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Do most stores keep credit card numbers and prescriptions? I tell patients to hold on to their prescription and bring it in when needed
Would you at least call the doctor to discuss? We are on the same team...you would or would not call the doc? I'm confused. Pt going to Japan for 2 months. If it was zoloft, there would be no issueUsually when people say they are going on vacation it is in the country so I tell them to take the script to a pharmacy where they are going on vacation.
If they are going out of the country, as you described, the doctor will be contacted and the approval will have to be documented. From here there are really two options:
1) They pay cash for the second script
2) Pharmacy has to call insurance to see if the plan offers a vacation override
I would absolutely not fill for double the dose as a way around this. Calling for vacation overrides is also a pain.
Having a family member pick up the med, pay for it, and mail it might also be an option but I'm not sure what kind of regulations there would be on mailing CIIs out of the country...
Would you at least call the doctor to discuss? We are on the same team...you would or would not call the doc? I'm confused. Pt going to Japan for 2 months. If it was zoloft, there would be no issue
I didn't fill it. I told the prescriber and my PIC I wasn't going to fill it. My PIC decided he wanted to check it and fill it.I don't get it, the doctor didn't have any problem at upsetting you, why worry about his fragile feelings? esp if he barked at you, pharmacist should stand up for what they believe in, if you are not comfortable with a prescription then don't fill it
Most pharmacies hold prescriptions if a patient requests it. Many won't hold on to CII's since a missing RX can't be replaced via phone, but otherwise it's common practice. That way patients can drop them off after their annual physical and not worry about the exact day their old prescriptions expire.Do most stores keep credit card numbers and prescriptions? I tell patients to hold on to their prescription and bring it in when needed
LOL, like I said.... I am relating what the PIC did. I never said that's what everyone should do when this situation arises.
I understand that.
Do most stores keep credit card numbers and prescriptions? I tell patients to hold on to their prescription and bring it in when needed
Do most stores keep credit card numbers and prescriptions? I tell patients to hold on to their prescription and bring it in when needed
Most pharmacies hold prescriptions if a patient requests it. Many won't hold on to CII's since a missing RX can't be replaced via phone, but otherwise it's common practice. That way patients can drop them off after their annual physical and not worry about the exact day their old prescriptions expire.
Credit cards are more variable. CVS won't keep them (per policy, but practice varies) and Walgreens will. Most independents will, but some still have internal "charge accounts" and send patients a bill every month.
Would you at least call the doctor to discuss? We are on the same team...you would or would not call the doc? I'm confused. Pt going to Japan for 2 months. If it was zoloft, there would be no issue
We keep one of those "page a day" tear off calendars and put everything in there. In the morning you tear off the page, laugh at Snoopy, and process the rx that were on hold.When I type a script into their file and put it on hold, there isn't a way for me to schedule it to fill on a certain day (at least at my pharmacy). So the patient has to call us on the day it's due and tell us to fill it. 50% of the time they don't listen to us and just show up. It's annoying because they usually get mad and we have to prioritize the script since they are waiting.
Maybe some stores keep a notebook or something to keep track of this stuff. I prefer that they bring it in on the day it's due but I if they want to leave the script at the pharmacy I tell them to call us when it is due to be filled.
...which is a direct violation of policy. The policy says prior to each delivery the store must contact the patient and get the card info, then use it and destroy it. But that seems unreasonable to most humans with the power of logical thought, so I'd say it happens rarely to never.As you said, it varies at CVS. I do know that stores that offer delivery keep credit cards on file.
It happens...1 or the other, not both unless it's a scheduled + a pro re nata. What's more troubling was a physician who was okay with Rx-ing Oxycodone/APAP to a woman who was literally off of buprenorphine-naloxone for just over 1 month after extensively titrating down. To be fair, it was only a few day supply but still, there are plenty of other options for analgesia (ketorolac would seem like a good alternative).
Any studies on phentermine for ADHD? That's news to me. Why do you choose that particular medication over other available ADHD meds?
Would you at least call the doctor to discuss? We are on the same team...you would or would not call the doc? I'm confused. Pt going to Japan for 2 months. If it was zoloft, there would be no issue
How are the risks and side effects of phentermine different from Adderall?ketorolac is a terrible choice for most people.
I agree, I have never heard of using phentermine for ADHD, while I could see that it might be theoretically effective for ADHD, the risk/side-effects would seem to outweigh any usefullness.
FYI, this would be an issue in some states. In IL, it is illegal to dispense over 30 days of a CII, so it would be pointless to call the doctor (other than to let her/him know that it's illegal to fill a 60 day supply. )
How are the risks and side effects of phentermine different from Adderall?
it would be nice. Son of us straddle two states like Wisconsin where two months is legal
Could it be for binge eating disorder?Was counseling a patient on Belviq the other day and asked her if she has tried other medications before. She said "Yeah my Dr also has me on Vyvanse for weight loss". Not filling that one anymore.
If pph is post post partum hemorrhage, why would that be somethingI'd be concerned about in most of my patients? Any effects that are more generalized?
Would you at least call the doctor to discuss? We are on the same team...you would or would not call the doc? I'm confused. Pt going to Japan for 2 months. If it was zoloft, there would be no issue
I've been to Japan and it's illegal to bring any stimulant drugs into the country. It doesn't matter if it is prescribed and dispensed in the US legally or not. Adderall and other stimulants are illegal in many countries (particularly Asian countries) and not approved to treat psych conditions. This may be a tangent point, but any patient going international absolutely needs to check the the country's laws they are visiting to make sure the meds they want to bring in are legal, in the right quantity, and bring any necessary documentation as well. If a patient needed extra supply for vacation I'd have the patient contact their physician and explain their situation directly to their prescriber so everyone is on the same page and then work with them in ways that are legal and ethical to cover them on their trip. I always tell patients to check the country's customs laws or embassy website for information regarding bringing medications there first.
With all due respect, it's nice that you tell patients to check the country's customs laws, etc, but that really isn't part of what we do. If a patient is going to Japan and needs a two month supply of a C-II, then you check your state vs. federal law and you either fill it or not because whichever the stricter one of the two laws, either allows it or not. That's all you are concerned with.
Shouldn't you also be concerned with the well-being of your patient, and particularly in this case, their ability to adhere to drug therapy? Counseling patients that they should check the other country's customs laws seems like a reasonable thing to do. Not saying you shouldn't fill the two month supply of a C-II until you confirm the other country will allow the patient to take it in with them, but giving the patient a heads up that they might have problems bringing their medication into another country seems like it is well within our duties as a pharmacist. Most patients would probably appreciate it, although I can also imagine some patients will then demand you check the country's customs laws for them because they don't know how to... So there is that...
With all due respect, it's nice that you tell patients to check the country's customs laws, etc, but that really isn't part of what we do. If a patient is going to Japan and needs a two month supply of a C-II, then you check your state vs. federal law and you either fill it or not because whichever the stricter one of the two laws, either allows it or not. That's all you are concerned with.
I'm not going to look up customs info for them, but if they are asking me for an extra fill for vacation I'd drop the sentence that they should also check with the country they are visiting regarding customs and bringing in medicine. Mentioning it is just a 10 second sentence. If it's legal in the US to fill it and ethical to do so then I'd have no problem with it.
Do you guys fill stuff like Adderall 30 mg take 1 tid? The maximum daily dose that I'm aware of is 60 mg.
I've seen pharmacists reject these scripts and I've seen some fill them.
90 mg of amphetamine a day does sound ridiculous but I've seen patients on it.
Do you guys fill stuff like Adderall 30 mg take 1 tid? The maximum daily dose that I'm aware of is 60 mg.
I've seen pharmacists reject these scripts and I've seen some fill them.
90 mg of amphetamine a day does sound ridiculous but I've seen patients on it.
Do you guys fill stuff like Adderall 30 mg take 1 tid? The maximum daily dose that I'm aware of is 60 mg.
I've seen pharmacists reject these scripts and I've seen some fill them.
90 mg of amphetamine a day does sound ridiculous but I've seen patients on it.
Bidingmytime meant Primary Pulmonary Hypertension, I am pretty sure. It's also known for Valvular Heart Disease. Phentermine is a dirty drug, plain and simple. It gets in everywhere. If you read the mechanism of action you will see that it does not do 1 thing; instead, it gets in everywhere and it happens to cause appetite suppression like any other sympathomimetic would. So if the desired effect is ADHD management, there are much cleaner drugs that can achieve that. Because it is a dirty drug, it is only indicated for the short term treatment of exogenous obesity. So there you have it. ADHD is a chronic condition. You manage it. It never quite goes away. So you would not want to treat it with something that is not indicated for long term use. That's what Bidingmytime meant to say, in a nutshell. Just a hunch...
Shouldn't you also be concerned with the well-being of your patient, and particularly in this case, their ability to adhere to drug therapy? Counseling patients that they should check the other country's customs laws seems like a reasonable thing to do. Not saying you shouldn't fill the two month supply of a C-II until you confirm the other country will allow the patient to take it in with them, but giving the patient a heads up that they might have problems bringing their medication into another country seems like it is well within our duties as a pharmacist. Most patients would probably appreciate it, although I can also imagine some patients will then demand you check the country's customs laws for them because they don't know how to... So there is that...