Prescribing tips for fixed-dose combination medicines

Fixed-dose combination medicines (FDCs) have benefits but may cause confusion for some

There is a risk of overdosing if patients take the medicines in a fixed-dose combination or co-pack in addition to the separate medicines the fixed-dose combination or co-pack replaces, or under-dosing if patients do not take all the tablets intended for a daily dose from a co-pack.

Information for your patients

Show people which medicines are being replaced by the combination medicine – eMIMs contains drug images for most products.

Explain to patients that:

  • combination medicines contain more than one active ingredient; the active ingredient is the chemical that makes the medicine work
  • the individual medicines are no longer required
  • a co-pack contains two or more different medicines that each need to be taken daily
  • the risk of errors is reduced by returning unneeded medicines to a pharmacy for safe disposal.

Encourage patients to use and maintain a Medicines List to keep track of the active ingredients and brand names of their medicines. This way the patient can see what medicines are contained in their fixed-dose combination medicines and avoid doubling up.

For more information

  1. Moulds RFW. Combination products – love them or loathe them? Aust Prescr 2001;24:127–9. [Full text]
  2. Llibre JM, Arribas JR, Domingo P, et al. Clinical implications of fixed-dose coformulations of antiretrovirals on the outcome of HIV-1 therapy. AIDS 2011;25:1683–90. [PubMed]
  3. Australian Government Department of Health and Ageing. Compliance Medicines Working Group Report to Pharmaceutical Benefits Advisory Committee. April 2010. [Online]  (accessed 11 December 2012).
  4. Simons LA, Ortiz M, Calcino G. Persistence with a single pill versus two pills of amlodipine and atorvastatin: the Australian experience, 2006–2010. Med J Aust 2011;195:134–7. [PubMed]
  5. Gupta AK, Arshad S, Poulter NR. Compliance, safety, and effectiveness of fixed-dose combinations of antihypertensive agents: a meta-analysis. Hypertension 2010;55:399–407. [PubMed]
  6. Bangalore S, Kamalakkannan G, Parkar S, et al. Fixed-dose combinations improve medication compliance: a meta-analysis. Am J Med 2007;120:713–9. [PubMed]
  7. Alphapharm Pty Limited. Glucovance. 2010. [Online] (accessed 9 October 2013).
  8. Merck Sharp & Dohme (Australia) Pty Limited. Juvicor Product Information. 2012. [Online] (accessed 28 February 2013).
  9. Gadzhanova S, Gillies M, Roughead E, et al. Fixed dose combination diabetes medicines - usage in the Australian veteran population. Aust Fam Physician 2011;40:811–5. [PubMed]
  10. Australian Government Department of Health and Ageing. Home Medicines Review (HMR). 20 August 2013. [Online] (accessed 9 October 2013).