so how early do you fill controls?

[DAW2]

as a retail monkey i'll do up to 3 days early, but i know someone that won't do it until the day it is due. so you have to be out and then you can get your refill. law's not clear on what the definition of early is, so what do you all think?

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[Praziquantel86]

The pharmacists I work with fill it to the day.

Our state law specifies that they be filled no earlier than 7 days over the life of the prescription, so that way we avoid all the annoying math. Plus, once the patients get used to it, most have no problem and understand why we do it.

 

[Aznfarmerboi]

No earlier than 7 day supplies over the life of the prescription based on rx history.

 

[Old Timer]

The same as any other prescription. Following the Pennsylvania code:

Pennsylvania Code:

§ 27.18. Standards of practice.

(t) A pharmacist may only renew a prescription at a reasonable time prior to the time when the contents of the prescription shall be consumed according to prescriber’s directions.

 

[lorain]

depends on my mood

but 2 days is my rule

 

[Old Timer]

depends on my mood

but 2 days is my rule

That's what I love about pharmacists, they make their own rules.....

 

[Praziquantel86]

That's what I love about pharmacists, they make their own rules.....

That's not necessarily a bad thing. Sometimes it serves a legitimate purpose, in this case, limiting the potential for stockpiling and/or abuse (criminal or medical) of controlled substances.

I've seen quite a few people who would otherwise be overdosing on Lortab, but are prevented from doing so by the pharmacist limiting refills above and beyond the state law. This also provides an opportunity to discuss other options for adequate pain relief with the patient.

You run into a problem where the pharmacy is unwilling to bend or break their rules when the situation legitimately calls for it.

 

[johnep34]

In UK script cannot be dispensed before date on script. Repeats (refills) not permitted.
For addicts on daily pick up or supervised consumption we have a special blue form which has to be used under the NHS or a pink form for private scripts. Drs not allowed to write CDs on ordinary headed paper. After dispensing, scripts have to be sent to govnmt agency to keep a check on the Dr.
This all due to Dr Shipman who killed some 200 patients.
johnep

 

[Praziquantel86]

In UK script cannot be dispensed before date on script. Repeats (refills) not permitted.
For addicts on daily pick up or supervised consumption we have a special blue form which has to be used under the NHS or a pink form for private scripts. Drs not allowed to write CDs on ordinary headed paper. After dispensing, scripts have to be sent to govnmt agency to keep a check on the Dr.
This all due to Dr Shipman who killed some 200 patients.
johnep

Most of (if not all) of our daily pickups for addiction go through specialized clinics in the states.

What was the story for Dr. Shipman?

 

[nnguyenc]

increasing script count?

 

[johnep34]

Here is Shipman link. one of hundreds.

http://news.bbc.co.uk/1/hi/uk/3391897.stm

johnep

 

[Old Timer]

You run into a problem where the pharmacy is unwilling to bend or break their rules when the situation legitimately calls for it.

Bend rules that don't exist???

 

[MountainPharmD]

That's what I love about pharmacists, they make their own rules.....

When the law states a reasonable time what else are you supposed to do? Ask 10 pharmacists what a reasonable time is and you will get 10 different answers. At some point you have to come up with a consistant standard for your pharmacy.

Of course if you work for CVS and fill a 1000 scripts on a 14 hour day by yourself you don't have time time to pay attention to anything let alone little details like refills to soon. I told a patient who was always trying to get her and her husbands controls filled early to go to the CVS across the street. I told her I was tired of playing the refill too soon game and CVS is so busy and disorganized your lucky to get the right medication let alone have them worry about refill too soon. By God she went to CVS and I never saw her again. They probably give her a refill of her 30 day supply of 240 Norcos every 10 days like she was always trying to get from us.

 

[Praziquantel86]

Bend rules that don't exist???

I should say when the pharmacist is unwilling to be flexible with their own non legally binding standards.

 

[Old Timer]

When the law states a reasonable time what else are you supposed to do? Ask 10 pharmacists what a reasonable time is and you will get 10 different answers. At some point you have to come up with a consistant standard for your pharmacy.

Of course if you work for CVS and fill a 1000 scripts on a 14 hour day by yourself you don't have time time to pay attention to anything let alone little details like refills to soon. I told a patient who was always trying to get her and her husbands controls filled early to go to the CVS across the street. I told her I was tired of playing the refill too soon game and CVS is so busy and disorganized your lucky to get the right medication let alone have them worry about refill too soon. By God she went to CVS and I never saw her again. They probably give her a refill of her 30 day supply of 240 Norcos every 10 days like she was always trying to get from us.

It shocks me how little you know about what goes on as opposed to what you assume goes on. The pharmacists at CVS are younger and tend to be more cautious and therefore more strict or more likely to invent their own rules than anything I ever experienced as an independent. In PA, it would be illegal to refill a 30 day supply of Norco, or anything else, in 10 days...

 

[lorain]

When the law states a reasonable time what else are you supposed to do? Ask 10 pharmacists what a reasonable time is and you will get 10 different answers. At some point you have to come up with a consistant standard for your pharmacy.

Of course if you work for CVS and fill a 1000 scripts on a 14 hour day by yourself you don't have time time to pay attention to anything let alone little details like refills to soon. I told a patient who was always trying to get her and her husbands controls filled early to go to the CVS across the street. I told her I was tired of playing the refill too soon game and CVS is so busy and disorganized your lucky to get the right medication let alone have them worry about refill too soon. By God she went to CVS and I never saw her again. They probably give her a refill of her 30 day supply of 240 Norcos every 10 days like she was always trying to get from us.

i just tell them my pharmacy wont fill their script

its mostly the phentermine and suboxone crowd, the suboxone crowd is sometimes a pain to track they pay cash...i dont deal with their BS, dont have the time

 

[lorain]

That's not necessarily a bad thing. Sometimes it serves a legitimate purpose, in this case, limiting the potential for stockpiling and/or abuse (criminal or medical) of controlled substances.

I've seen quite a few people who would otherwise be overdosing on Lortab, but are prevented from doing so by the pharmacist limiting refills above and beyond the state law. This also provides an opportunity to discuss other options for adequate pain relief with the patient.

You run into a problem where the pharmacy is unwilling to bend or break their rules when the situation legitimately calls for it.

for me, if you have a legitimate reason, have the md call me and confirm it, as long as the md confirms it, i will fill stuff early(like going out of town, increased dose, etc) o....but i realized, when the md calls, theyve been told fluffed up stories that are not true and then they go with me and tell me not to fill early

 

[Farmercyst]

We usually don't go more than 5 days ahead. With patients that have a history of early fills we may be a little more strict.

 

[kmb71179]

We only do 2 days early. Of course you have your usual early refill folks. Amazingly, those early refill folks are usually going out of town. My answer, where are you going? Oh, within the states, then we will be happy to transfer your prescription when its due.

 

[DAW2]

ya but if they have to go somewhere else theyre gonna have to go there first and ask if they have the watson brand yadda yadda yadda

 

[lorain]

When the law states a reasonable time what else are you supposed to do? Ask 10 pharmacists what a reasonable time is and you will get 10 different answers. At some point you have to come up with a consistant standard for your pharmacy.

Of course if you work for CVS and fill a 1000 scripts on a 14 hour day by yourself you don't have time time to pay attention to anything let alone little details like refills to soon. I told a patient who was always trying to get her and her husbands controls filled early to go to the CVS across the street. I told her I was tired of playing the refill too soon game and CVS is so busy and disorganized your lucky to get the right medication let alone have them worry about refill too soon. By God she went to CVS and I never saw her again. They probably give her a refill of her 30 day supply of 240 Norcos every 10 days like she was always trying to get from us.

1000 in 14 hours? id go crazy!

 

[Old Timer]

1000 in 14 hours? id go crazy!

Pay him no mind. In a store that does 1000 per day there would be three pharmacists. Those stores are few and far between anyway....

 

[pharm B]

We only do 2 days early. Of course you have your usual early refill folks. Amazingly, those early refill folks are usually going out of town. My answer, where are you going? Oh, within the states, then we will be happy to transfer your prescription when its due.

Isn't there a limitation on how often you can do this? I thought a Control Rx could only transfer once and then stay put.

 

[Praziquantel86]

We only do 2 days early. Of course you have your usual early refill folks. Amazingly, those early refill folks are usually going out of town. My answer, where are you going? Oh, within the states, then we will be happy to transfer your prescription when its due.

There are states that allow you to transfer controls? I didn't know that.

 

[pharm B]

Our pharmacy will fill 3 days early, unless they're repeat-offenders and frequent jet-setters. In that case, they get their full 30 days between fills.

 

[spacecowgirl]

I'm a floater who only works retail a shift or two every month at a very busy store. I really don't worry about fill dates too much. I used to be militant in school because we had laws about it there, but my current state doesn't have any guidelines on this as far as I know. I also came to the conclusion that I didn't go to school for that long and get in that much loan debt to be a white-coated police officer. Now I don't really care about busting peoples' balls about stuff like that as long as they aren't taking over the max of APAP or something. I'm not going to fix anyone's pill addiction by squabbling with them over a few days early; if I have a genuine health concern, that's another story that I will take up with the prescriber instead.

 

[genesis09]

Isn't there a limitation on how often you can do this? I thought a Control Rx could only transfer once and then stay put.

At Walgreens, since they have a real time computer system, you can transfer a controlled script as many time to another Walgreens without limit.

 

[Old Timer]

At Walgreens, since they have a real time computer system, you can transfer a controlled script as many time to another Walgreens without limit.

It varies by state law. If your state permits it, your software will permit it. If your state doesn't allow it, the software probably wont allow it.

 

[Sparda29]

Generally at our store, if the computer allows it to go through, we'll fill it, otherwise no.

 

[Doctor M]

It varies by state law. If your state permits it, your software will permit it. If your state doesn't allow it, the software probably wont allow it.

This isnt necessarily true...in florida, when i worked for CVS the rx2000 system would not allow us to transfer controls from cvs to cvs from a store down the street, even though there was nothing the fl statues that said otherwise...i generally tend to follow federal law since florida is so lax with their control laws...

 

[Old Timer]

This isnt necessarily true...in florida, when i worked for CVS the rx2000 system would not allow us to transfer controls from cvs to cvs from a store down the street, even though there was nothing the fl statues that said otherwise...i generally tend to follow federal law since florida is so lax with their control laws...

In PA you are allowed to transfer controls once, that's all RX2000 allows..

 

[Doctor M]

In PA you are allowed to transfer controls once, that's all RX2000 allows..

What im saying is that the rx2000, at least when i worked for them, stopped you from transferring controls, no matter where it was going within the CVS system...Maybe it has changed now...but i dont think there is any correlation between the rx2000 and a corresponding state law...

Dr. M

 

[Doctor M]

In PA you are allowed to transfer controls once, that's all RX2000 allows..

Oldtimer, so let me understand, Pa law only allows the transfer of controls between real time computers only once? New York doesnt allow any transfers at all of controls...So maybe the rx2000 defaulted to no transfers at all???

 

[DAW2]

in texas you can transfer controls once. except for walgreens since they have a real time system they said they can go bouncing through walgreens all they want

 

[SClENCE]

The rule that the pharmacists I work with set in place is 2 days early, and strictly on the exact day due day for CII's

As far as refusing CII's just tell them you aren't comfortable filling the prescription due to the dose/quantity/patient history. They don't need any further explanation other than "I'm not comfortable filling this" as far as I'm concerned.

Some people will flip, especially the ridiculous amount of suboxone patients

 

[BenJammin]

You 3 days or less people are so inhumane it's outrageous. When I do part time retail work, it's 5 days and no more than a week through the life of a script.

 

[zelman]

You 3 days or less people are so inhumane it's outrageous. When I do part time retail work, it's 5 days and no more than a week through the life of a script.

Your patients who get their oxys 5 days early one month will not throw a fit when you only let them get it two days early the next month? and zero days early the following month?

 

[BenJammin]

Your patients who get their oxys 5 days early one month will not throw a fit when you only let them get it two days early the next month? and zero days early the following month?

A week is reasonable. People should not be slaves to their medications. The idea that someone might have to completely transfer their meds out of town for something like a family emergency is outrageous.

 

[zelman]

A week is reasonable. People should not be slaves to their medications. The idea that someone might have to completely transfer their meds out of town for something like a family emergency is outrageous.

I don't think the inspiration for this sort of thread is reasonable people.

 

[Dr Wario]

I do 2 days early on controls because I don't have the time to sit there and do lookbacks (I'm actually hoping we get the CVS enhancement that will actually calculate this for you). I personally don't give one bit of damn what people do to themselves, but when I was lax on filling too soon, I was getting all the controls from pharmacies around town without getting the legit stuff.

 

[sosoo]

if u feel like a monkey working at cvs, do not fill it a day early. that way u have several days to get it filled, instead of "i want it now!" the laws are there to give u an excuse to reject the prescription. period.

 

[NateRobinson]

Let's say you are a legit pain patient. And your pills run out on Sunday. It's Friday night, and you know you will be away for the weekend. Naturally, you'd want to fill it Friday night so that you'd have your meds.

I shudder to think of that inhumanity of the RPH that turns down the man/woman in this situation.

 

[zelman]

Let's say you are a legit pain patient. And your pills run out on Sunday. It's Friday night, and you know you will be away for the weekend. Naturally, you'd want to fill it Friday night so that you'd have your meds.

I shudder to think of that inhumanity of the RPH that turns down the man/woman in this situation.

It feels like making policies for the "legit pain patient" is applicable about as commonly as making rules for astronauts who need to fill their oxys early because they'll be in orbit when it is actually due. Consider the frequency of filling of oxycodone 5 mg prescriptions written for "1-2 tabs q 4-6 hr prn #180". I'd say 99.9% are filled every 27-29 days unless the doctor takes the time to calculate "do not fill before" dates. Assuming a dose of 1-2 tablets is needed every 4-6 hours by this patient who does not sleep, we should be seeing a normal distribution of fills between 30 and 45 days apart. My intuition that this is not the case may be completely off, but pharmacy professionals need to practice defensively in the current political environment.

 

[NateRobinson]

I've been filling controls and Narcs early for yeArs. Nobody has said jack **** to me. Do you want to know why?

1. I have the common sense to be able to distinguish the difference between a 93 year old woman who needs her ambien 4 days early because it's 3 degrees outside and she can't make it out again VS a guy who needs his oxycodone 30 mg #270 early just because.

USE COMMON SENSE!!! If the insurance claim goes through, look at your patient, put yourself in their shoes. 99% of the time you can tell the difference between a legit pain/anxiety/insomniac patient vs a shady guy who wants 473 mL of prometh-codeine early every month. USE DISCRETION, but not to the point where you are making life difficult for people.

How would you like it if your mother was denied her anxiety meds 3 days early because she's elderly and can't be leaving the house every day to come to the pharmacy? Do you really think the DEA will take your license away if that happens?

Believe me, nothing will happen To you. Just use discretion and stop filling insane quantities of oxycodone 30mg for everyone every month. After a few months, the junkies will get the idea and leave you alone.

 

[ExpressMaiL]

I've been filling controls and Narcs early for yeArs. Nobody has said jack **** to me. Do you want to know why?

1. I have the common sense to be able to distinguish the difference between a 93 year old woman who needs her ambien 4 days early because it's 3 degrees outside and she can't make it out again VS a guy who needs his oxycodone 30 mg #270 early just because.

USE COMMON SENSE!!! If the insurance claim goes through, look at your patient, put yourself in their shoes. 99% of the time you can tell the difference between a legit pain/anxiety/insomniac patient vs a shady guy who wants 473 mL of prometh-codeine early every month. USE DISCRETION, but not to the point where you are making life difficult for people.

How would you like it if your mother was denied her anxiety meds 3 days early because she's elderly and can't be leaving the house every day to come to the pharmacy? Do you really think the DEA will take your license away if that happens?

Believe me, nothing will happen To you. Just use discretion and stop filling insane quantities of oxycodone 30mg for everyone every month. After a few months, the junkies will get the idea and leave you alone.

I want Actavis only. What do you mean I can't get it anymore?

 

[BidingMyTime]

Well, my state is one that is vague, generally if it goes through the insurance and there is no history of problems with early refills, then I will fill it. For a cash patient I will do 3 days early for a 30 day supply (1 day early for a 15 day supply.) I will make exceptions if the person has a reasonable story and no history of making up stories to get early refills. When the law is vague, it really has to be done on a case by case basis.

 

[Stephen South]

It feels like making policies for the "legit pain patient" is applicable about as commonly as making rules for astronauts who need to fill their oxys early because they'll be in orbit when it is actually due. Consider the frequency of filling of oxycodone 5 mg prescriptions written for "1-2 tabs q 4-6 hr prn #180". I'd say 99.9% are filled every 27-29 days unless the doctor takes the time to calculate "do not fill before" dates. Assuming a dose of 1-2 tablets is needed every 4-6 hours by this patient who does not sleep, we should be seeing a normal distribution of fills between 30 and 45 days apart. My intuition that this is not the case may be completely off, but pharmacy professionals need to practice defensively in the current political environment.

Although one of the team members and astronauts on that space shuttle is a MD...... And the physical riggers of space and beating around you get.... You do get a 5mg oxy before you rack time... Just in case you were wondering...... Research goes along way....... And yeah I was in the Air Force for a long time.... I go to refill my 120 30mg oxy and my 20 mg opana er 1-3 days early.... Because the stage 2 multiple myeloma will not stop me from doing what I love to do.... I may not be able to be in the Air Force anymore.... But I can compete in long range rifle shoots 1000yds and a mile away..... But the most fun I have is teaching young children weapon safety, and how to use those weapons properly... And then help them learn to shoot....
Now I'll ask you one question, can you determine from. Your computer system that I am in actual pain or if I'm a junkie? Well other than the fact my pain doc puts multiple myeloma on my scripts?

Have a nice day

 

[zelman]

Although one of the team members and astronauts on that space shuttle is a MD...... And the physical riggers of space and beating around you get.... You do get a 5mg oxy before you rack time... Just in case you were wondering...... Research goes along way....... And yeah I was in the Air Force for a long time.... I go to refill my 120 30mg oxy and my 20 mg opana er 1-3 days early.... Because the stage 2 multiple myeloma will not stop me from doing what I love to do.... I may not be able to be in the Air Force anymore.... But I can compete in long range rifle shoots 1000yds and a mile away..... But the most fun I have is teaching young children weapon safety, and how to use those weapons properly... And then help them learn to shoot....
Now I'll ask you one question, can you determine from. Your computer system that I am in actual pain or if I'm a junkie? Well other than the fact my pain doc puts multiple myeloma on my scripts?

Have a nice day

The "Reply" button should only be used if you are going to reply to any of the content of the post.

 

[Corpseman]

Although one of the team members and astronauts on that space shuttle is a MD...... And the physical riggers of space and beating around you get.... You do get a 5mg oxy before you rack time... Just in case you were wondering...... Research goes along way....... And yeah I was in the Air Force for a long time.... I go to refill my 120 30mg oxy and my 20 mg opana er 1-3 days early.... Because the stage 2 multiple myeloma will not stop me from doing what I love to do.... I may not be able to be in the Air Force anymore.... But I can compete in long range rifle shoots 1000yds and a mile away..... But the most fun I have is teaching young children weapon safety, and how to use those weapons properly... And then help them learn to shoot....
Now I'll ask you one question, can you determine from. Your computer system that I am in actual pain or if I'm a junkie? Well other than the fact my pain doc puts multiple myeloma on my scripts?

Have a nice day

.....what?

 

[Sunshine98]

2 days. If they give me grief...I will hold them to the day.