Manufacturer bottle vs pharmacy RX label expiration date

[lsexie]

How do your pharmacies handle situations where the pharmacy label says discard one year from the fill date while manufacturer bottle expires a few months before then? I just got a letter of complaint from board of pharmacy that a patient at a store i floated at complained because the label said discard by June 2016 (it was filled in June 2015) while manufacturer bottle said expiration date of March 2016. She complained that without the manufacturer bottle she would have been taking expired meds from March to June. Im trying to see how best to handle this. I don't think there is anything i could have done about the date since the pharmacy label automatically generates the dates. Thanks in advance!

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[ancienbon]

I dont think you are liable. If anything it would be the chain you work for that will be liable

 

[BF7]

How do your pharmacies handle situations where the pharmacy label says discard one year from the fill date while manufacturer bottle expires a few months before then? I just got a letter of complaint from board of pharmacy that a patient at a store i floated at complained because the label said discard by June 2016 (it was filled in June 2015) while manufacturer bottle said expiration date of March 2016. She complained that without the manufacturer bottle she would have been taking expired meds from March to June. Im trying to see how best to handle this. I don't think there is anything i could have done about the date since the pharmacy label automatically generates the dates. Thanks in advance!

I think that it may vary by state but you most certainly could be held liable if your initials on on that bottle. In FL for example, that bottle should have had the discard by: March 31,2016 date on the label. The Pharmacy system needs to be able to integrate that functionality into it's labels.

But I have a question for you, how in the world would that patient gain knowledge of the manufacturer's stock bottle expiration date? Was it dispensed to the patient and she pulled back the label to reveal the manufacturer expiration date? If that's the case then you should enact a policy that your store never dispenses manufacturer stock bottles for 99% of meds...

 

[Old Timer]

Just how many pills, did she get. Did she get a 9 month supply. Why would you assume she would have any left anywhere near the expiration date. This is without a doubt one of the most ridiculous complaints I have heard in the 30 some years I have been doing this.

 

[BF7]

Just how many pills, did she get. Did she get a 9 month supply. Why would you assume she would have any left anywhere near the expiration date. This is without a doubt one of the most ridiculous complaints I have heard in the 30 some years I have been doing this.

Because patients seldom take their meds as directed on the bottle. We still have a legal duty to have the correct expiration date on our labels

 

[Old Timer]

Because patients seldom take their meds as directed on the bottle. We still have a legal duty to have the correct expiration date on our labels

I'm not sating you don't I'm just saying this is BS. I would have to know the drug and the sig. If it was any mtc med this is a joke......

 

[strawberry606]

I actually think the patient's complaint is 100% valid. We should be doing more than sticking on labels and counting pills. Just because the computer label says so, doesn't mean you just stick it on!!!

You shouldn't be certifying that something is correct when it is not. In this case, don't say sometime expires at X date when it actually expires at Y.

Here is how I see this... some patients get things filled for prophylaxis! You wouldn't hand someone an epipen and tell them it is good for one year when it expires in a month... And then act like it isn't your fault when 8 months after the fill date they went into anaphylaxis and died because their pen didn't work... Sigh... I really think you messed up big time. But, we all live and learn.

 

[Old Timer]

I actually think the patient's complaint is 100% valid. We should be doing more than sticking on labels and counting pills. Just because the computer label says so, doesn't mean you just stick it on!!!

You shouldn't be certifying that something is correct when it is not. In this case, don't say sometime expires at X date when it actually expires at Y.

Here is how I see this... some patients get things filled for prophylaxis! You wouldn't hand someone an epipen and tell them it is good for one year when it expires in a month... And then act like it isn't your fault when 8 months after the fill date they went into anaphylaxis and died because their pen didn't work... Sigh... I really think you messed up big time. But, we all live and learn.

Epi-pen's are labeled on the pen. You have to do better. This is a a BS technical violation. If this is 90 Zocor, this is a joke.....

 

[genesis09]

I'm assuming the patient got something like a cream where they can see the manufacturer's expiration date. The by the book way of dealing with expiration dates is that it should be one year from dispense date or actual expiration date, whatever is first. If the state board decides to act it will no more than a fine or more likely a letter. However, if it is from a manufacturer's bottle for tablets, your line of defense should be how would it be known which bottle the patient got the medicine from.

 

[ancienbon]

I actually think the patient's complaint is 100% valid. We should be doing more than sticking on labels and counting pills. Just because the computer label says so, doesn't mean you just stick it on!!!

You shouldn't be certifying that something is correct when it is not. In this case, don't say sometime expires at X date when it actually expires at Y.

Here is how I see this... some patients get things filled for prophylaxis! You wouldn't hand someone an epipen and tell them it is good for one year when it expires in a month... And then act like it isn't your fault when 8 months after the fill date they went into anaphylaxis and died because their pen didn't work... Sigh... I really think you messed up big time. But, we all live and learn.

I think you are really out of touch. I bet you never work in retail.

 

[strawberry606]

Epi-pen's are labeled on the pen. You have to do better. This is a a BS technical violation. If this is 90 Zocor, this is a joke

Look, it is the same thing. If the bottle says expired in February and it was dispensed for 90 days in January. I would think that is wrong too. Just because the consequences are probably negligible to none doesn't mean it is right to give someone expired meds. I dont see why the OP couldn't just check the expiration date?! When I was a tech, I worked with a really good pharmacist who did this amazing thing of picking up her pen and crossing out the "wrong date" and handwriting the correct one.

 

[strawberry606]

I think you are really out of touch. I bet you never work in retail.

Honey, I have been in retail for a long time but you are right, I jumped ship as a pharmacist because I know retail is full of crap like this... And that is why I think the OP should pay more attention... because stuff like this is what screws over good pharmacists.

 

[ancienbon]

wha

Honey, I have been in retail for a long time but you are right, I jumped ship as a pharmacist because I know retail is full of crap like this... And that is why I think the OP should pay more attention... because stuff like this is what screws over good pharmacists.

Why did you say the op messed up big time then? The med was not expired until 9 months later. How could that have been prevented ?

 

[ancienbon]

I can tell you in retail , unfortunately stuff happens . That is just a minor one. In a fast pace environment like cvs, this could have happened to any seasoned pharmacist.

The other day my partner just found out he verified metformin for the wrong patient. The patient took it for a month. that is a big one...the name was not even similar, and different date of birth too. I doubt he will file an incident report for it. He usu

 

[ancienbon]

I can tell you in retail , unfortunately stuff happens . That is just a minor one. In a fast pace environment like cvs, this could have happened to any seasoned pharmacist.

The other day my partner just found out he verified metformin for the wrong patient. The patient took it for a month. that is a big one...the name was not even similar, and different date of birth too. I doubt he will file an incident report for it. He usually does not.

 

[doublehh03]

I can tell you in retail , unfortunately stuff happens . That is just a minor one. In a fast pace environment like cvs, this could have happened to any seasoned pharmacist.

The other day my partner just found out he verified metformin for the wrong patient. The patient took it for a month. that is a big one...the name was not even similar, and different date of birth too. I doubt he will file an incident report for it. He usually does not.

He better. IF the patient complains to the BOP and they follow up and no IR filed, he will be in bigger trouble.

Incident reports aren't a bad thing. It's a good thing to know your and the store's trends in terms of how many errors are happening.

To the OP, I always put the expiration date on the label regardless. But it's a petty complaint. But I've seen pettier complaints.

 

[owlegrad]

Despite this, the BOP found some return to stock bottles with a date later than the open stock bottle on the shelf. I was written up for it. Total BS, but the only way to deal with it is to trust techs to initial or have them send down the stock bottle on every rx for you to check.

How could they know the pills came from that bottle? Total BS.

 

[confettiflyer]

This isn't just a retail issue. This would be a pretty bad violation from BOP, TJC, CMS, or whatever pencil-pushing organization is passing through that day for hospital. When we unit dose from mfr. bottles, the expiration has to be 1yr from unit dose date, or mfr's date, whichever is sooner.

If it's slightly wrong, the sky comes crashing down and fire comes spilling down the mountains alongside the four horsemen.

It's stupid, but the commisar's in town and it's some power hungry gov't/quasi-gov't worker's "priority" and then we all gotta bend over for the cavity search!

 

[Rockinacoustic]

Agree it's stupid, but legally isn't this misbranding?

 

[PharmdA07]

I think this depends on state law and where you practice; however, the whole point is it's against the law (as well as unsafe) for patients to take expired meds. For most drugs, the expired date is the last date of the month stated on the manufacturer's bottle.

And yes, I know this is sometimes total BS (as others have said) for loonie people who want to make a big deal out of nothing to sue and to hurt good practitioners. I had a talk with my staffs regarding this issue before because there are always patients (and we have several of them here) who demand manufacturer's bottles and not the amber vials that you usually put the pills in. Most of these people belong to these categories: (a) old patients who are extremely meticulous about their meds and want the same looking things; (b) old people or people who remember their meds by shape/color/bottle; (c) patients with legitimate medical OCD or Psych disorders with special needs; (e) plain straight crazy and whining people who complain about everything even their own body odor (yes, I have had a couple of menopausal women who fall into this category, believe it or not!)

-To protect your practice, the computer system should have a fixed-in function of matching the expiration date of the stock bottle and the max allowable expiration date from your state board and choosing whichever comes first. This happens when your techs scan in the bottle before they fill and then again when I check it (for my system, there's a place where I can see the infos on the bottle the tech scan in and its expiration date, then I look at the date the Rx was written and compare these two dates one more time)
-Of course, your inventory with the 6-month BUD should be checked often by your staffs; since your whole drug seller may also have their own policy on returns
-Keep in mind that the expiration dates may be different for other products: reconstituted antibiotics for kids, injections (insulin, hormone, etc.) once brought to room temp, special meds (Pradaxa, Xalatan generic, etc. ) once bottles are open, and of course the usual NTG etc. For these, you just have to manual check and do it yourself to ensure accuracy.
-At my other practice where I take care of LTC patients, meds are packed in blister paks and unit-dose: these follow a different set of rules; one of which requires the techs to write the expiration date and the lot# of the stock bottle onto the paks.
-You should have a process or at least a protocol on how your staff respond to patients when this kind of problem happens, just to cover yourself and your license cause you never know: people will say "oh, this expired med made me vomit and then I had to see my stomach doctor. I will sue you for pain and suffering" etc. I've heard quite a few of these in the past.

 

[npage148]

I guess this makes a strong case for not leaving drugs in stock bottles and putting everything you can in a vial.

 

[confettiflyer]

(as well as unsafe) for patients to take expired meds.

This part of your post is debatable. While I would never dispense an expired med, my general advice when I'm off duty (as well as my own practice) is to go ahead and take it...except for narrow TI drugs or transplant regimens.

 

[txpharmguy]

Ideally, one would have updated rx and changed use before date to March 31, 2016 before dispensing. Like OT says, I'd have to know circumstances of medication dispensed before commenting further

 

[genesis09]

Expiration dates on most prescription/OTC products are dates of convenience for the manufacturer. They are required to test the medicine for stability over a set period of time. Once that is done and they have reached the manufacturer's hoped for date for the drug to be good; they will use that timing as the expiration date. People have kept medicine for years after its expiration and when tested, it is still good. There are a handful of drugs which do turn toxic, but most just become less effective over time.

 

[Deja]

ummm I thought it was standard to cross out the expiration date and re-write it (if you can't change it in the system) if it expires earlier than what is said on the bottle... i guess not everyone do this -______-

 

[Old Timer]

Agreed .It should be standard of practice to check thee expiration date on every drug you dispense

So, every rx you get you also get the stock bottle and check the exp date?

 

[Corpseman]

So, every rx you get you also get the stock bottle and check the exp date?

We check every stock bottle we dispense from. if we are dispensing from an old vial, then the old vial has the expiration date verified off the stock bottle it was taken from.

 

[Old Timer]

We check every stock bottle we dispense from. if we are dispensing from an old vial, then the old vial has the expiration date verified off the stock bottle it was taken from.

The pharmacist does this? and you verify how many prescriptions per day?

 

[pillpharmer14]

I actually think the patient's complaint is 100% valid. We should be doing more than sticking on labels and counting pills. Just because the computer label says so, doesn't mean you just stick it on!!!

You shouldn't be certifying that something is correct when it is not. In this case, don't say sometime expires at X date when it actually expires at Y.

Here is how I see this... some patients get things filled for prophylaxis! You wouldn't hand someone an epipen and tell them it is good for one year when it expires in a month... And then act like it isn't your fault when 8 months after the fill date they went into anaphylaxis and died because their pen didn't work... Sigh... I really think you messed up big time. But, we all live and learn.

Hold on a minute. I agree that this is misbranding, but if your pharmacy system does not integrate the stock bottle exp date into the label, how would a pharmacist even know? Pharmacists (most of the time) don't put pills in bottles, and many chains don't pass stock bottles down to the pharmacist. It's not part of workflow to check expiration dates because if the inventory is managed correctly, you should never have expired medication on the shelf. How is the pharmacist supposed to be checking expiration dates if they never even see the stock bottle?

 

[ancienbon]

Hold on a minute. I agree that this is misbranding, but if your pharmacy system does not integrate the stock bottle exp date into the label, how would a pharmacist even know? Pharmacists (most of the time) don't put pills in bottles, and many chains don't pass stock bottles down to the pharmacist. It's not part of workflow to check expiration dates because if the inventory is managed correctly, you should never have expired medication on the shelf. How is the pharmacist supposed to be checking expiration dates if they never even see the stock bottle?

I could not agree with you more. I dont knoe where some rphs work. There is no way that is possible at my cvs

 

[ancienbon]

Yes, why is that hard to imagine. What if the drug was expired 2 years ago and you dispense it?

You are supposed to check for expired meds every 3 months or monthly at least. If is expired it should not be on the shelf. You should pull them 3 months before expiration date

 

[ancienbon]

Probably it is because some rphs dont work for a chain.

 

[Corpseman]

The pharmacist does this? and you verify how many prescriptions per day?

The tech is supposed to do this for every rx filled, gotta trust that they are doing their job correctly.

 

[FarmD711]

And if you miss it in the monthly check?

You're pulling 3 months ahead so you'd have to miss it 3 times

 

[wagrxm2000]

And if you miss it in the monthly check?

This dude is clueless, rarely I repeat rarely does anyone get pills for more then 3 months out. We pull 3 months out so its going to be impossible to get an expired pill. Combine this with the fact that if a person is getting 90 days its typically a popular drug and the fact that the techs check the date, you are wasting your time.

If you want to check the date on an ointment that's fine by me or even a prn pill but don't waste your time checking expiration dates on everything, trust the system.

No wonder people say they don't have enough time, its because they are wasting it. I hope you don't triple count a control after its already been double counted by the techs unless it's required by your company.

 

[ancienbon]

This dude is clueless, rarely I repeat rarely does anyone get pills for more then 3 months out. We pull 3 months out so its going to be impossible to get an expired pill. Combine this with the fact that if a person is getting 90 days its typically a popular drug and the fact that the techs check the date, you are wasting your time.

If you want to check the date on an ointment that's fine by me or even a prn pill but don't waste your time checking expiration dates on everything, trust the system.

No wonder people say they don't have enough time, its because they are wasting it. I hope you don't triple count a control after its already been double counted by the techs unless it's required by your company.

I have to agree with you on that one. I cant believe what i read on this thread

 

[NateRobinson]

The problem is, when you're doing hundreds and hundreds of scripts a day, who the hell has the time to change the freaking expiration date on every single drug every time the drug expires sooner than 1 year? You would be sitting there, reprinting labels, changing expiration dates all day.

 

[ancienbon]

some of the folks here are really clueless. I dont even think they work in retail. They expect the pharmacist to change expiration date each time the drug expires sooner than a year. that is impossible at my cvs.

 

[Corpseman]

I think it depends on the system. Kroger's system makes it ridiculously easy to change the date, takes less than 3-4 seconds.

 

[zelman]

I think it depends on the system. Kroger's system makes it ridiculously easy to change the date, takes less than 3-4 seconds.

CVS makes it very easy, too...however, nobody does it unless I'm working and force them to.

 

[trailerpark]

Each tech in my pharmacy is assigned a section and they must sign off every month that they pulled for outdates.

 

[Carboxide]

I honestly can't imagine working in a pharmacy with some of you. I worked retail for 3 years and never let an Rx out without a right expiration. All you have to do is scratch out the printed one and put a sticker on where you wrote the expiration! 2 seconds tops. And as for whether it is a maintenance med...it does not matter. People have the right to have correct dating on their labels. Many times a patient will have a dose change and will keep the old medication in case they go back down, or perhaps go up further and can take 2 tabs of the old rx. There is nothing wrong with that. There IS something wrong with essentially lying to the patient.

 

[pillpharmer14]

I honestly can't imagine working in a pharmacy with some of you. I worked retail for 3 years and never let an Rx out without a right expiration. All you have to do is scratch out the printed one and put a sticker on where you wrote the expiration! 2 seconds tops. And as for whether it is a maintenance med...it does not matter. People have the right to have correct dating on their labels. Many times a patient will have a dose change and will keep the old medication in case they go back down, or perhaps go up further and can take 2 tabs of the old rx. There is nothing wrong with that. There IS something wrong with essentially lying to the patient.

It's not about time, it's about workflow. Having technicians check them while filling is just about the only way to do it. And before you say to just sent down the stock bottles to the pharmacist, keep in mind that most chains use baskets that aren't big enough to hold rx bottles and stock bottles. So in the end, it's not just as easy as "scratching out the printed date." The issue is discovering the expiration date in the first place.

If there is anyone to blame it's IT/system administration for not incorporating this into rx systems, or even legislators for not requiring this of rx systems.

 

[DASicari]

At CVS stores in CA, we solved this issue a different way. Our labels automatically print with a blank line for expiration date that is to be manually written in at production. The expiration date will only print on the label if the fill is to be completed utilizing an RTS vial with the expiration date pre-entered during the RTS process.