(c) The general patient's preference for branded products and the absence of formulation substitution rights for pharmacists resulted in a barrier that prevents usage of generic drug products.
A survey of 130 expert electrophysiologists analysed their experience with formulation substitution using AADs [ 124].
Another patient presented a recurrence of AF with a rapid ventricular response to a quinidine formulation substitution, which simultaneously resulted in a decline in the digoxin blood concentration.
If formulation substitution is undertaken, it is strongly recommended to employ rigorous monitoring of drug levels and/or ECG or other PD markers.
Some sparse evidence indicated that formulation substitution involving AADs (quinidine, procainamide, disopyramide, amiodarone) can be associated with clinical equivalence, inequivalence [ 2, 3] and sometimes with adverse clinical consequences [ 2, 3, 126– 132].
In this case, formulation substitution resulted in a change in serum and tissue levels of one drug which, in turn, led to changes in the concentrations of a second agent if the PK of this second agent is directly influenced by the amount of the first agent [ 2, 3].
Thus, it seems reasonable to avoid formulation substitution from the brand-name drug to a generic drug, from a generic drug to another generic drug or from a generic drug to a brand-name drug, when the possible recurrence of the arrhythmia due to a lower drug plasma concentration or when an increase in drug plasma levels due to a PK interaction can lead to a serious event for the patient.
Gradual substitution of anticorrosive coating formulations revealing hazardous effects on the environment by eco-friendly ones is nowadays an ongoing trend in the coating industry.
The present article is devoted to these so-called bone substitute materials, with an emphasis on four aspects: (1) the various materials used for bone substitution, (2) the various formulations that are commercially available (granules, blocks, pastes, cements, membranes), (3) the special architectures used for such materials, and finally (4) the main resorption mechanisms of bone substitutes.
In fact, in theory, a "drift" may appear upon generic-generic drug substitution, meaning that generic formulations that are bioequivalent to the innovator drug, respectively, may not be bioequivalent to each other [ 6].
