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Discussion in 'Pharmacy' started by Ilikechemicals, 02.06.10.

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  1. Ilikechemicals

    Ilikechemicals New Member 10+ Year Member

    I have a question that 3 other pharmacists and a search on SDN and google havent been able to answer.

    If the doctor writes the generic name of a drug (such as cyclobenzaprine) and then marks do not substitute or DAW 1 do you fill generic or brand.

    For DAW 1 Ive sometimes seen it mean "Do not substitute" and other times I have seen it mean "Brand is medically nesescary."

    As for "do not substitute" and writing the generic name, it would seem logical to fill as generic since they wrote the generic name. I wasnt sure if "checking do not substitute" means you can only fill brand regardless of what writen. Maybe the MD cant remember the name of the brand?

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  3. Praziquantel86

    Praziquantel86 Moderator Emeritus 7+ Year Member

    Fellow [Any Field]
    You would fill generically. The DAW does not automatically mean you fill the brand, just that you're obligated to fill whatever drug the prescription is written for. I'll see DAW written every once in a while for a specific generic brand (i.e., Greenstone alprazolam), and it that case it gets filled as that specific generic brand. If you see a generic name with DAW, but no brand specified, you fill with whatever the preferred brand is. Likewise, if you see a generic brand specified, but no DAW, you're legally entitled to substitute with a less expensive brand (at least in New York).

    Now, if you see brand medically necessary written on a prescription that was written for the generic, I would probably ask the patient. If the patient doesn't care either way, just fill it generically. If the patient does care, give the doctor a call and see what he has to say. I've never seen that situation occur though, seems like the docs are more likely to forget the generic name than the brand.
  4. johnep34

    johnep34 2+ Year Member

    Suppose it depends if the Dr owns shares in that company.
  5. MountainPharmD

    MountainPharmD custodiunt illud simplex 10+ Year Member

    What does DAW stand for? It stands for dispense as written. If a Doctor writes for cyclobenzaprine and checks a box that says do not substitue or DAW or they write DAW then you dispense as written. If it says Flexeril you dispense Flexeril if it says cyclobenzaprine you dispense cyclobenzaprine.

    I have seen a few Doctors of late doing this because of some bogus news story that came out that said pharmacists were making therapuetic substitutions without consulting the Doctor. I have seen a few Docs write for drugs like Liptior and specify dispense as written because they think someone will try and do a therapeutic substition to simvastatin or some other statin. This is totally absurd since this is not allowed in any state that I know of.

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