Active Ingredient Prescribing

Prescriptions created in Communicare V20.2 and later meet the requirements of the Active Ingredient Prescribing legislation (2019), which is mandatory from 1 February 2021.

This legislation ensures that doctors make a clinical decision about the inclusion of the brand by prohibiting prescribing software from including brand names on prescriptions by default.

To meet the requirements of the legislation, set your Prescribing Options to Generic Prescribing. For more information, see Prescribing options in System Parameters - Clinical .

Prescriptions created before the introduction of active ingredient prescribing are displayed according to the new rules if doing so does not change the original intent of the prescriber.

For those medications on the LEMI, prescriptions created before the upgrade are displayed as intended by the original prescriber. However, if a prescription is reprinted, the format abides by the new rules for prescriptions.

Generic medications

Active ingredients are included on all Pharmaceutical Benefits Scheme (PBS) and Repatriation PBS (RPBS) prescriptions, except for medications with four or more active ingredients and a number of other specified items (see LEMI and LMBC below).

For generic medications, Communicare lists each of the items in the pack where each item is made up of one or more active ingredients with varying strengths.

active_ingredient1 strength, active_ingredient2 strength, 
active_ingredient3 strength, active_ingredient4 strength 
form unit_volume [pack_size] Rpts:number_of_repeats
The following rules are used to determine the generic composition of a brand drug/pack:
  • PBS prescriptions - if the generic composition contains only one item with one active ingredient, the form is not included.
  • However, if the formulation of the product contains the terms modified or release, each active ingredient in the product indicates the form.
  • Also, if the formulation of the product does not contain the terms "modified" or "release", but an active ingredient within it does contain these terms, this active ingredient indicates the form of the ingredient.
  • The volume information is added only when it is available. If the volume is 1 per unit, that is 1 / g, the 1 is ignored. For example, 50 mg / g compared to 50 mg / 2 g.
  • If subpackage information is present, this is used, otherwise the number of items per pack is used. For example, [8]x2 means that there are 2 subpackages of 8 items in each pack.

Examples

  • One item, with one active ingredient:
    Metformin hydrochloride 500 mg coated tablet
  • One item, with three active ingredients of varying strengths:
    Aluminium hydroxide 250 mg/5 mL, Magnesium hydroxide 120 mg/5 mL, 
    Magnesium trisilicate 120 mg/5 mL oral suspension 500 mL [1]x2
  • Two items, each with one active ingredient:
    Peginterferon alfa-2b 80 mcg powder for injection [4] & Ribavirin 200 mg capsule [140]
  • Two items, with three active ingredients each:
    Paracetamol 300 mg, Dextromethorphan hydrobromide monohydrate 10 mg capsule & Paracetamol 300 mg, 
    Dextromethorphan hydrobromide monohydrate 10 mg, Doxylamine succinate 6.25 mg capsule [12]

Brand medications

Prescribers may continue to include a brand name on prescriptions wherever clinically necessary for their patient.

When you prescribe by brand, the format of the medication displayed in and printed from Communicare is as follows:
active_ingredient strength form (BRAND_NAME)
For example:
Warfarin sodium 1 mg tablet (COUMADIN)
where COUMADIN is the brand name.

LEMI

Items included in the LEMI are displayed and printed by brand in Communicare. In Communicare, when you add, edit or represcribe an item included in the LEMI, you can select the medication only by brand and an information banner is displayed, This medication is excluded from generic prescribing.
Example LEMI brand only prescribing with banner

For those medications on the LEMI, prescriptions created before the upgrade are displayed as intended by the original prescriber. However, if a prescription is represcribed or reprinted, the format abides by the new rules for prescriptions, except for medications that are represcribed in bulk. For these medications, if they were prescribed by active ingredient before the upgrade and are on the LEMI, they are represcribed by active ingredient.

LMBC medications

Medications included in the LMBC are flagged in Communicare. Providers should consider prescribing these medications by brand. For example, Marevan and Coumadin are not bioequivalent despite both having the same active ingredient of warfarin sodium, so should be prescribed by brand.

In Communicare, when you add, edit or represcribe a medication on the LMBC, the following warning banner is displayed, This medication should be considered for brand inclusion. Is brand name clinically necessary?.
Example LMBC medication in prescribing

Extemporaneous preparations

If you prescribe an extemporaneous medication, an extemporaneous preparation medication warning is first displayed then the following format for the medication is displayed in Communicare:
generic
recipe
The format of extemporaneous preparations printed from Communicare is as follows:
active_ingredient strength form, volume (FREE TEXT)
recipe
FREE TEXT indicates that this is a custom medication.
For example:
Boric acid 1g Solution, 60 mL (FREE TEXT)
Formulation: Mix 20mL of 5% Boric Acid solution with 40mL of deionised or distilled water.