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" Why do medicines sometimes have more than one name?  Medicines will often have more than one name:   a generic name, which is the active ingredient of the medicine  a brand name, which is the trade name the manufacturer gives to the medicine.   The generic name is the official medical name for the active ingredient of the medicine.  The brand name is chosen by the manufacturer, usually on the basis that it can be recognised, pronounced and remembered by health professionals and members of the public. An example would be Viagra - this is the well-known brand name given by Pfizer to the generic medicine sildenafil. (Brand names are capitalised; generic names are not.)    The naming process  When a pharmaceutical company discovers a new generic drug to treat or prevent a condition, they put it through a series of clinical trials in order to gain approval for marketing from the Medicines and Healthcare products Regulatory Agency (MHRA). The MHRA is a government body responsible for ensuring that all medicines that reach the UK market meet appropriate standards of safety, quality and efficacy. If the clinical trial results show the new drug to be safe and effective for the condition in question, the MHRA approves the drug and gives it a licence.  Once the licence has been granted by the MHRA, the pharmaceutical company can then market the generic medicine under a brand name. The company then has exclusive rights to market the medicine for the licensed uses for a certain period of time, usually around 15 years. This is known as a patent, and allows the drug company to recoup the costs of research and development of the new medicine, before other drug companies are allowed to produce it as well. Other drug companies are likely to be able to produce and sell the medicine at a cheaper rate, because the research and development has already been done.  Once a patent expires, other drug companies then have the right to manufacture and market the generic drug. However, they must market it under its generic name, or under a different brand name (this is known as a branded generic).  For example, the patent that Pfizer has held for Viagra since 1998 has recently expired and this medicine can now be manufactured and marketed by other pharmaceutical companies as well as by Pfizer to treat erectile dysfunction. The generic versions of sildenafil that become available are likely to be cheaper than Viagra. They may be marketed either as generic sildenafil tablets, or under a different brand name (examples include Nipatra and Vizarsin).  Another example is ibuprofen, which is a much older medicine that has been available for years under various different brand names, eg Nurofen (made by Reckitt Benckiser), Brufen (made by Abbott) and Anadin ultra (made by Wyeth Consumer Healthcare), to name but a few. All of these contain ibuprofen as the generic medicine. Ibuprofen can also be bought simply as ibuprofen tablets, made by various different manufacturers who market it without a brand name.     How does this affect me?  When a doctor is writing a prescription, or a consumer is buying an over-the-counter medicine, they may have a choice between a branded medicine and the generic version of that medicine. Generic medicines are sometimes cheaper than brand-name medicines, but the active ingredient (the ingredient that produces the therapeutic effect of the medicine) is the same in both.  Medicines also contain inactive ingredients, which are used to formulate the active ingredient into a tablet, liquid, cream or other preparation. These inactive ingredients are called excipients, and different manufacturers do not always use the same ones when formulating their product. This is why medicines containing the same active ingredient, but made by different manufacturers, may vary in appearance. The excipients used may create small differences between them, such as in colour, or the amount of time it takes for a tablet to dissolve in the gut and be absorbed into the bloodstream. However, these differences are rarely significant, which is why generic and branded medicines are (with a few exceptions) interchangeable.   Prescription medicines All high-street pharmacists are obliged by law to dispense whatever the doctor has written on the prescription. If your doctor has prescribed a medicine by its brand name, your pharmacist must dispense that brand. However, if a medicine has been prescribed by its generic name, your pharmacist can dispense whatever generic version of the medicine they have available, because each version will have the same therapeutic effect, regardless of whether one manufacturer makes the tablets a different shape or colour. As a result your regular medicines may vary in appearance each time you renew your prescription. Generic prescribing like this is one of the ways in which the NHS can save money that can be better spent elsewhere. There are a few exceptions to this. There are a handful of medicines that your doctor must prescribe by the brand name because the inactive ingredients do affect the action of the medicine. These include:   beclometasone dipropionate CFC-free inhalers for asthma, eg Qvar, Clenil modulite modified-release theophylline for asthma, eg Nuelin SA, Slo-phyllin, Uniphyllin continus modified-release aminophylline for asthma, eg Norphyllin SR, Phyllocontin continus modified-release diltiazem for angina and high blood pressure, eg Adizem-XL, Slozem, Tildiem retard modified-release nifedipine for angina and high blood pressure, eg Adalat retard, Coracten XL the immunosuppressant ciclosporin, eg Neoral, Capimune, Capsorin, Deximune  the immunosuppressant tacrolimus, eg Prograf, Adoport, Capexion, Tacni, Vivadex, Modigraf, Advagraf lithium, which is a mood stabiliser for manic depression, eg Camcolit, Liskonum, Priadel mesalazine for inflammatory bowel disease, eg Asacol, Ipocol MR, Mezavant XL, Octasa MR, Pentasa, Salofalk carbamazepine, phenytoin, primidone and phenobarbital for epilepsy.  If you take any of the above medicines it is important that you always take the same brand, because different brands of these medicines may differ significantly in the way they are absorbed. If a different brand than usual is taken, the blood levels of the active ingredient could stray outside the required therapeutic range. If the amount in the blood becomes too low, the effect of the medicine may be lost; if the amount in the blood becomes too high, there may an increased chance of side effects.  Your pharmacist will always make sure you receive the correct medicine, but if you are taking any of the above medicines it is also wise for you to know which brand you normally take.  If you are ever concerned that the medicine you have been given is different to what you normally take, always check with your pharmacist, who will be happy to explain any discrepancies. Although generic prescribing is an important cost-saving mechanism for the NHS, do remember that if you have a particular reason for wanting a particular version of a medicine, for example because you find that size and shape of tablet easier to swallow, or because it is a different colour from your other medicines and stops you getting confused between them, that your pharmacist should normally be happy to always give you that version.  Biosimilar medicines There are an increasing number of medicines being developed that are known as biological medicines. These medicines are derived from naturally-occurring proteins such as hormones, enzymes and antibodies. They are designed to interact with processes within the body in a very specific way, for example by targeting particular cells. Biological medicines have very complex molecular structures and are created using biotechnology. The manufacture of these medicines involves using living organisms such as plant and animal cells or bacteria and viruses to create the medicine. The complex structure and manufacturing process means that exact copies of these biological medicines, or generic versions, cannot be made.  However, once the patent on a biological medicine expires, other companies can make biosimilar medicines. These produce a similar effect to the original biological medicine, but since they cannot be exactly the same they should not be substituted for the original. This means all biological and biosimilar medicines must be prescribed by brand name. Some examples include:  Neupogen, which contains filgrastim, and Nivestim, Ratiograstim and Zarzio which contain biosimilar filgrastim Eprex, which contains epoetin alfa, and Binocrit, which contains biosimilar epoetin alfa Remicade, which contains infliximab, and Inflectra and Remsima, which contain biosimilar infliximab Genotrope, containing somatropin and Omnitrope, containing biosimilar somatropin.    Over-the-counter medicines When you buy medicines without a prescription to treat minor ailments you can usually be sure that generic or own-brand medicines will be cheaper than their branded equivalents. As long as both medicines contain exactly the same active ingredients at the same strength (always check the packaging) and are in the same form (eg tablets/soluble tablets/capsules/liquid), the generic or own-brand medicine will ultimately have exactly the same effect as the branded one and thus could save you money.  If you have any questions about buying branded or generic medicines over-the-counter you should ask your pharmacist for advice.   References Brititsh National Formulary: March 2015 edition. ABPI position on biosimilar medicines: April 2014.  Last updated 12.04.2015 "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.netdoctor.co.uk/medicines/a4474/branded-and-generic-medicines/>