Dispense as written.... - page 3

Ugh!!! Anyone else have a problem with this? My husband takes Levoxyl for his hypothyroidism. Our doctor was adamant that he stick with this namebrand, he didn't want the namebrands changed. He... Read More

  1. by   kittyw
    No matter what, the doctor ordered dispense as written. For the pharmacy to fill it with something else is a med error.

    According to my drug book - you should not accept brand change as differences in bioequivalence exist among brands. Also, (not applicable in this particular circumstance but important in regards to brand names) Synthroid 0.1 and 0.3 mg contain tartrazine which may cause and allergic-type reaction in certain patients. It is frequently seen in persons who also have aspirin hypersensitivity.

    Now in this instance, it's up to you as to whether you think you can trust them in the future with your medications &/or report it. It was probably an honest mistake since most people want cheaper medication and they are probably in the habit of filling with generic without complaints. You may want to point out that the drug guide states that there are significant differences between brand names.
  2. by   montroyal
    Originally posted by hogan4736
    maybe first speak w/ said pharmacist, or the pharmacy supervisor, before going to the board.

    geez, and I'm high strung?
    If the MD wrote fill as written, the pharmacy can not legal dispense anything else. If the pharmacy dispense anything but the prescribed medication there is no justification. Its practice medicine without a liscence. They should of explained they were out of the drug and given you the option to go else were. By not saying anything to you, they took away your right to make an informed healthcare decision. What ever their motive, they have no right to take the choice away from you and your spouse and they need to be held accountable for their actions. At the very least, the board should come in and do an audit, to ensure this is not a common practice.
  3. by   hogan4736
    Originally posted by montroyal
    If the MD wrote fill as written, the pharmacy can not legal dispense anything else. If the pharmacy dispense anything but the prescribed medication there is no justification. Its practice medicine without a liscence. They should of explained they were out of the drug and given you the option to go else were. By not saying anything to you, they took away your right to make an informed healthcare decision. What ever their motive, they have no right to take the choice away from you and your spouse and they need to be held accountable for their actions. At the very least, the board should come in and do an audit, to ensure this is not a common practice.
    you've never written and order first, then gotten the actual order later (or gotten the doc to sign for it later)??

    that is something I think we've all done at least once...careful montroyal, that's practicing medicine w/o a license...what if you had an overzelous co-worker who witnessed you do that and called the board without talking to you first...wouldn't you at least deserve being confronted before having your livelihood possibly snatched away??

    relax...I disagree w/ what happened, but the pharmacist deserves at least hearing about it from his supervisor, before having his case immediately go in front of the board???

    what, in Canada one isn't innocent until proven guilty??
    what about due process
    besides, you're only hearing one side of the story

    again, RELAX...you are mistaking the pharmacist for another nurse (you know, nurses eat their young, no questions asked, as THAT'S what you seem willing to do in this case)
    Last edit by hogan4736 on Feb 28, '03
  4. by   RN2B2005
    Pharmacies make mistakes. So do nurses. Most of the time, they're innocent, as it seems was the case with the Levoxyl. I don't think we should be so quick to crucify pharmacists (a few major pharmacy chains being the exception....).

    I take multiple medications for asthma, allergies, and depression. Being a responsible patient, I try to have one doctor (my internist) prescribe all the medications, and I try to fill them through one pharmacy. Even with these precautions, mistakes have been made.

    A couple of years ago, I filled a prescription for prednisone. It was supposed to be a tapered regimen--6 tablets every X hours the first day, 5 every Y hours the second day, etc. The prescription I picked up was for the correct amount of tablets (around 50) but the SIG was wildly incorrect. The instructions read something like, take 6 tablets once daily for five days. Hmm.
    Even if the SIG had been correct, the # of tablets being dispensed should have set off alarm bells for the pharmacist, right?

    It turned out that the pharmacist actually had called the office to check on the SIG, which was called in by my doctor's MA. The MA had supposedly told the pharmacist that the SIG she originally called in was correct--leaving the pharmacist with no choice but to fill the prescription. When I called my doctor the next morning, my doctor told me that her assistant had read the chart notes incorrectly--yet another reason to have only licenced RN's call in scripts--and didn't have the training to realise that the SIG she called in made no sense.

    Another time, this same MA called in a script for 300 Tylenol #3 instead of 30!

    Also, as far as pharmacists switching patient medication (within a drug class), keep in mind that this might be due to insurance formularies. I don't know the law in this regard, but when I was on an HMO, my pharmacy once had to fill a sleeping medication Rx with trazodone instead of zolpidem; my doctor did approve the change but was not happy about it.

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