International Nonproprietary Names (INNs) are the official generic names for pharmaceuticals as designated by the World Health Organization (WHO). The other nomenclature systems in use are BAN (British Approved Names), USAN (United States Adopted Names), AAN (Australian Approved Names). New Zealand does not specify which nomenclature to use in legislation or as part of the medicine registration process so could receive medicines using any of these nomenclature. However Medsafe (regulatory body) has advocated use of the INN (other than on products containing adrenaline and noradrenaline) in its medicine labelling guideline for the industry.
As some countries have changed completely to using rINNs, New Zealand has been receiving a number of INN labelled medicines. There is no official change over period for the naming of these medicines in New Zealand so doctors, pharmacists, nurses and patients may first observe the change when they see the medicine or someone tells them. While for most medicine names there will be little or no change, there is concern about the impact this may have on patients who have supplies of the same medicine with different nomenclature and may not take a medicine with an unfamiliar name or end up taking duplicate doses (Figure 1).
Figure 1 - Examples of common medicines facing a name change:
Current term | INN |
thyroxine | levothyroxine |
amoxycillin | amoxicillin |
frusemide | furosemide |
bendrofluazide | bendroflumenthiazide |
dothiepin | dosulepin |
eformoterol | formoterol |
methotrimeprazine | levopromazine |
oestradiol | estradiol |
The following tips may minimise the confusion caused by medicine name changes:
- Inform health care staff (including part-time and locum staff) who deal with medicines in their roles of the name changes.
- Use the NZ Formulary to check the name of the medicine as it lists both the INN and alternate name(s) for medicines.
- Alert patients, carers and those who collect medicines on patients’ behalf that the medicine name on the prescription or dispensing label has changed.
- Update electronic systems that have medicine information with the new medicines names.
- Ensure that dispensing systems can produce labels using the new name and can maintain effective ordering communication with pharmaceutical suppliers.
- When dispensing original medicine packaging, ensure that they all have either the former name or the new name but not a combination of the two.
- Ensure that the names are changed on repeat prescribing forms and on medicine administration record forms in aged care facilities.
- Place reminders of medicines whose names have changed significantly in prescribing, dispensing and administration areas and in medicine storage areas in both the new and previous location.
- Withdraw from clinical areas stocks of medicines whose names have changed significantly and are considered to pose a higher risk and supply them in