My husband was diagnosed two weeks ago with Lyme after an exhaustive 11 month search for a diagnosis. He was started out on 100 mg of doxycycline in the morning and 100 mg of doxycycline in the evening. After two weeks at this level, the LLMD increased the dosage to 200 mg in the morning and 200 mg in the evening. I went to pick up the perscription this evening and the pharmacy refused to fill the perscription, asking what he was being treated for. When I told them Lyme, the pharmasist said the dosage was double what it should be and refused to fill the perscription. Has anyone else encountered this? What do we do?!
Posted by Getting Better (Member # 8919) on :
That's nutty. Why wouldn't the pharmacist call your husband's doctor to confirm the amount?
Go to another pharmacy and file a complaint against this pharmacist.
If he/she thinks 400 mg doxy is a lot, you'd better get another pharmacist.
Posted by seekhelp (Member # 15067) on :
No, I believe that's illegal and an invasion of privacy.
Posted by duke77 (Member # 5051) on :
Its not up to the pharmacist. He cannot override a doctors orders.
Posted by Dawnee (Member # 15089) on :
Illegal. I think I'd be letting him know he was being reported.
Posted by pab (Member # 904) on :
I would find another pharmacy.
Posted by Leelee (Member # 19112) on :
That sounds way out of line to me. I don't think the pharmacy is allowed to do that.
If anything, they might need to verify the dosage with your husband's doctor.
Hope you are able to get his medicine without more trouble.
Posted by shazdancer (Member # 1436) on :
The only thing I can think of is that the pharmacist may have wanted to check with the doctor that the prescription was correct. That he CAN do. But he can't simply deny the request.
Feel free to show him the front page of the IDSA guidelines (the 100mg 2X/day guidelines). The front page says, in small print:
quote:It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations.
~ Sharon
Posted by Keebler (Member # 12673) on :
-
When you find a new pharmacy, do not tell them about lyme -
if pressed you can just say something like "some sort of strange infection" like you are not even sure exactly what - in a very low key sort of way.
-
Posted by Lymetoo (Member # 743) on :
quote:Originally posted by seekhelp: No, I believe that's illegal and an invasion of privacy.
I think it IS illegal to do that! and an invasion of privacy to boot!
Ditto!!
Posted by glm1111 (Member # 16556) on :
The pharmacist has the right to refuse if he feels in his opinion it is harmful to the patient.
I know when I was working in a hospital as a nurse I refused to give my patient an injection because in my opinion he was having a reaction to that medication.
The symptoms I viewed him having where backed up by the PDR. The head nurse told me to give it to him anyway and I refused.
She called the dr and he cut the order because the dr agreed. If I would have given him the injection and he died it would have been on my shoulders.
I know it is frustrating and it feels invasive given what we are dealing with. Sorry you had to go through this,
Gael
Posted by omgwtfbbq (Member # 15446) on :
find a new pharmacy, simple.
I have been told my dose of abx was higher than normal, and I just mumble something along the lines of that being what works for me and yes that was the dose I discussed with my doctor.
Posted by MY3BOYS (Member # 17830) on :
nursing discresion is diff. from
pharm. responsabilities. asking pt
for dx is invasion of privacy. if
order is verified with md (have
ran into this) then rx is filled.
agree with above, change phar.,
u r not obligated to say dx.. just
say infection if feel u need to
respond. md orders, once verified
r to b dispensed as ordered and pt
can be counseled on risk, etc. report pharm maybe if store does
not respond. pharm. r licenced,
hate for anyone licence to b reported if other avenues of
resolution not tried. I would b
upset if my licence was reported
without chance to fix it..however
I am not a pharmasict. may look
into pharm licence, regs, then talk
to store owner?? in mean time use new one
Posted by 'Kete-tracker (Member # 17189) on :
Sick In Georgia: That pharmacist is (probably unkowingly) breaking federal law. HE isn't Allowed to regulate dosing of any dispensed drug as prescribed by an M.D. You could probably get him fired by reporting this to the pharmacy's head office. But I wouldn't burn bridges until you find a place that you can 'switch' to... not difficult to do in these prescription-proliferous days. I doubt you'll encounter this again. If so, let us Know... & let the DOC know! (Eeegazeezus)
Posted by 'Kete-tracker (Member # 17189) on :
glm: He has a right to refuse only so FAR as he can feel the need to verify dosing w/ the doctor's office. A good example is being given an Rx for a drug that he has "good reason to believe will interact dangerously" with another drug previously dispensed. In this case, he MUST follow up with communication (typ call or FAX) with the doctor or doctor's staff. He can't simply refuse the prescription. This acc to a friend who works as a local certified pharmacist.
Posted by glm1111 (Member # 16556) on :
I am not saying I agree with not being able to get your prescription filled but here is what I found..
It is specified in the Pharmacy laws of many states that it is the pharmacists duty to refuse to dispense if, in the pharmacists professional judgement filling the prescription as written could cause inadvertant harm to the patient.
In this case he might have been alarmed at the high Doxy dose which he probably doesn't see.
Posted by Tincup (Member # 5829) on :
There are different doses for doxy... some go by weight.
WELL... he can't often judge what would or Wouldn't "cause inadvertant harm to the patient", as he is not familiar with Many things. First, he's not familiar with the patient's medical records, all other drugs he's on (usually the case) nor is he familiar with drug treatment histories of the patient. The pharmacist's job is to carefully dispense.
But if something seems odd or erroneous, my pharma friend is instructed to call the doctor's & verify things. If he can't reach anyone, he puts them off a day.
It's possible this GA pharmicist is unfamiliar with 200mg b.i.d., but that wouldn't give him reason to refuse the Rx.
An interesting side-note, my friend has seen many more 200mg bid Rx's for doxy in the last 2 years. Guess the Merrimack valley where he works is seeing a Jump in Lyme cases, & MDs that are going with ILADS protocols over the IDSA. (hooray!)
Finally, I would Think proper doxy dosing is more a matter of the patient's skin surface area than weight, i.e: a 175# eskimo needs less than a lanky 175# 6'4" 20-yr old. I surmise this due to the fact that the 'cyclines concentrate in the skin. Haven't seen it discussed though.
Posted by Getting Better (Member # 8919) on :
Awwwww, too bad for the pharmacist. 1. He'll be getting a complaint. 2. He'll be losing your business. (My drugs last year were $24,000). Talk about shooting himself in his own foot ...
Who knows why he did it? Some people are zealots, some people are ignorant of lyme, and some are super conservative. I bet there are provisions in the law that any professional can refuse an action if they think it is going to cause harm (cite: Law and Order rerun #122 . . . lol)
To be a little more serious, Seriously >>> you want your pharmacist to smile when you come in. How's it going? Any changes? Remember to stay out of the sun on this one . . . etc. You want him/her on your side for a number of reasons.
I wonder what they did to the pharmacist that refused giving birth control pills?
Posted by treepatrol (Member # 4117) on :
Tell them call the Dr. And they have to fill it. But insurance may not pay because its in the same month?
Posted by Judy G. (Member # 18498) on :
My pharmacy made me wait until the dosage was confirmed by my doc. (Same thing - 400 mg doxy/day)They were quite apologetic about it and when my doc did not call them right back they gave me pills for a few days.
I felt like they were doing something that was standard practice. My doc clearly wrote on the script "for Lyme arthritis" so it was no secret.
I do have the feeling that we are outside the regular medical establishment in so many ways. It becomes a tightrope walk to get the care we need.
The next thing that happened is that my insurance stopped paying for it since they had some sort of threshold for amount of doxy prescribed over a period of time. Fortunately it is not a very expensive med.
Still, I am grateful for all the help I have had from this site, from my doctor and all the support I have had from family and friends. And the insurance did pay for my Igenex test. Grateful.
Posted by mustluvdogs (Member # 18273) on :
Get a new pharmacist. Hopefully pharmacist didn't report doctor.
When I thought I had FMS and after 4 years started narcotics, my pharmacist asked me what was wrong with me and i told her none of her business.
That's just not right. He should have called the doctor to confirm.
Good luck
Posted by Lymetoo (Member # 743) on :
Where's sickingeorgia?
Posted by Leelee (Member # 19112) on :
I just thought of something this morning.
My PCP now transmits prescription requests directly to the pharmacy near my home via computer. It is very convenient. It seems that would also clear up any questions the pharmacist might have about the correctness of the Rx.
Don't get me wrong, though. I think my PCP is horrible and I am changing to someone else, but I do like the prescription-ordering service she provides.
Posted by kmj (Member # 18400) on :
That happened to us too. The dosage for the Azithromycin was twice the normal dose so the pharmacist refused to fill until such time as he had spoken to the doctor. The LLMD called him back and confirmed the dosage and we picked up the rx. Once they have spoken to your doc, I don't believe that they have the right to refuse meds. The insurance company might however.
Posted by Wimenin (Member # 15294) on :
Go to another pharmacy, and if they ask what the treatment is for, say its personal. If they press, tell them that if they really want to know, they can contact your doctor for verification. If they say they won't fill it without knowing why, signal them to come closer to you, whisper that its a highly contagious STD, and then be sure to shake their hand before you leave!! : - )
Seriously, they can't override a doctors prescription. If that happens again, ask to speak to the manager, get all of the employees full names, and let them know you'll be contacting the state licensing and examining board, and state dept of health as well.
Its sad when you cant admit to lyme.. cancer, sure... STD..no problem.. but lyme...no.
Posted by NeuroEcclectic (Member # 17783) on :
Georgia,
In my memory the only time that
a pharmacist can expect an answer or have the
right to ask that question is if it is a
narcotic.
Change to another pharmacy as others have
suggested and if that happens again tell the
pharmacist to consult with your physician over
the telephone.
Sorry that this happened.
Posted by 2roads (Member # 4409) on :
I think we need a legal answer state by state.
What are the rights of patients being prescribed their medication?
Not an opinion, but fact.
Can anyone site documentation as to the law, state by state?
I too, would like to know this answer. I have been getting more and more apprehensive about returning to the Pharmacy for refills on my son.
They have not given me a problem....yet.
But I don't like how stressed I get because of what grief they may give me.
Please, maybe there is a lawyer on the board.....what are the facts?
2roads
Posted by stella marie (Member # 7216) on :
sickingeorgia....are you still here? Can you give us an update?
Posted by sickingeorgia (Member # 18419) on :
Thank you to everyone who posted a response! Just wanted to give you all an update that the pharmacy did call the LLMD to confirm the dosage and they did end up filling the perscription after all. Thanks again for the advice and suppport!
Posted by bettyg (Member # 6147) on :
![[Eek!]](eek.gif)
Sick In Georgia: That pharmacist is (probably unkowingly) breaking federal law.