What are Specials?
A 'Special' is an unlicensed medicine that has been made especially to suit your needs. Your doctor will tell you if they have prescribed you or your child a Special and they will also tell you why. You may have been prescribed a Special for a number of different reasons; however it will be because there is no licensed alternative that is suitable to help treat you. It may be that you're allergic to the medicine, that the medicine you need is currently unavailable or maybe you have difficulty swallowing tablets.
Unlicensed medicines are made up of well-known medicinal ingredients that can, sometimes, just be mixed in a different way or provided as liquid instead of a tablet.
How Specials are made
The doctor who has prescribed your medicine will write on a prescription what needs to be in the medicine for your treatment. In most cases the pharmacist will order your medicine from a 'Specials manufacturer' who will hold a Specials Licence. Manufacturers who hold a licence have proved that the products they produce are safe and made to a high quality as a pharmaceutical medicine.
How to take your Special
Your doctor and pharmacist will do their utmost to ensure you get your medicine as speedily as possible, however because it has to be ordered and sometimes made especially for you, you may have to collect it the following day.
Your medicine will have been prescribed to you by a doctor and usually prepared by a Specials manufacturer. In order for the medicine to be effective you must follow the instructions accompanying it, including when and how often you should take it.
As with any medicine, licensed or unlicensed, there are occasionally side effects. If you have any serious side effects or reactions, it is important that you contact your doctor or pharmacist as soon as possible. They have a duty of care to you and will need to know this information to help care for you.
The code of ethics says that the patient is the first concern to a doctor or pharmacist, so they need to be sure that the quality, safety and effectiveness is top notch before they pass it on to you.
If you have any questions regarding your medication then always discuss these with your doctor or pharmacist who will be happy to help.
Many people have difficulty swallowing tablets and capsules, but you should be very cautious before attempting to dissolve tablets in water by crushing or splitting them. This is because the effect of the drugs can be changed in the process of opening a tablet. There are different ways this can happen, for example:
- They may not fully dissolve in the water in which case you don’t get the full dose.
- The capsule may be a slow release formula, designed to gradually dissolve inside your body over several hours – taking the whole dose in one ‘hit’ could be dangerous.
- The ingredients inside the tablet or capsule could irritate your skin or stomach.
- Some drugs are de-activated by acids in your stomach and need the protection of the capsule
- Also, some drugs have a very unpleasant taste when not in a tablet form
Splitting tablets to obtain a smaller dose is also not recommended. This is because the drug (active ingredient) is not always evenly distributed within the tablet so you may get more, or less, than you need with every dose.
Unless it says so on the label, you shouldn’t crush, split or open tablets and capsules without first CHECKING WITH YOUR DOCTOR OR PHARMACIST.
If you are unable to swallow your tablets, or you need a smaller dose then your doctor may be able to prescribe a different medicine that is already licensed. If not, they may prescribe a Special for you, which will be a liquid version specially formulated for you.
Frequently asked questions
Medicines and licenses
What is a licensed medicine?
A licensed medicine is a medical product prescribed by doctors to patients, which holds an MHRA (Medicines and Healthcare products Regulatory Agency) approved marketing authorisation.
In order to get a licence, the medicine that has been discovered, must be successfully tested via clinical trials. These trials will be carried out on people with the aim of ensuring that the medicine is safe, effective and to discover what side effects the medicine may cause. About one fifth of medicines that are tested on clinical trials are successful.
Once the clinical trials have proved successful, then the MHRA can issue a marketing authorisation for that medicine and it can go on the market. The effects of the medicine will be continuously monitored for safety.
Why do medicines need to be licensed?
Having a marketing authorisation means that the medicine has passed all the safety checks, which will have included a clinical trial on humans. In order for a marketing authorisation to be issued, the trials must have concluded that the product is of a high standard, will effectively treat the ailment it was designed for and also that the risks and side effects are at a minimum. In short, licensing medication helps to protect patients from adverse side effects.
Who licenses medicines?
The Medicines and Healthcare products Regulatory Agency (MHRA) are in control of the issue of a marketing authorisation. The MHRA are a government controlled organisation founded in 2003 and are responsible for making sure that medicine and medical devices work effectively and are safe to all users.
When is a Special be prescribed?
Specials need to be prescribed when a patient needs treatment for an illness that no licensed medicine can treat, or if a Special formulation of an existing licensed medicine needs to be made. For example, if someone has suffered a stroke and has lost the ability to swallow, then they may need a medicine that is only licensed in the form of a tablet. In this case, a Special will be made changing this tablet into a liquid. There are many different reasons and types of Special and so the medicine is always made up to meet the exact needs of an individual patient.
Is it safe to take Specials?
Specials manufacturers in the UK must hold a 'Specials Manufacturing Licence' which is issued by the MHRA. Risks to patients are minimal, as in most cases, the prescribers are experts in the use of Specials. Risks can be reduced further by selecting a reliable manufacturer and supplier, ensuring that the quality and safety of Specials does not differ from a licensed medicine. Specials are manufactured to a very high standard in premises regulated to pharmaceutical standard and regularly checked by MHRA inspectors. Read more about our Quality Processes.
What do I do with a Special prescription?
You can take it to your pharmacy and hand it in, like any other prescription. The pharmacist will probably need to order the Special from a Specials Manufacturer, which will usually take about 24 hours.
How do I take a Special?
Your pharmacist will provide written instructions telling you exactly how to take the Special and for how long. Always follow this information. If you’re not sure, it is important to ask your pharmacist or doctor.
SAFETY. If you are unsure about a medicine, or experience any side effects, you should contact your doctor or pharmacist immediately for advice. More information about medicines safety and reporting can be found here