i need a confirmation with this...

[iphetamine]

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A patient on Zenhale (mometasone/formoterol) 100/5 and has Seretide (fluticasone/salmeterol) 125/25 available to him, can he use as a replacement?

 

[BidingMyTime]

What kind of situation are you talking about? Are you a retail pharmacist giving him advice (legally no, you can't tell him its OK to use one as a substitute.) or are you a hospital/nursing home pharmacist wanting to make a recommendation to his physician?

 

[iphetamine]

What kind of situation are you talking about? Are you a retail pharmacist giving him advice (legally no, you can't tell him its OK to use one as a substitute.) or are you a hospital/nursing home pharmacist wanting to make a recommendation to his physician?

Neither, it's a question came across in the family and I'm curious to find an answer. 🙂

 

[confettiflyer]

What kind of situation are you talking about? Are you a retail pharmacist giving him advice (legally no, you can't tell him its OK to use one as a substitute.) or are you a hospital/nursing home pharmacist wanting to make a recommendation to his physician?

I'm pretty sure you're legally allowed to give the public drug information...if the patient is in possession of both, it's your right to tell him all this crap is pretty much a patent extension ploy and "me too" drugs and pretty much does the same ****.

As an aside, I hate patients that worship Dr. Google as much as I hate pharmacists who make up stupid rules and treat them as law.

 

[iphetamine]

Is a pharmacokinetic/pharmacological reasoning behind it?

 

[BidingMyTime]

I'm pretty sure you're legally allowed to give the public drug information...if the patient is in possession of both, it's your right to tell him all this crap is pretty much a patent extension ploy and "me too" drugs and pretty much does the same ****.

Well yeah, I guess I was picturing a situation where the guy had been prescribed Zenhale, but his friend/SO/roommate gets Seretide at a cheaper copay, but doesn't use it as prescribed, so the guy wanted to know if it was OK for him to use his friend/SO/roommates inhaler instead of his own. (I guess because when I work retail and get a question about how does one drug compare to another drug, 99% of the time its a scenario where someone wants to use somebody else's medication.) This is what I mean would not be legal to tell him OK about, but yeah, no problem with just giving drug information on the similarities between the 2.

 

[iphetamine]

So the Seritide is fine, even though different concentration?

 

[BidingMyTime]

So the Seritide is fine, even though different concentration?

Well, they are different drugs, so of course they are different concentrations. That has nothing to do with their similarities. But equivalency-wise, you would want a higher strength of Seretide, in order to be more equivalent to the Zenhale. Key word is more, the action of the different drugs means their is no way to make them equivalent. Whether its "fine" or not depends.....many people would probably do fine on either drug. I wouldn't tell someone they would be fine switching, unless I had access to their medical history. There could be a reason why the doctor prescribed one over the other.

 

[confettiflyer]

Well yeah, I guess I was picturing a situation where the guy had been prescribed Zenhale, but his friend/SO/roommate gets Seretide at a cheaper copay, but doesn't use it as prescribed, so the guy wanted to know if it was OK for him to use his friend/SO/roommates inhaler instead of his own. (I guess because when I work retail and get a question about how does one drug compare to another drug, 99% of the time its a scenario where someone wants to use somebody else's medication.) This is what I mean would not be legal to tell him OK about, but yeah, no problem with just giving drug information on the similarities between the 2.

Yeah, there are ways to phrase things, and there's always plausible deniability.

"Of course I would never advocate for someone to break federal law, I just provided the patient with information about the similarities and differences of these drugs and what they're used for, your honor."

But really the best thing is to tell patients straight up: "I legally cannot tell you that these drugs are pretty much the same damn thing and that you can use your friends inhaler...legally I can't say that."

The just smile and ask if they have any questions, extra points if you have a twinkle in your eye.