Since APAP/ Codeine is contraindicated in children <12 years old now, has anyone refused to fill this for this age group? There have been two occasions when I have talked to parents to let them know it is now contraindicated in their child’s age (one child was around 8 and the other 10) because of fatal reports. Both times the parents insist that their child just had dental surgery and are in pain and assure me they will give the prescribed dose, if not less. I have let them walk out the door after warning them again, but I don’t know if I should be doing this or in the future, refuse to fill. Has anyone had similar experiences? I ask them to try just APAP for the pain first and the parents insist basically. I know I have the right to refuse but haven’t done so yet... Getting worried I am not making the right call in these situations. Thanks for any advice
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APAP/Codeine Contraindication
Started by MV777
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we removed it from formulary for this very reason. and ya - it is not the dose that is the issue like cetialphafive said - I heard a perfect analagy - ask the parent - if there was a concert at a local large arena - and two kids were going to die at the concert - would you still let your kid go to the concert? risk is low- but it is obviously there for those that are fast metabolizers - you give the correct dose and kid can still die - I would never fill it - if something does happen - the best lawyer in the world can't help you against an absolute contraindication - especially if a kid dies.
Fill all the time just make sure you freak the parent out so much that they don't want it or watch them closely.
Nope. Hard no for anyone under 16 where I work. I rarely have to turn anybody away as it is nonformulary for that age group for the major prescriber in town due to the risk for peds.
"Codeine: When you don't know how much morphine to prescribe"
Why wOuld an ER prescribe Cytomel?
I am trying to decode the secret message here. So far I have "WOERC" which I think is an oblique reference to "WORK" which is your way of asking if Niceguy90 works for a chain?
lol you are right, T3 is Cytomel.
But to put it into context, he would have meant Tylenol #3 with codeine in it.
Had a physician prescribe this for an 8 year old for post-op tonsillectomy pain.We outright refused to fill of course.
Though I'm still seeing this being filled for pediatric patients (except for when it's used in post-op tonsillectomy or adenoidectomy).
Jesus wept
Most pharmacies I've worked at do carry Hycet, but we can't simply call to change the script via phone. The parents can go back to the MD office and pick up the hardcopy, but many times the script is from the hospital/ER...and we all know how that plays out when trying to get a drug change.
I got cussed out by an old MD and name called for not filling it for a 6 year old last year. I just told him no I'm sorry can't do it/please consider an alternative therapy or I'd simply have to refuse to fill it...the risk here is death so I don't mess around with this one. Most parents understand when explained to them.
hydrocodone/apap elixer, although admittedly easier to change in hospital, than in retail.
hydrocodone is the obvious choice
