10 nights worth of sleep meds

[PsychNurseWannaBe, BSN, RN]

I have a question. When it comes to sleep meds like Ambien, the pharmacy only sends a 10 day supply to the resident, even if the med is scheduled every night. So I have to order 3x in one month. Does that sound right? Is there some reason for this. I was just wondering because if I had to fill a script 3x in a month and have to pay 3 co-pays, I would be quite annoyed.

All other meds come in 30 days supply including narcs...so why are sleep meds so special??

Thanks

[rehab nurse]

Are they billing for 3 co-pays??? My gosh, I would be upset too if I had to pay 3 co-pays for a month's supply of medication.

I would ask the pharmacy how to prevent this. If your patient is going to be on this long term, I would ask the doctor about putting a quantity on the order. A lot of meds, not just narcotics, are limited. I believe Ambien is suggested not to be used more than 10 days, although so many use it more than that, so I bet that's why they only send 10.

I bet the pharmacy needs a quantity. If the doctor is okay with it, I would just write "Ambien 10mg (or 5mg, whatever...) one by mouth q HS." In my old job we would write "send 30" or "quantity 30".

I hope that helps. It's most likely an automatic self-limiting order in the pharmacy computer and needs to be over-rided . I would also follow up with the billing department if you know a specific name and make sure this gets fixed so a bit of money can be saved.

[BrnEyedGirl, BSN, MSN, RN, APRN]

My insurance,.through the hospital where I work,..has many meds it will only pay for X # a month. Ambien is one of them,.they will only pay for 15 a month period,.even if the rx says take every night,.only 15,.if you need more you have to pay yourself!

There are also several meds they won't pay for unless you have documentation that you've tried "x" med first and for some reason either can't take it or it wasn't effective,....HMO's practicing medicine if you ask me.!

[KeechieSan]

I'm not sure if this has anything to do with it, but Ambien is not meant to be used long term. I spoke to a neurologist at work about it and he said (and other docs I know agree) that Ambien is for 1-2 weeks max, just to get someone back on a normal sleeping pattern.

Maybe thats why they only give 10?

[PsychNurseWannaBe, BSN, RN]

Thanks everyone for the replies. Great suggestions. I will call the pharmacy and see what they say.

[CapeCodMermaid, RN]

Ditto...Ambien shouldn't be used every night and shouldn't be ordered to be used every night. It should be used on occasion. Have the residents try melatonin or trazodone or hmmmm how about some decaf tea?

[PsychNurseWannaBe, BSN, RN]

Ditto...Ambien shouldn't be used every night and shouldn't be ordered to be used every night. It should be used on occasion. Have the residents try melatonin or trazodone or hmmmm how about some decaf tea?

This one residents take Ambien every night. No ifs ands or buts. It is what she wants... other residents have more of a PRN. I don't have any residents on melatonin and only one on trazodone.

Now that you mention it...why not melatonin?? I should inquir about this when I work next. Thank you

[Furwillfly]

I work in geriatric/psych, and yes Ambien is not good for elderly or long-term use. Melatonin is a good place to start, but doesn't work for everyone. Have u tried all non-medication interventions?

[PsychNurseWannaBe, BSN, RN]

Thanks everyone for the replies. The MD just came in and d/c the med. Don't know if the res. knows about that or not though. The rest of my ladies have it PRN.

[Lexxie, LPN]

At my facility, any anti-anxiety or sleep med is only ordered for 10 days at a time. All non-medication interventions are supposed to be used first. There's a whole slew of paperwork to be started, from Behavior Sheets, etc., if these meds are used. I sometimes think the paperwork is supposed to be a deterrent - who wants all that added documentation? hehe