Hi everyone! I'm a fairly new graduate, so I wanted to get some opinions from more seasoned pharmacists on a dose increase of a medication for a patient. I know that I'm probably over thinking this, but just wanted to have others throw in their two cents and experience with this.
77 yo patient on glimepiride 4 mg - originally taking 1 tablet BID. Got a new prescription today saying 2 tablets in the morning and 1 tablet at night. I had a DUR saying that the max dose of the medication is 8 mg/day. As far as I know this is the only diabetes medication for the patient.
My question is, would you fill it as is? Or would you contact the doctor and question why the patient isn't on additional therapy since he has maxed out on his glimepiride. I've read in school about sulfonylureas having a decreased effectiveness over time due to over stimulating the pancreas, so I thought the dosing makes sense, but then again it is over the max dose.
I ended up filling it (patient hasn't picked it up yet), but I'm having second thoughts. What would you do in this situation? Thanks in advance for the advice!
77 yo patient on glimepiride 4 mg - originally taking 1 tablet BID. Got a new prescription today saying 2 tablets in the morning and 1 tablet at night. I had a DUR saying that the max dose of the medication is 8 mg/day. As far as I know this is the only diabetes medication for the patient.
My question is, would you fill it as is? Or would you contact the doctor and question why the patient isn't on additional therapy since he has maxed out on his glimepiride. I've read in school about sulfonylureas having a decreased effectiveness over time due to over stimulating the pancreas, so I thought the dosing makes sense, but then again it is over the max dose.
I ended up filling it (patient hasn't picked it up yet), but I'm having second thoughts. What would you do in this situation? Thanks in advance for the advice!