Poor drug regulation in India is not a recent problem. The Indian drug market is full of look-alike, sound-alike (LASA) drugs which have not yet caught the attention of the media or the medical community. This viewpoint highlights the problem of LASA drugs and poor prescription practices and proposes solutions for involving all stakeholders in this unaddressed issue which is a huge public health problem in India.
LASA drugs are medications that can easily be confused with one another due to similar appearances, names, or packaging, and they represent a significant patient safety concern in healthcare.
Type.
- Look-alike medicines Look-alike medicines appear visually similar with respect to packaging, shape, color, and/or size. For example, medications like GNAP-10 (antihypertensive), generic Telmisartan (antihypertensive), Glimeimore (oral hypoglycemic agent), and generic Metoprolol tartrate (beta-blocker) are manufactured as round white tablets of nearly identical size, making them extremely difficult to distinguish.
- Sound-alike medicines Sound-alike medicines have phonetically similar names, doses, or strengths. Examples include the confusion between Olvance (Olmesartan—antihypertensive) and Oleanz (Olanzapine—antipsychotic), or between different medications sharing the same brand name like Medzol, which is used for both Midazolam and Pantoprazole.
Clinical Impact and Risks
LASA medication errors account for an estimated 25% of all medication errors and represent a preventable threat to patient safety.These errors can occur at any stage of medication use—prescribing, dispensing, administering, monitoring, or providing advice on medicines.
This can be very dangerous.
Prevention and Safety Strategies
Multiple interventions at different levels can reduce LASA medication errors:
Healthcare provider level: Writing prescriptions in capital letters using International Nonproprietary Names (INN) of drugs, listing diagnosis and indications for prescribed medications, and promoting generic prescriptions.
Drug dispensing level: Implementing double-check systems, ensuring trained pharmacists dispense medications, and separately storing LASA drugs.
Clinical decision support: Computerized systems that flag LASA drugs and highlight potential name pairs, urging providers to verify their selection.
Storage and labeling: Using Tallman lettering (capitalization of specific letters to distinguish similar names) and physically segregating LASA drugs in storage areas.
What’s your thought on LASA drug?
How to prevent misleading to wrong drug?
MBH/AB