XL, CD, LA, ER...Is there really a difference?

An interesting development has happened in the naming of medications over the past 15-20 years.  After a medication has been on the market for a few years, quite often, the manufacturer will have done some more research and developed a longer acting form of the same medication.  We like this.  Medication adherence is a HUGE issue and whenever we are able to offer a patient once daily dosing, rather than 2 or 3 or 4 times per day dosing, we are greatly increasing the chance for medication compliance.

Here is the issue.  There has been absolutely no standardization in the naming of these medications.  Acronyms are batted around like dented ping-pong balls, and they are not interchangeable.  This is difficult to explain without being too confusing; however, I am going to give it a try.

After the name of the medication, you may see any number of acronyms describing that this particular product is a longer acting product.  Some examples may be as follows: 

·         XL (extra-long?)
·         CD (controlled delivery)
·         LA (long acting)
·         ER (extended release)
·         XT (extra time?)
·         SR (sustained release)
·         SA (sustained action)
·         DR (delayed release)
·         EC (enteric coated)
·         TR (time release)
·         HS (bed time dosing)
·         PM (bed time dosing)
·         CC (continuous control?)
·         XR (extra release?)
·         CR (controlled release)

The point is, there are numerous acronyms, and zero standardization.  Each acronym is considered part of the name of the product and is specific for the product it is designated to.  In other words, there is no set definition for any of the above acronyms and how they apply to the medication they are associated with.

To confuse matters more, there are a few medications that have two different forms of acronyms.  For example, one product has an EC which is a twice daily dosing product and an ER which is a once daily dosing.  Another product has an SR version which is twice daily dosing while it also has an XL version which is once daily dosing.

These acronyms pose as special problem for pharmacists when filling prescriptions.  Not only are we evaluating the entire patient profile to make sure the medication is appropriate for the current situation, we also need to assure that the dosing parameters associated with the particular medication are appropriate for the acronym designation.

Please, if you take any medication that has some sort of long acting or extended release acronym associated with it, take a moment to discuss with your pharmacist exactly what this means.

You may also be interested in reading:

Medication Responsibility
My Pills Look Different


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