Day and Night Pharmacy – Pills, Glorious Pills

Pills, Glorious Pills! by Abel Kubare

 

One question I often get asked is, ‘’ The name and the strength of my repeat medicine is the same each month but the size and colour of the tablet is almost always different- are these tablets the same?’’. The answer I tend to give is ‘’Yes.’’. I mean, you know I love a chat- I won’t fob you off just for the fun of it- but sometimes there is limited time….

However, I’ve decided to bore you to death by attempting to respond to that question at length.

Usually the very big pharmaceutical manufacturers conduct research and discover the chemicals which are rigorously tested before being formulated into a suitable syrup, tablet, capsule, pessary or cream etc. They then release the drug onto the market and for a while they will hold a patent which allows them to be the sole manufacturer of that medicine. In this period these guys charge as much as they wish to recover the cost of their research and even more. In other words until the patent expires these big guys hold us at ransom- they call the shots, the NHS just has to pay up or the folks suffer.

While the research to discover medicinal chemicals is fairly complex, their formulation into dosage forms like syrups and tablets is dead easy, even I- your simple local chemist has worked as a production pharmacist supervising the production of commercial batches for human consumption. (I always make sure I mention that. It’s a source of pride.) So once the patent has expired it’s free for all. Every Tom, Dick and Harry who has a licenced pharmaceutical factory can buy the medicinal chemical (active ingredient) and make their own copy of the original brand. Hang on don’t start worrying. The copycat still undergoes checks to ensure that it matches the original to acceptable limits otherwise it won’t be unleashed onto the great British public and beyond.

The most common process of making tablets involves making a porridge-like slurry (wet granulation), drying of the slurry, followed by milling- all this is designed to produce spherical granules which are compressible into a good tablet otherwise direct compression of powder is difficult and would  not produce viable tablets- too hard or too brittle.

 

Usually the active  ingredient forms a very small part of the tablet. So we have to add apparently inactive materials to bulk up the tablet. Common bulking agents are maize starch or lactose powder. At the stage of making slurry a binder like gelatine or starch syrup is added. Colourants, preservatives and lubricating powders (like talc) are usually added at blending-  a process after milling to ensure that the active ingredient is evenly distributed throughout the blend before compression into tablets.

Has the brand got higher potency than Harry’s copycat? No, not necessarily. A copycat steroid cream that we were producing at a manufacturer I worked for back in Zim apparently had superior trans-membrane permeability compared with the leading brand. Sometimes copycat is superior but within acceptable limits  otherwise patients switched from brand to generic would get an overdose. The limits of bio-equivalence are tight enough; for standard tablets, a  patient should get the same clinical effect- remember we are all of different sizes anyway (the big lumps and midgets like me) are still prescribed the same dose of paracetamol or whatever… There are very few drugs for which the dosage for adults is tailored    according to one’s individual weight. So yes these different looking tablets are the same after all,  except for the price.

A common drug for reducing cholesterol cost about £25 pounds for 28 tablets before the patent expired but when the generics were introduced the same pack cost about £2. Hey, these guys do well to    conduct research and discover important             medicines but it should be fair to propose that they also bleed the NHS into intensive care units.

Yours Medicinally, Abel Kubare,

Superintendent Pharmacist Day & Night Pharmacy

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One Comment

  1. Abel and his staff are great..a totally different experience to any other chemist in the area….and probably the world!

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