Control drug, patient not taking it as prescribed and has ran out early?

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swatchgirl

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Patient has been taking diazepam 5 mg four times a day instead of Q day as written on the script since the first day he was dispensed the medication (he was given 120 tablets 18 days ago on 9/22/16 at another pharmacy, where he paid cash for them). Patient gets a new script for diazepam 10 mg QID today from the same doctor, and wants to pay cash.

Can this new script be filled? Isn't he still 12 days early? Should we call the MD to clarify how and why the patient has ran out of his med so soon before we fill it? I'm just concerned the prescriber doesn't really know how the patient has been taking it either and just prescribed it on a whim based solely on the patient's claim that he has ran out early.

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I doubt diazepam 10 mg #120 on 9/22/16 was actually written for once-daily dosing. In any case, it's early so FTS. Waste of time.
 
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Talk to the doctor and make sure the pharmacy, provider, and patient agree on how the medication should be taken. If the doc says 10mg QID has been okay with them since 9/22 and the patient had to use 8 per day of the 5mg since then, document the dose change and fill it. As long as everyone's math adds up and the dose is reasonable I don't know what your concern is.


The reasons to deny the prescription are when the math doesn't add up ("Yeah, they got #120 last week and they are only to take 2 per day, but as their doctor I think it's okay to fill it today") or the dose is not appropriate ("Yes, I want them to take 1 gram of diazepam every 3 hours ATC").
 
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OP, are you a pharmacist? I only ask since most of the questions/threads are questions that could be easily asked by checking a law book or having any time in retail
 
I think swatchgirl is a new grad maybe? We all know how scary it is to first practice in retail and deal with controlled scripts and their related complication. Plus, it's always good to hear different opinions/ ways to deal with situations from different practitioners anyway--we can always learn something new from other people.

My motto with these situations is primarily to "always follow the law" and secondarily to "follow my judgement i.e. my gut :)" (if i feel uncomfortable in anyway with these controlled scripts, I'll not do it). When it comes the worst and the board/DEA shows up, it's me who filled the scripts having to answer and nobody else...
 
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OP, are you a pharmacist? I only ask since most of the questions/threads are questions that could be easily asked by checking a law book or having any time in retail

The law book I have is so vague. Which law book do you use?
 
Talk to the doctor and make sure the pharmacy, provider, and patient agree on how the medication should be taken. If the doc says 10mg QID has been okay with them since 9/22 and the patient had to use 8 per day of the 5mg since then, document the dose change and fill it.

Saw this too late. But I actually ended up doing exactly that. :)
 
Why would the doctor write #120 QD and then tell the patient to take it QID? Really stupid when doctors do this kind of crap. I would document and fill it, and if the doctor did not authorize more than one a day I wouldn't even consider refilling it early.
 
Ten bucks says QD pharmacy mis-filled it.

I would've checked PMP and probably refused it and told the patient to address it with the previous Rxy
 
since they are not taking it as prescribed, and you can only fill prescriptions as prescribed, what's the dilemma? send that pill pusher to Duterte and see how he deals with it.
 
since they are not taking it as prescribed, and you can only fill prescriptions as prescribed, what's the dilemma? send that pill pusher to Duterte and see how he deals with it.
Do you always post based on the thread title alone? Or did you completely misunderstand the OP?
 
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Call the office and find out how the previous script was written then ask if they are ok filling it today. Document your conversation and fill it. Let the customer know they have to stick with you or you won't be able to fill it again.

As long as this doesn't occur numerous times there's really nothing to worry about. If you feel your at a bad store just get more strict, 1 day early and no pharmacy hopping.
 
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