity is required as instruction between brands and pen devices are different, and user training is required. There are many insulin products that include the same, or similar, active ingredient names |
interferon beta-1a; available as:
| Similarity of active ingredient names | No ‘a’ flagging across brands Potential for pegylated interferon to be confused with interferon products and may lead to selection error |
Iron injections; in all available strengths and formulations including:
| Differences in administration/ delivery device Differences in dosing regimens for the same indication Similarity of active ingredient names | Some brands are administered by intravenous injection or infusion while others may also be administered intramuscularly. |
Itraconazole capsule available as:
| Differences in dosing regimens for the same indications | Preparations are not interchangeable |
| Latanoprost 0.005% + timolol 0.5% eye drops | Similarity of active ingredient names | |
| Latanoprost 0.005% eye drops | Similarity of active ingredient names | |
| Lenalidomide; in all available strengths in all available formulations | Highly Specialised Drug | The bioequivalent brands of lenalidomide are not considered equivalent for the purposes of substitution on the PBS as each brand has specific patient risk management programs. |
| Leuprorelin acetate modified release injection; in all available strengths | Differences in administration/ delivery device | Lucrin is administered by intramuscular injection Eligard is administered by subcutaneous injection |
| levodopa + benserazide; in all available strengths and formulations | Differences in release characteristics Similarity of active ingredient names | |
| Levothyroxine sodium tablet; in all available strengths | Brands not therapeutically equivalent | Eltroxin is not bioequivalent on a same-dose basis with Oroxine, Eutroxsig or Levoxine. |
Lithium carbonate available as:
| Narrow therapeutic index. Similarity of active ingredient names. | |
| Melatonin; in available strengths in all available formulations | Brands not therapeutically equivalent Differences in dosing and/or rates of administration Differences in release characteristics Differences in dosing regimens for the same indications (insomnia) Difference in dosing regimens for different approved indications | Different formulation exists for different indications, with the same strength (Voquily immediate release capsules 5mg indicated for children 6-18 years while Slenyto prolonged release tablet 5 mg is indicated for children 2 – 18 years). The active ingredient of melatonin meets the principles for inclusion in the LMBC - different formulation, same active, different indications or dosing regimens or different release characteristics. |
| Mesalazine; in all available strengths in all available formulations | Brands are not therapeutically equivalent Differences in release characteristics Similarity of active ingredient names | There is no ‘a’ or ‘b’ flagging across the different brands of enteric tablets including Mesasal, Salofalk and Asacol. Therapeutic equivalence has not been demonstrated Pentasa and Salofalk brands of mesalazine modified release granules. There is no ‘a’ or ‘b’ flagging across the different brands of mesalazine suppository or enema formulations. |
Methylphenidate 10 mg available as:
| Differences in release characteristics. | Similarity in strength and active ingredient. |
Methylprednisolone 40 mg injection available as:
| Differences in dosing and / or rates of administration Similarity in active ingredient name. | Similarity in active ingredient names may lead to selection error. |
Methylprednisolone aceponate ointment available as:
| Differences in dosing and / or rates of administration Differences in release characteristics | |
Misoprostol tablet available as:
| Brands are not therapeutically equivalent Differences in dosing regimen for different indications Similarity of active ingredient names | |
| Monobasic sodium phosphate (161mg/mL) + dibasic sodium phosphate heptahydrate (59.3mg/mL) enema | Differences in dosing and / or strength Similarity in active ingredient name | |
| Morphine hydrochloride trihydrate 10 mg/mL injection | Different formulation release characteristics High-risk medicine (opioid analgesic) Differences in administration/delivery device Narrow therapeutic index | Hydromorphone immediate release and modified release tablets have overlapping strengths which may cause selection error. There may also be confusion between hydromorphone and other morphine salt injections. Formulations are not interchangeable |
| Morphine sulfate pentahydrate 10 mg/mL injection | Different formulation release characteristics High-risk medicine (opioid analgesic) Differences in administration/delivery device Narrow therapeutic index | Hydromorphone immediate release and modified release tablets have overlapping strengths which may cause selection error. There may also be confusion between hydromorphone and other morphine salt injections. Formulations are not interchangeable |
| Morphine; in all available strengths and formulations | Differences in release characteristics Highrisk medicine (opioid analgesic) Similarity of active ingredient names | There is immediate release and modified release formulations for both capsules and tablets. Similarities in active ingredient names may lead to confusion and selection error. It is not possible to ensure bioequivalence between different brands of modified release morphine products Caution is needed when changing between different brands of sustained or modified release morphine, or other strong opioid analgesic preparations |
| Olanzapine for intramuscular injection; all available strengths | Differences in release characteristics High-risk medicine (antipsychotic) | |
| Combined contraceptives | Similarity of active ingredient names will likely cause confusion and selection errors | There are many oral contraceptive products that include the same, or similar, active ingredient names which could lead to prescribing, dispensing and administration errors |
| Oxycodone hydrochloride; all available strengths in all available formulations | Differences in release characteristics Highrisk medicine (opioid analgesic) | |
Paclitaxel (as nanoparticle albumin-bound) powder for injection vial available as:
| Differences in release characteristics. Differences in dosing regimens for different indications Similarity of active ingredient name | The brands of Paclitaxel (NOT nanoparticle albumin bound) are interchangeable. |
Paclitaxel injection vial available as:
| Differences in release characteristics. Differences in dosing regimens for different indications Similarity of active ingredient name | The brands of Paclitaxel (NOT nanoparticle albumin bound) are interchangeable. |
| Paliperidone palmitate modified release injection; all available strengths | Differences in release characteristics High-risk medicine (antipsychotic) | |
| peginterferon alfa-2a injection | Similarity of active ingredient names | No ‘a’ flagging across brands Potential for pegylated interferon to be confused with interferon products and may lead to selection error |
| peginterferon beta-1a injection | Similarity of active ingredient names | No ‘a’ flagging across brands Potential for pegylated interferon to be confused with interferon products and may lead to selection error |
| Pomalidomide capsules; all available strengths | Highly Specialised Drug | The bioequivalent brands of pomalidomide are not considered equivalent for the purposes of substitution on the PBS as each brand has specific patient risk management programs. |
| Primidone 250 mg tablet | Narrow therapeutic index (anti-epileptic) | There is no ‘a’ or ‘b’ flagging across both brands of primidone |
| Progesterone pessary; all available strengths | Differences in dosing regimens for the same indication Brands are not therapeutically equivalent | Different brands have not been assessed as therapeutically equivalent |
| Quinine bisulfate heptahydrate 300 mg tablet | Similarity of active ingredient names Brands are not therapeutically equivalent | |
| Quinine sulfate dihydrate 300 mg tablet | Similarity of active ingredient names Brands are not therapeutically equivalent | |
| Risedronate enteric coated 35 mg tablet | Differences in release characteristics Different brands have been assessed as not therapeutically equivalent. Different formulations for the same indications, the similarity in the strength and active ingredient may lead to confusion between products. | |
| Risperidone for intramuscular injection; all available strengths | Differences in release characteristics High-risk medicine (antipsychotic) | |
| Salbutamol 100 mcg/actuation inhalation | Differences in administration/delivery devices | An autohaler is a breath actuated inhaler, which automatically releases a metered dose, without the patient having to manage actuation with inspiration. An inhaler is a conventional press and breather metered dose inhaler. Delivery device continuity is recommended |
| Semaglutide solution for injection; in all available strengths | Same active ingredient and strength for different indications. | Different brands of the same active ingredient and strength have different dosing regimens for different approved indications. |
| Somatrogon 24 mg/1.2 mL injection cartridge, pre-filled pen | Similarity of active ingredient name | Similarity of active ingredient name with somatropin may cause confusion and selection errors |
| Somatropin; in all available strengths and formulations | Differences in dosing regimens and / or rates of administration Differences in release characteristics Similarity of active ingredient name and strength Highly specialised drug | There are many different brands of somatropin, which all come in different devices, formulations and presentations and are not interchangeable Confusion in dosing could lead to adverse results in children diagnosed with growth hormone deficiency. |
| Tacrolimus capsule; in all available strengths in all available formulations | Narrow therapeutic index Differences in release characteristics | There are overlapping strengths between the immediate release and modified release capsules |
| Theophylline; all available strengths in all available formulations | Narrow therapeutic index | |
| Timolol 0.5% eye drops | Similarity of active ingredient names | Different formulations with the same active ingredient and strength may cause confusion and selection errors |
Tolvaptan tablet; available in:
| Different formulations of the same active ingredient have different dosing | Brands are not interchangeable |
| Tramadol; in all available strengths in all available formulations | Narrow therapeutic index High-risk medicine (opioid) | |
Trastuzumab injection vial; available as:
| Similarity of active ingredient names | The availability of the same active ingredient as different formulations may cause confusion and selection error. Potential for confusion between an antibody and antibody-medicine conjugate. |
| Warfarin tablets; all available strengths | Brands are not therapeutically equivalent | Brands are not interchangeable. |
| Zuclopenthixol acetate injection; all available strengths in all available formulations | Different formulations of the same active ingredient have different release characteristics High-risk medicine (antipsychotic) |
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