• Michael G Kirby, Paula Allchorne, Tim Appanna, Patrick Davey, Richard Gledhill, Green James S A JSA Barts Health NHS Trust, The Royal London Hospital, London, UK., Damian Greene, and Derek J Rosario.
• The Prostate Centre, London, UK.
• Int. J. Clin. Pract. 2020 Jan 1; 74 (1): e13429.

BackgroundTherapeutic drug switching is commonplace across a broad range of indications and, within a drug class, is often facilitated by the availability of multiple drugs considered equivalent. Such treatment changes are often considered to improve outcomes via better efficacy or fewer side effects, or to be more cost-effective. Drug switching can be both appropriate and beneficial for several reasons; however, switching can also be associated with negative consequences.AimTo consider the impact of switching in two situations: the use of statins as a well-studied example of within-class drug switching, and gonadotropin-releasing hormone (GnRH)-targeting drug switching as an example of cross-class switching.ResultsWith the example of statins, within-class switching may be justified to reduce side effects, although the decision to switch is often also driven by the lower cost of generic formulations. With the example of GnRH agonists/antagonists, switching often occurs without the realisation that these drugs belong to different classes, with potential clinical implications.ConclusionLessons emerging from these examples will help inform healthcare practitioners who may be considering switching drug prescriptions.© 2019 John Wiley & Sons Ltd.

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