Filling rx for holly trinity

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
M

mona2004

Full Member
10+ Year Member
Joined
Jan 2, 2012
Messages
45
Reaction score
2
Members don't see this ad.
Just have a question. If MD (not a pain management )writing soma norco Xanax combination (with diagnose code pain and anxiety ) in a daily bases for some pts what would be the best practice for pharmacist?
 
mona2004 said:
Just have a question. If MD (not a pain management )writing soma norco Xanax combination (with diagnose code pain and anxiety ) in a daily bases for some pts what would be the best practice for pharmacist?
Click to expand...
Refuse to fill if you have suspicion that it is not for legitimate purposes.
 
Dred Pirate said:
nope, it is zithromax 1 gram, rocephin 250 IM, and flagyl 2 grams
Click to expand...
OK I'm stumped. What's the indication for this trifecta? Trying to cover gonorrhea and other stuff at the same time?
 
When I was working in pharmacy 7 years ago we flat out refused to fill those triple cocktails. We were always "out of stock" or "on backorder" considering those people shot a pharmacist in our area.
 
Might want to give your local DEA office a tip about this MD.
 
Leaving all the STD discussion aside,

Are we really assuming that no patient in the united states actually has a medical need for these three drugs in combination? I am all for refusing anything you truly suspect to be illegitimate, but we also should be careful not to put up unnecessary barriers for patients with real needs.
 
KidPharmD said:
Leaving all the STD discussion aside,

Are we really assuming that no patient in the united states actually has a medical need for these three drugs in combination? I am all for refusing anything you truly suspect to be illegitimate, but we also should be careful not to put up unnecessary barriers for patients with real needs.
Click to expand...

How many patients need:

  • Norco 10/325 or Percocet 10/325 120 1 qid
  • Fkexeril 10 1 tid
  • Xanax 1 mg qid
The answer is not many. You should consider any patient that comes with the Holy Trinity, The Trilogy or the Trifecta to be suspect until proven otherwise.
 
KidPharmD said:
Leaving all the STD discussion aside,

Are we really assuming that no patient in the united states actually has a medical need for these three drugs in combination? I am all for refusing anything you truly suspect to be illegitimate, but we also should be careful not to put up unnecessary barriers for patients with real needs.
Click to expand...


When it's not from a pain management office? Absolutely.
 
Old Timer said:
How many patients need:

  • Norco 10/325 or Percocet 10/325 120 1 qid
  • Fkexeril 10 1 tid
  • Xanax 1 mg qid
The answer is not many. You should consider any patient that comes with the Holy Trinity, The Trilogy or the Trifecta to be suspect until proven otherwise.
Click to expand...
When I see a holy trinity it's oxy 30, soma 350, Xanax 2mg.
 
KidPharmD said:
Leaving all the STD discussion aside,

Are we really assuming that no patient in the united states actually has a medical need for these three drugs in combination? I am all for refusing anything you truly suspect to be illegitimate, but we also should be careful not to put up unnecessary barriers for patients with real needs.
Click to expand...
If there is a doctor who writes for this combo exclusively, the appropriateness of the therapy in those instances would be entirely coincidental.
 
If the issue is that the physician is writing this a lot then, yes I would consider this suspect by default. However, if the combo is of a low proportion to the number of normal prescriptions you get from this doctor then you would be hard pressed to refuse solely base on the fact that the prescribing doctor is not a pain management specialist. We have so many "pain" doctors that do only that but don't have any special certification that I would suspect them just as much.
 
Old Timer said:
Whatever you call it, it is:

  1. A Narcotic Analgesic
  2. A Muscle Relaxant
  3. A Benzodiazepine
Click to expand...


Agreed, at recent district discussion in 2014, a Pharmacy District Manager stated the same idea: as pharmacist, we should watch out for classes of med, we watch out for people looking for having fun with B.A.R.
B = Benzodiazepine: Alprazolam, Clonazepam, Diazepam (Valium)...
A = Analgesic (Narcotic Analgesic)...Oxy, Oxy-combo (Oxycodone+Acetaminophen), Hydrocodone...
R = Relaxer (Muscle Relaxer): Carisoprodol, Methocarbamol...
 
You must log in or register to reply here.

Similar threads

D
Cvs rx connect question
Replies
1
Views
2K
Old Timer
Old Timer
M
DEA to process rx from the veterinarian clinic
Replies
12
Views
2K
CetiAlphaFive
CetiAlphaFive
M
Fraud Rx for oxy as an Escript
2
Replies
56
Views
5K
PharFromNormal
P
storyhill2
medication vending machines for ED outpatient rx's? Instymeds competitor?
Replies
1
Views
1K
storyhill2
storyhill2
Mr.Smile12
Call for nominations for 2025 Advisor of the Year
Replies
0
Views
709
Mr.Smile12
Mr.Smile12
Top