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
- Key messages on fixed-dose combination medicines
- Definition of fixed-dose combination medicines
- Place in therapy of fixed-dose combination medicines
- Indications for fixed-dose combination medicines
- Adverse effects of fixed-dose combination medicines
- Resources on fixed-dose combination medicines for your patients
- Moulds RFW. Combination products – love them or loathe them? Aust Prescr 2001;24:127–9. [Full text]
- 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]
- Australian Government Department of Health and Ageing. Compliance Medicines Working Group Report to Pharmaceutical Benefits Advisory Committee. April 2010. [Online] (accessed 11 December 2012).
- 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]
- 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]
- 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]
- Alphapharm Pty Limited. Glucovance. 2010. [Online] (accessed 9 October 2013).
- Merck Sharp & Dohme (Australia) Pty Limited. Juvicor Product Information. 2012. [Online] (accessed 28 February 2013).
- 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]
- Australian Government Department of Health and Ageing. Home Medicines Review (HMR). 20 August 2013. [Online] (accessed 9 October 2013).