Question about colonoscopy kits?

Discussion in 'Pharmacy' started by Pharm113, Sep 7, 2014.

  1. Pharm113

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    Is Gavilyte N and Trilyte both the generic of nulytely? If a doctor writes for nulytely would giving gavilyte N or trilyte be okay? It kind of confuses me that they seem like a brand by the name so with the generic substitution. Also, in this case is Gavilyte N and Trilyte interchangeable or MD would need to be notified if you change between them. Anyone in retail help me out? Thanks.
     
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  3. zelman

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    Those are branded generics.

    They are AA rated


    They are the last two listed here: (...though I don't know why Gavilyte-N is listed with the generic name, it is the product made by Novel listed below)​
     
  4. Pharm113

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    So in this case does it mean you can switch from gavilyte n to trilyte or other way without consulting w md? Are they treated as generic? Or do you still have to go with the peg 3350?
     
  5. BidingMyTime

    BidingMyTime Lost Shaker Of Salt
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    AA rated means they can be switched without consulting the physician (unless your state has some strange law otherwise.) All that matters is they are AA rated, it doesn't matter if they are plain generics or branded generics.
     
  6. PharmdA07

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    As a CYA, I've and would always call. I've been asked by the board inspector on AB-rated drugs that needs to be called for approval on switching to generic (!!). Plus it's only about 5 minutes for "Is it OK to give them the generic Trilyte because their insurance only covers this generic?" and 98% of the time the answer would be "Yes". I once had a Gastro told me "As long as he sh!t completely, I don't care!" LOL
     
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  7. zelman

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    You have 5 minutes extra in your day for every generic substitution?
     
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  8. Wheresmyaricept

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    I actually had to research the difference between all the bowel preps for one of my rotations.

    They have the exact same amount of ingredients in them and are AA rated so they can be substituted.

    If you were to change Gavilyte-N to Gavilyte-G, I would call because they have different amounts of electrolytes in them. According to my preceptor at the time who had a masters in something relevant that I can't remember, different amounts of electrolytes light up differently on different colonoscopy machines. I can't actually confirm if that's true because I'm too lazy to look it up and contrary to popular belief, staring up people's buttholes is not my area of expertise. But he sounded like he knew what he was talking about.
     
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  9. Dred Pirate

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    This is what annoys me about our profession - we all know these things are virtually the same, there is never any clinical reason to choose one over the other 99.999999% of the time, yet we have to call and get permission? With 8 years of edcuation, can't we just make a clinical decision? (That is one of the driving factors why I will always stay in hospital vs retail is that I can do things like that without calling and annoying the doc - because believe me, they do get annoyed and most would be more than happy to just let us change. I wish they would just write -"bowl prep- whatever is covered buy ins" - and do this for a variety of drug classes (PNV's, renal vitamins, PPI, H2's, etc)
     
  10. zelman

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    H2's? Randomly swapping between Ranitidine and Tagamet might create some drug interaction problems. (Consider the snowbird who goes to a different pharmacy every other 6 months)
     
  11. Dred Pirate

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    In this case I would hope a pharmacist would be smart enough to never start someone on tagament (hence why we went to school for 6-8 years)
     
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  12. PharmdA07

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    ;) I know it's the story of retail. I used to resent that but after a while practicing, I've come to accept the reality. I've realized that the ultimate goal is to get the most clinically appropriate and affordable medication for my patients and to ensure their understanding of how/what they are taking. To achieve that, I don't mind jumping through hoops or getting yelled at (provided that these things don't get past my limits). As long as my patients get what they medically need, I don't care what these docs think! As far as the permission and formality of calling for substitution, it's just our intrinsic setting and legal obligation that restrain us and force us to follow the norms. To quote my dad "it's what it is, so stop whining and start doing!"
    These things are the reason why I keep my sanity loving my other job at the hospice facility where I have more autonomy adjusting pain n/v meds or antibiotics and deciding appropriate routes of admin.
     
  13. PharmdA07

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    LOL no not really ! I don't have 5 minutes for every single substitution. However, with things like these and birth controls, or Narrow therapeutic meds (e.g. generic of transplant/ psych/ seizure meds etc.), I usually find time to do what I need to do to protect my license--it's really is CYA if you think about it.
     
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  14. npage148

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    If something is AB rated I will never call which is legally allowed by the FDA and lower state laws so I don't need to cover my arse
     
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  15. owlegrad

    owlegrad Uncontrollable Sarcasm Machine
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    Dear god please do not call for AA or AB rated substitutions (stupid negative formularies notwithstanding of course).
     
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  16. Ackj

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    Theoretically sounds good, but insurances probably wouldn't like it. Kind of like "test strips - 100 count" doesn't go over very well.
     
  17. sakigt

    sakigt Junior Member
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    I thought they were just replacing the electrolytes youre poopin' out.
     
  18. Dred Pirate

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    so, I don't work retail, but when I used to, I would get those scrips and just fill with what they were on before, if they were new, I would pick one that I liked. Can you not do that anymore?
     
  19. Wheresmyaricept

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    That's what I thought but he said he talked to one of the local docs and that's what they said. It's not really a topic I cross too often so I don't care to research it. Like I said--I'm lazy.
     
  20. DelPharm

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    If you're randomly switching people to Tagamet, it's time to give your license back.
     
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  21. BidingMyTime

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    I would never call on an AA/AB rated substitution, there is no legal or therapeutic reason to do so, a complete waste of time....the sole exception would be if I thought the physician had made an error (ie the patient had been on DAW-1 Coumadin for the past year, and the new RX said substitution allowable & the pt aid the dr hadn't talke to him/her about changing to the generic.)....but then I would call for any unusual change in a patient's prescription that the pt hadn't been told by the doctor about.
     
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  22. RX2090

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    It's not so much asking for permission versus letting the prescriber know what you want to do. Yes, we know enough to make the switch ourselves. But don't you think the prescriber has a right to know that you are changing the medication, however small it may be? If he wrote nasonex, and only Flonase is covered, obviously it's a no brainer. But as the prescriber, it's his right to be informed.

    It's all about how you approach it. If you call the doctor and say "insurance doesn't cover nasonex. May I please switch to Flonase?" Is wrong and makes you look bad. If you call and say "hey doc, his insurance only covers Flonase, just wanted to call you and see if we can switch it." Sounds much better.
     
  23. Dred Pirate

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    I actually disagree with your second part - I always tell my students/new hires that you can't call a doc and just say "you can't do this" you ALWAYS have to give an alternative. I personally thing the first line sounds better, but that is just my two cents worth
     
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