Prescrire examined the packaging of 190 medicines in 2020. As in previous years, too few met the required standards of quality and safety required of healthcare products.

Knowledge about drug packaging is useful in various ways. It enables healthcare professionals to choose among all the medicines that contain a given drug, and to prescribe the one whose packaging is safer and more likely to ensure the drug is used correctly. It enables them to help patients use their medicines properly. And it helps healthcare professionals to administer drugs safely.

As in previous years, international nonproprietary names (INNs) were too often hard to see on drug packaging, and overshadowed by the invented name. And only a handful of the medicines marketed in dry oral forms (such as tablets or capsules) examined by Prescrire in 2020 were supplied in perforated unit-dose blisters, despite being easy to produce. Worse still, many drugs that are toxic when accidentally swallowed, especially by a child, were marketed in bulk bottles or blister packs with no child-resistant film. Many liquid medicines in bottles were still marketed without a child-proof cap, increasing the risk of overdoses.

A few advances in safety are to be commended, such as clearly displayed warnings for patients about unusual dosing frequencies, and the almost systematic presence of a needle protection system to prevent injuries from used needles.

The recommendations on drug labelling issued in 2018 by the French Health Products Agency (ANSM) offer hope that INNs will be more clearly displayed, at least on drugs authorised by the ANSM.

Pharmaceutical companies that develop and manufacture drugs, and the agencies that authorise them, still have a long way to go in protecting patients and their families from the dangers of poor-quality drug packaging.

©Prescrire 1 September 2021

Source: "Drug packaging, a key factor of quality that sometimes determines the choice of a medicinal product: 2020 review" Prescrire International 2021; 30 (229): 218-222. Free.

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