posted
My daughter and I both left the LLMD's office with scripts for 200 mg doxy twice a day. Routine for us lymenetters.
But pharmacist wouldn't fill them because the dosages were too high. He even knows we have lyme disease. He is a good man,caring and well meaning and concerned for our welfare.
SADLY- he even showed me his reference guide for Lyme Disease which states clearly 100mg Doxy 2 x daily for 14-21 days. He told me this is what he learned in pharmacy school.
I went off in his face and started spitting about the fact I recognized those as the ridiculous guidelines put out by the IDSA-and that's why I am now in the situation where I have to take Mega Whatts of Antibiotics.
He was apologetic, but said he could not dispense the script without talking to my doctor. I am to call him back tomorrow.
You have to educate on every front. I may drop him off a copy of Dr. B's guidleines tomorrow.
posted
That's dreadful. Yes, we have to be the re-educators. IMO bringing Dr. Bs guidelines is a great idea. hats
Posts: 956 | From MA | Registered: Nov 2004
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NP40
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Member # 6711
posted
WHAT ? Doctor's diagnose and write scrips. Pharmacists fill bottles. What planet did this guy descend from ?
Posts: 1632 | From Northern Wisconsin | Registered: Jan 2005
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mojo
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Member # 9309
posted
That really irks me. When I had my first script for Doxy the Dr. had really bad handwriting so they filled my script as 2 100mg pills FOUR times per day. I didn't figure it out for 10 days (man did I herx!) and it was a weekend and the Dr.'s office was closed. I called CVS (who filled the script) and they said it did seem like a high dose but that it was correct per their records. Fortunately it was Sun. evening and I called my Dr. first thing in the a.m. and she confirmed the correct dose.
Posts: 1761 | From USA | Registered: May 2006
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Go to another pharmacy. One where they follow your doctor's orders and mind their own business. Pardon me, but doctors trump pharmacists...
-------------------- Getting older is when we would rather not have a good time than have to get over it. - Oscar Wilde Posts: 386 | From Radnor, PA - where the ticks run free | Registered: May 2006
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SForsgren
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posted
I would take your business elsewhere and write to his superiors. If you were just infected for example, an extra day could have made all the difference and he could have just kept someone from a true cure. I get questioned often, but never have been denied. They are not filling pain pills.... Sheesh.. Like we want to take the ABX...no thanks..
-------------------- Be well, Scott Posts: 4617 | From San Jose, CA | Registered: Jul 2005
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quote:Originally posted by NP40: WHAT ? Doctor's diagnose and write scrips. Pharmacists fill bottles. What planet did this guy descend from ?
NO kidding!
I agree with Scott...go elsewhere, but drop off a copy of Dr B's guidelines at your FORMER pharmacy!
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | From Texas | Registered: Feb 2001
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Jill E.
Frequent Contributor (1K+ posts)
Member # 9121
posted
My pharmacies have never been able to fill the prescriptions as written, but it's because my PPO insurance will only let them fill the usual dosage for that antibiotic, not a Lyme dosage.
So I tell them to fill the maximum that the insurance will let them fill, and I pay the co-payment or out-of-pocket for that amount.
Then I have to go back very frequently to get a refill, of a limited number of the antibiotic, and go through this charade each time.
One time, a substitute pharmacist came out from behind the glass and interrogated me like I was a junkie - over Ketek! Yeah, like I'm going to take a liver-damaging antibiotic for fun!
Every one at the pharmacy now knows I have Lyme and multiple TBDs, and they never reject the prescription (except Bicillin which they couldn't get), but just have to fill it to the limits of my insurance.
Personally, I don't think a pharmacist would be willing to suddenly be persuaded by ILADS guidelines given that none of the non-LLMD doctors I've seen would agree to them either.
I agree that it's worth just trying a different pharmacy.
Hang in there, Jill
-------------------- If laughter is the best medicine, why hasn't stand-up comedy cured me? Posts: 1773 | From San Diego | Registered: Apr 2006
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Carol in PA
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Member # 5338
posted
quote:Originally posted by Penn92: I don't think this is legal.
Go to another pharmacy. One where they follow your doctor's orders and mind their own business. Pardon me, but doctors trump pharmacists...
I believe that pharmacists are duty bound to question the doctor's orders when they think there may be a problem.
Nurses are too.
One time I had a patient with a head injury, and his doctor ordered a certain medication. I had the med at the nurse's station, ready to administer, but I was not familiar with it, so I looked it up in the Physician's Desk Reference.
The doctor had ordered a dosage that was double what the patient should have received. This would have been harmful to the patient.
I checked the patient's chart, and yes, that's what the doctor wrote.
I phoned down to the pharmacy, and talked to the pharmacist. He phoned the doctor to confirm the dosage, and the doctor realized he had made an error. He then changed the order and adjusted the dosage to the proper level.
The pharmacist had filled the prescription without finding out why the dose was so much higher than usual. He didn't do his job.
But if I had given the patient the dose that was ordered, it would have been on my head if the patient suffered harm.
So please don't be annoyed when the pharmacist is doing his job.
In your case, it wasn't necessary, but in another case, it may be.
Carol
p.s. Professionals like Pharmacists and Registered Nurses carry malpractice insurance in case they make a mistake that harms the patient, and it results in a lawsuit.
And their license can be revoked if they do something unlawful. If you don't have a license, you cannot be employed in that position.
Pharmacists earn a very good salary, and I'm sure they don't want to jepardize that by not following the rules.
[ 15. September 2006, 09:30 AM: Message edited by: Carol in PA ]
Posts: 6956 | From Lancaster, PA | Registered: Feb 2004
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Michelle M
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Member # 7200
posted
Interesting.
My pharmacist did not have any Mepron. Anywhere. They had to go to great lengths to get it.
They called my doctor about it.
My front office LLMD girl was a little shocked when the pharmacist asked her, "What's she got, AIDS or something?"
She thought it was pretty outrageous that the pharmacy person would ask that (which even if I DID she certainly wouldn't have told her!), and of course the pharmacy lady had never even heard of babesia.
Ahh. Small towns. Gotta love em.
Michelle
Posts: 3193 | From Northern California | Registered: Apr 2005
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bettyg
Unregistered
posted
Carol, so sorry to read this for you/daughter! How disgusting.
Carol in PA made a good point as well. Never thought of that end of it before.
I was given 3 "mystery" pills in 1 of my pills; can't remember if it was abx or what! They were not ever able to figure out what it is.
I'm sending my sample to my step-daughter in Tulsa who is now a pharmacy tech; having her check their books/computer down there.
Best wishes on getting this straightened out. You've got enough other stuff going on; you don't need this hassle too. Bettyg
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sometimesdilly
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Member # 9982
posted
Carol-
I'm thinking we must go to the same pharmacy, neighbor. I had a very similiar experience when trying to fill my first lyme script, for amoxy. He looked at me and said, I've never heard of doses this high for amox, there must be a mistake.
Then he asked me what I was being treated for, and after I said lyme,(between gritted teeth) he then informed me that amox wasn't the right med, doxy is. He too would not fill the prescription until he spoke to my DR., which was the next day.
Carol, I'm right there with you .
I understand your point, Carol in PA, but what I heard was that as I was merely a patient I could not be expected to understand or consent to what was being prescribed to me.
I have no doubt you'll get your script tomorrow, Carol, but let us know if you don't. And hey, if you have to go to another pharmacist, let me know and I'll meet you there and help you stare down the next guy if it comes to that.
Bellowing in Baltimore, Dilly
Posts: 2507 | From lost in the maze | Registered: Aug 2006
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Cobweb
Unregistered
posted
I didn't become livid until I saw what he was basing his decision on- the IDSA guidelines-then it was like waving a red flag in front of a bull.
BTW I heard bulls were color blind ? I think the IDSA is color blind too, they don't see lyme !
sometimesdilly
Frequent Contributor (1K+ posts)
Member # 9982
posted
Let's dream of a time when pharmacists will look at scripts with low doses of abx and say, gee, I hope you aren't being treated for lyme, because this dose is just way too low for that. Think I'd better call your DR to be sure s/he knows what he is doing.
Yep, that would be good times.
Dilly
Posts: 2507 | From lost in the maze | Registered: Aug 2006
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lymemomtooo
Frequent Contributor (1K+ posts)
Member # 5396
posted
Carol, I am so sorry about this..I am sure it is the 200 mg doxy that it throwing him...My daughter has had the same strength but with 4-100mg and no questions asked.
They probably do not carry the 200mg pills
Come on up, our pharmacist is a lymie and he does his best to always help us out. hugs lmt
Posts: 2360 | From SE PA | Registered: Mar 2004
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TerryK
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Member # 8552
posted
I have to say that I'm glad the pharmacist is on the ball and looking out for your interests. Doctor's do not have degrees in pharmacology. Doctors do make mistakes with medications and it does cost lives.
Antibiotics are not benign medications. If one has an allergic reaction, an accidental double dose might make a big difference. So, while it is not the job of the pharmacist to second guess the doctor, I'd stick with this one since he is obviously paying attention and looking out for your interests. I'm sure it would have been easier for the pharmacist to not have to take the time to call your doctor and to not have to deal with an upset customer but it is their job to clarify if they think a mistake has been made.
If one is denied a prescription and they feel they absolutely must have some of the medication NOW, ask the pharmacist to give you enough to last until they can get verification from your doctor. In most cases, you will probably get it.
Terry
Posts: 6286 | From Oregon | Registered: Jan 2006
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liz28
Unregistered
posted
Can you get to a different pharmacist? There has to be a chain store near you.
If they ask questions, you could say that your doctor is doing this to save you money without having to come to his/her office so frequently, and that the script is for acne.
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Aniek
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Member # 5374
posted
I've had pharmacists confirm dosage before.
When I first had Ketek, they called the doctors office. When I went to pick it up, it wasn't ready, but I told them I understood it was higher than the traditional prescription and my doctor had discussed it with them. I appreciated they were looking out for me.
I prefer my pharmacists that look out for me over the one that twice gave me 30 pills when the prescription said three a day, 90 pills. Even if there is a bump in the road once in a while.
But if the pharmacist will continue to be difficult, it might be time to find a new one.
-------------------- "When there is pain, there are no words." - Toni Morrison Posts: 4711 | From Washington, DC | Registered: Mar 2004
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posted
pharmacists are more thanjust dispensing techs. They are obligated to do their best to catch med errors. some rx errors can kill you, and a diligent pharmacist could save your life. He just needs education and a conversation with your MD. Re the comment about Mepron, while the receptionist was out of line, Mepron IS an aids drug.
Posts: 688 | From CT | Registered: Jan 2003
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TerryK
Frequent Contributor (5K+ posts)
Member # 8552
posted
visionoftruth wrote: we are talking doxy.. not dangerous ketek.. 200mg vs 400mg / day? The pharmacist is over reacting...
a life-threatening allergic reaction (symptoms are trouble breathing; closing of the throat; swelling of the lips, tongue, or face; hives) blood problems (symptoms are unusual bleeding or bruising) liver damage (symptoms are yellowing of the skin or eyes, dark urine, nausea ,vomiting, loss of appetite, abdominal pain) irritation of the esophagus Other more common, but less serious, side effects include:
nausea, vomiting, diarrhea increased sensitivity of the skin to sunlight vaginal yeast infection
Posts: 6286 | From Oregon | Registered: Jan 2006
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posted
Told a pharmacist I only wanted part of a script filled. I decided not to take the prednisone. The lady stated she could not do it. I could have easily just filled the script and paid for only what I wanted. Anyway it was to late. I bought the prednisone with the rest of the script. I then proceeded to take out the prednisone, took of the lid and poured all the prednisone on the counter and left. It's the little things Posts: 731 | From Humble,TX | Registered: Feb 2005
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posted
This sounds like a good pharmacist to me. Many years ago I knew a baby that died because the doc wrote the wrong dosage for a scrip.
All is did was ?? the safety of the dosage for you and said he wanted to be sure by speaking to the doc first.
Writing the wrong dosage on a scrip is not that uncommon and I would think that having a pharm. who double checks for your safety is a good thing.
Now if he refused to refill it after talking with your doc then you have a right to lay down at his entry with a nasty sign warning all customers away.
Posts: 561 | From connecticut | Registered: May 2004
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sometimesdilly
Frequent Contributor (1K+ posts)
Member # 9982
posted
Maybe responses here vary in part because everyone's circumstances were just that little bit of different approaching the pharmacy counter.
In my case, I was scared to death of what was going to come next, particularly of herxes, having not had the good fortune to have yet found lymenet or the equivalent.
I had pysched myself up, my husband had taken the day off work to be there for me, and people close to me waited for a phone call to come swoop up my son if need be.
It was not a good thing to have to wait a day, and in my case, I don't think the pharmacist should have asked me to. I told him I was fully aware that doxy was what was typically recommended. I also told him that the dose of amox was high by some DR's standards, that my DR had fully explained everything to me, and that I had consented to what he was prescribing.
In those circumstances, yes, I think he should have just filled the blasted thing and send me on my way.
Dilly
Posts: 2507 | From lost in the maze | Registered: Aug 2006
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groovy2
Frequent Contributor (1K+ posts)
Member # 6304
posted
Hi All
I have thought for along time that LLMDs are being Turned In (outed) by pharmicists-
I think LLMDs would have much less problems if they wrote several perscriptions for lower doses- that are filled at Different pharmaciey locations--
I have had almost every pharamicists question the doses the doc wrote for me--
As far as pharmacists being professional-- most of them are perty much a Joke-
Over the 3 years I have been buying medicine my med orders have been screwed up 75% of the time- Im Serious--
The Very first meds I got from a pharmacy was screwed up-
Nystatin powder was stored warm- Totally Ruined it --out of the 4 bottles of nystatin I bought this happened 2 times 2 out of 4- not good-
The first time I got doxi the pharmacy gave me 100 extria doxi pills-- and then shorted me on my Happy pills-
I have had better luck getting correct orders from- Jack in the Box- Seriously--
I now use a pharmacy here in Austin that is Very Professional in everyway--
They are Really sharp and on the ball and help me in anyway they can--
They also sell there meds MUCH Cheaper too (about 70% cheaper--) same meds -better service- and very helpful I cant ask for more--Jay--
Ps the phamacy I use will fill perscription from Texas doctors and they will mail meds to you --PM me if you want there name-
Posts: 2999 | From Austin tx USA | Registered: Oct 2004
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quote:Originally posted by TerryK: visionoftruth wrote: we are talking doxy.. not dangerous ketek.. 200mg vs 400mg / day? The pharmacist is over reacting...
a life-threatening allergic reaction (symptoms are trouble breathing; closing of the throat; swelling of the lips, tongue, or face; hives) blood problems (symptoms are unusual bleeding or bruising) liver damage (symptoms are yellowing of the skin or eyes, dark urine, nausea ,vomiting, loss of appetite, abdominal pain) irritation of the esophagus Other more common, but less serious, side effects include:
nausea, vomiting, diarrhea increased sensitivity of the skin to sunlight vaginal yeast infection
Aren't these the side effects for majority of RXs?
-------------------- Sometimes when I say �Oh, I�m fine� I want someone to look me in the eyes & say �tell the truth�
posted
Good Morning Good Friends- We have our Doxy !
Side note, our LLMD does not prescribe Doxy in summertime because of the sun issues. So she is happy for FAll to be here and she can switch patients over to it.
She also gave us the name of the one sunscreen recommended by a dermatologist which helps tolerate the sun sensitivity-Neutrogena SPF 45 dry touch.
Anyway-just wanted to repeat- the aspect of my recent encounter with the pharmacist that upset me the most was the fact that he clearly had been educated wrong about the treatment for Lyme.It just adds to the popluation of Ignorant Medical professionals we have to deal with.
I appreciated his ethics,but his research was limited to IDSA. I wasn't upset that he denied filling it withough checking with doc, I was upset when he showed me WHY he wouldn't fill it-because it was outside the standard protocal for treating lyme.
I tried to make the point to him that those standards were outdated, inadequate, ineffective and the reason I am in this predicament today.
Interesting to see what a nerve this topic has sparked-shows the level of frustration we all have to deal with. Thanks all
posted
pharmacists and nurses can question the doseage prescribed. They are obligated to confirm with the physician the script as written if they feel it is in error. After confirming , they can fill or administer the drug. They are equally guilty if patient suffers harm and did not question it. I think the legal term is respondant superior.
The other problem could be your insurance formulary which tells what drug and doseage , the insurance covers. If the pharmacist checks with the doctor the prescription and your insurance pays for the total amount and he still does not fill, then you have a problem. At that point, letters or phone calls need to be made. Good luck with the process.
Posts: 719 | From Delaware | Registered: Jan 2006
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TerryK
Frequent Contributor (5K+ posts)
Member # 8552
posted
AP wrote: Aren't these the side effects for majority of RXs?
Not to my knowledge, why, what difference would it make? My point was that these drugs are not benign and a double dose could make a difference. Others are entitled to their opinion but I personally don't feel that the pharmacist over-reacted. I would rather error on the side of caution. My father died due to misuse of a drug by his doctor. It happens to senior citizens all the time. The more safeguards the better.
Terry
Posts: 6286 | From Oregon | Registered: Jan 2006
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posted
Having been a RPh for almost 50 years, I think you should be glad the person was looking out for your best interest. You think he was ignorant about the dosage and the treatment for your illness? You are well versed in Lyme Disease and possibly a few other illnesses but that person has to be aware of hundreds if not thousands of illnesses and drugs. If that dose was by chance wrong and he filled it without checking you would be on the way to a lawyer, and he would bear the blame for something the doctor did. There are the proper ways to handle this situation and it sounds like you got someone with poor people skills. Or did you react to cause a scene? It seems some of the respondents are not too patient with the med professionals. Too Bad. They would get further with honey.
Posts: 13 | From Fort Wayne, IN | Registered: Aug 2006
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Areneli
Frequent Contributor (1K+ posts)
Member # 6740
posted
I was in this situation before. The pharmacist refused filling 500 doxy per day without talking to my doctor. At the time my doc was away for a week.
Just went to another pharmacy, explained that I had Lyme, they filled my script no problem. They had a lyme patient before so they knew.
Posts: 1538 | From Planet Earth | Registered: Jan 2005
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Cobweb
Unregistered
posted
Dean said:Having been a RPh for almost 50 years, I think you should be glad the person was looking out for your best interest.
posted
Dean asked :You think he was ignorant about the dosage and the treatment for your illness?
Carol answers: I know he was ignorant about the proper dosage because the pharmacology schools are still teaching from the dark ages-he showed me what he learned in school about Lyme. It set me off and made me so sad and mad that at such a ground level we can't even get the message across.
And yes I went off before I could stop myself because I wouldn't be in the position of losing health, job, home, finances if I had been treated properly to begin with.
I know it wasn't this pharmacist's fault I was undertreated initially-he just happened to be the the most recent reminder that it didn't have to be this way-if only...
So I strive for acceptance, punctuated with a dash of anger once in a while.
posted
Meg- my daughter is a short slender 15, but LLMD thinks she is big enough to be treated as an adult. Carolyn's meds are increased at a slower pace than mine, and only if she can tolerate them.
2roads
Frequent Contributor (1K+ posts)
Member # 4409
posted
Wow,
Brings back memories of getting my chidren's scripts filled.
I had my 6 month old, at the time, needing oral antibiotics from Doc J. The pharmacist at Painter's Crossing did not want to fill it, and urged me to go to an infectious disease doctor at the Dupont Hosp for children for a second opinion....can you imagine.
Believe it or not, I humored him and went as long as he would fill my prescription that day. The ducks at Dupont said nothing intelligent. This pharmacist had told the doctor he recommended me to about my situation without my knowing. I never went back to that pharmacy again.
I hit up CVS, but I always felt like I had to explain, or was on the verge. I believe they did call Doc J once or twice. I always worried about the office when they did that. I don't know if pharmacists can report a doctor.
Anyway, they should take it up with the office, not you if they are concerned.
RRRR....
2Roads
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