Open AccessPrescription switching: Rationales and risks
Author(s) -
Kirby Michael G.,
Allchorne Paula,
Appanna Tim,
Davey Patrick,
Gledhill Richard,
Green James S. A.,
Greene Damian,
Rosario Derek J.
Publication year - 2020
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.13429
Subject(s) - medicine , drug class , drug , medical prescription , class (philosophy) , immunoglobulin class switching , realisation , risk analysis (engineering) , intensive care medicine , pharmacology , computer science , immunology , artificial intelligence , antibody , physics , b cell , quantum mechanics
Summary Background Therapeutic drug switching is commonplace across a broad range of indications and, within a drug class, is often facilitated by the availability of multiple drugs considered equivalent. Such treatment changes are often considered to improve outcomes via better efficacy or fewer side effects, or to be more cost‐effective. Drug switching can be both appropriate and beneficial for several reasons; however, switching can also be associated with negative consequences. Aim To consider the impact of switching in two situations: the use of statins as a well‐studied example of within‐class drug switching, and gonadotropin‐releasing hormone (GnRH)‐targeting drug switching as an example of cross‐class switching. Results With the example of statins, within‐class switching may be justified to reduce side effects, although the decision to switch is often also driven by the lower cost of generic formulations. With the example of GnRH agonists/antagonists, switching often occurs without the realisation that these drugs belong to different classes, with potential clinical implications. Conclusion Lessons emerging from these examples will help inform healthcare practitioners who may be considering switching drug prescriptions.