Look-alike Sound-alike Health Product Names

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Contact: Policy and Promotion Division

What Are Look-alike Sound-alike (LA/SA) Health Product Names?

The names of some marketed health products appear similar to other products when written or spoken. This is known as a look-alike sound-alike (LA/SA) issue. LA/SA health product name similarities may contribute to medical errors when two products are confused and one is used instead of the other. The confusion may be related to similarities in the written name on a prescription or similarities in how the name is pronounced when ordered over the telephone. The confusion may also occur when a consumer (human drugs) or a farmer/pet owner (veterinary drugs) obtains an over-the-counter product whose product name is very similar to another product name.

An example of similar human brand name drugs that have been confused include Losec and Lasix¹. Losec (omeprazole) is often used to treat ulcers while Lasix (furosemide) can be used to treat hypertension.

What Types Of Health Products Are Affected By This Issue?

The types of health products that are affected by this issue include:

• biologics and pharmaceutical drug products that are intended for use in either human or veterinary medicine;
• natural health products that are intended for human use;
• medical devices that are intended for use in either human or veterinary medicine.

To date, the majority of documented LA/SA health product names are human prescription drugs. Statistics show that name confusion accounts for one in every four medication errors² and that one of the most frequent causes of dispensing errors (29%) is due to look-alike sound-alike product names³.

What Is The Impact Of The LA/SA Health Product Name Issue?

Medication errors caused by LA/SA health product names may result in adverse events that cause harm to the patient (human or animal), especially when two products have different uses. People and animals who are especially vulnerable include the young and the old, those with allergies, those taking other medications or those with concomitant medical conditions.

Currently, when LA/SA drug names are identified, Health Canada works with the sponsors to find an appropriate solution to reduce the potential for confusion between the products. Some possible solutions include:

• requiring the manufacturer to change the name of the proposed health product; and
• increasing public awareness of documented LA/SA health product names.

What Are Some Of The LA/SA Health Product Names That Are Currently Marketed?

Some of the more common LA/SA health product brand names that may be confused include:

• Accutane™
• Accupril™⁴
• Celebrex™
• Celexa^®
• Cerebyx^{® 5}, ⁶
• Lamictal^®
• Lamisil^{® 7}
• Losec^®
• Lasix^{® 8}
• Narcan^®
• Norcuron^{® 9}
• Serzone^®
• Seroquel^{® 10},¹¹
• Taxol^®
• Taxotere™¹²
• Zantac^®
• Zyrtec^{® 13}

What Is Health Canada's Role?

Health Canada minimizes health risk factors to Canadians while maximizing the safety provided by the regulatory system. It critically reviews scientific information and works to ensure that health products in Canada are safe, effective and of high quality.

Health Canada has established a Working Group to review and analyze issues relating to LA/SA health product names and to recommend an appropriate course of action to reduce the potential for confusion between the products.

What Can We Do To Help Prevent These Medication Errors?

Health Canada, health practitioners, pharmacists, veterinarians, manufacturers of human or veterinary drugs, consumers, producers and farmers all need to work together to minimize the potential for confusion between products with names that look or sound alike. The following are some suggestions to reduce medication mix-ups:

Manufacturers

Manufacturers of health products (for use in human or veterinary medicine) are responsible for naming health products.

Manufacturers can reduce the incidence of LA/SA health product names by:

• researching the proposed name to ensure that there are no health products with similar names currently on the market (i.e., computer searches of LA/SA names);
• choosing names that are distinctive, easily written and pronounced; and
• informing Health Canada, health practitioners, pharmacists, veterinarians,consumer groups producer and farming associations when a health product is identified as a LA/SA health product name (e.g., Health Product Advisories for health care professionals or consumers).

Physicians, Nurse Practitioners and Veterinarians

Prescribers, such as physicians, nurse practitioners and veterinarians write prescriptions for their patients.

In order to avoid the potential for LA/SA confusion, the prescriber can:

• write prescriptions clearly by printing the name of the product in block letters, by not using abbreviations or by using electronic prescriptions;
• include more information about the product (i.e., include both brand name and generic name,and the reason for prescribing the medication);
• ensure that the strength, dosage and directions for use are clearly indicated on the prescription;
• ensure the patient (or a family member) understands the reason the medication has been prescribed and verify that the patient can read the prescription; and
• spell out the name of the drug when giving verbal prescription orders.

Pharmacists

Pharmacists ensure that a patient obtains the correct drug, as directed by the prescriber. Furthermore, they provide advice to the patient regarding appropriate use of the product.

Pharmacists can reduce LA/SA errors by:

• keeping LA/SA health products separated from one another;
• creating a warning system for staff to notify them of potential LA/SA health products (i.e., computer alerts, warnings on stock bottles);
• verifying the name of the drug in written and verbal prescriptions;
• contacting the prescriber if they have any questions or need clarification regarding the prescription;
• confirming with the patient the reason they are taking the health product; and
• becoming familiar with LA/SA health products.

Consumers, producers and farmers

Consumers, producers and farmers can help reduce the likelihood of getting the wrong medications by being informed about the medications prescribed for them, being aware of the reasons for purchasing the medication, and following medication directions for appropriate usage.

Consumers, producers and farmers can do this by:

• ensuring that the prescriber has clearly written the name of the drug (i.e., the patient can read the name) and the reason for prescribing the drug;
• speaking with their physician, pharmacist or veterinarian if there are any questions regarding the medication;
• becoming more informed about their condition (or their animal's condition) and medication;
• ensuring that the drug is the same when getting a prescription refill or purchasing it from over-the-counter;
• listening and understanding prescription details given by the pharmacist or veterinarian, especially when obtaining a new prescription; and
• being sure to tell the pharmacist or veterinarian about any changes in medical history of the patient (human or animal), as well as any other medications that the patient is taking, including nonprescription and herbal products.

Questions ?

If you have any questions regarding LA/SA health products, enquire at:
BGTD_PPD_DPP@hc-sc.gc.ca or (613) 954-1798