Grr - my new pharmacist is questioning my pdoc.

I will freely admit that I use a lot of meds. But by some miracle, my pdocs and I have finally worked out a combination of meds that (a) really works for me, and (b) has minimal side effects. I've been on my current combo for over a year.

I recently moved, and changed pharmacies to one closer to me. So I'm in my first cycle of getting prescriptions renewed with them. Now they're giving me grief and don't want to fill my Risperidone prescription because I'm also taking Seroquel, and apparently you're not meant to be on 2 A-typical antipsychotics at once.

I went through this last year when I first went on the seroquel, but it just took me a quick explanation to the pharmacist to explain that they were for different symptoms, and so he just went ahead and filled the script, and had been filling it ever since. The new pharmacy has my meds record and can if they look, see that I've been taking both for the past year.

But no- little miss eager beaver new pharmacist wouldn't trust either my records or me. She's insisting on calling my Dr. I'm predicting that she won't enjoy the call. My pdoc is a senior research psychiatrist at Canada's largest psych hospital, and a full professor at our top medical school - he knows his meds.

I realize this isn't a big deal in the grand scheme of things, and it will get sorted out, it's just that it's an unnecessary step in refilling my script which will delay my getting them.

Ok - done complaining, it just seems to me that pharmacies are getting way too uptight over different psych meds in the past couple of years, and it's a pain for the customer.

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I think their systems flag prescriptions that could in some way interact, be duplicates, etc. because my pharmacist will also ask me about those kinds of situations. Usually though, she just approaches it as "are you aware you have prescriptions for two different antipsychotics?" Once I confirm that I am, she lets it go. The only time she pushed with the doctor was when his staff had called in a prescription for a fast acting rather than timed released. She was absolutely right to push that time.

If your pdoc can reasonably explain it, then you are fine.

APs are something that should be used careful. Multiple APs? Better use all the carefulness in the world, the risks are nothing to be overlooked. And pharmatcies are probably "uptight" because many doctors mistake APs for smarties and prescribe them for just about anything, not just actual psychotic symptoms.

Your pharmacist is good, keep her!
The system doesn't just flag a combination. The pharmacist knows her business and is honestly looking out for you. Doctors don't always pay attention to the combos. In fact there is a new push to get pharmacists more involved in medication decisions. I can see this is going to be difficult with doctor egos but they are trained to know their chemistry.

A friend of mine was added lithium. His doctor was in the habit of adding but not taking away meds. I don't recall the others he was on but there was definitely seroquel and carbamazepine. They all increase your salt levels. My friend even asked to have levels tested and the doc REFUSED! His pharmacist called and "discussed" it with him for several minutes and again the doctor REFUSED to reconsider the lithium or any of the dosages. Note that the pharmacist is familiar with the way that doc prescribes with is always at the top edge of recommend dosage. My friend should have not taken the lithium. He already had an appointment with a new doc and he just had a bad feeling. He did and two days later he had to call an ambulance for convulsions. His life was seriously threatened. The doc's response was so cavalier I wanted to go down there and smack him myself.

Your doctor may be more know what he is doing and if you have been taking them for a while... But please don't blame the pharmacist too much. She has probably seen enough stories like my friends to be cautious. And have your levels been checked (if applicable)? Seems like doctors have gotten lazy about this.

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Sounds like an awesome, on the ball pharmacist.
Last time I saw him, Pdoc gave me 2 forms, one for now - and one with an increased dose one month post dated
Brain wasn't working when I went in to get it filled and accidentally handed over the post dated one.
Not only did the pharmacist not notice the wrong date, but didn't figure out that 3 pills a day for 28 days = 84
They only had 15 in stock and handed me a note for 13 owing, so I had to go back next day for the rest
Different pharmacist on duty and she apologised for her colleagues error with the maths but queried me on being prescribed such a high dose, slightly confused I check my wallet and there's the one I was supposed to hand in (only 2x a day)
Got it all sorted pretty quick and thankfully this wasn't a remotely dangerous situation, but it is a worry that someone in that job could make that sort of mistake.

Of course there is that one time a few years ago I took my prescription to Boots as I usually do (the exact same branch as I had taken the exact same prescription for several years, getting served by the exact same girls)
and only when I got home did I realise they gave me the wrong pills.
My sticker, which has my correct prescription details on it (my name, Drug name and dosage) stuck on the box for something completely different. Cant remember what they gave me but it was some sort of super laxative!
If I was the type of person who had no real idea of what I was taking, that could have had a really bad result.

So in conclusion, yep I'd rather the super cautious, questioning everything pharmacist.

I would trust my pharmacist more than the few psychiatrists I've seen. Sounds like yours is ok, but I think most of them don't seem to know much about what they're doing.

You're in the uk? In the us I noticed about a year (?) ago they started putting the pill description on the bottle. Like yellow, round, whatever the imprint is. I think that is a really great thing!

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I'd be annoyed too, but in the end its always better to have a pharmacist err on the side of caution. In my experience most pharmacists are not so competent, so I think you are lucky. Your doctor might be mildly annoyed but will understand.

Just btw - i noticed a sticker on the top of my new antibiotic i got yesterday said "do not take if you become pregnant" - um - im 62!!

When they print out the label for a particular medication, there are always warning labels that automatically print out to go with it they put on the side.

I would understand if your pharmacist did that if you were prescribed two done antipsychotics like Haldol (haliperidone) and risperidone or two pine antipsychotics like seroquel (quetiapine) and asenepine but one done and one pine are supposed to work fine together.

I don't know much about Ontario but I'm guessing there's more druggies there and the pharmacists have bad experiences with people making fake prescriptions, seeing multiple doctors for pain meds etc.. So they're just pissed at everyone I guess because of the minority. If it was Mexico or something there would be no problem. Also, Canada is way more strict and has a smarter prescription drug system than say.. America.. Everything is on the computer now.

Wonder why in America they still use bottles for meds , England has used boxed blister packs for has long has I remember. I wondered what happened to all the empty bottles.

The plastic bottles can be recycled... Not that we are that great at recycling. Don't know why manufacturers would use a different method In a different country unless the uk requires it.

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the bottles are great to hold beads for my crafts in (I obtained few from my host family when i was in the US).

I think its progress the med are vacuum sealed in blister packs ,they must have a longer shelf life that way like food. Plus sneaking out a bottle in public is a dead give away if you want it to remain a secret. I have this vision of people in America all walking down the street bottles rattling away to the song on your I pod

They have iPod covers with pill pockets for just those times

If shelf life is the reason it doesn't matter. The FDA has a rule that everything expires in one year. The date of the bottle is one year from the day you fill it, they need to change that rule. One most stupid things I have heard.

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My pharmacy has flagged some of the meds the hospital put me on, and refused to fill them because of interactions. At first I was frustrated, but I went home and researched them and found out the pharmacist was on the ball. Bad combo. Thanks to the pharmacists I have avoided several medication problems.

Blister packs must be The way forward then it say, s expiry 06- 2016 on my Lexapro box

you mean the chemist fill your bottle with meds, how do you no how long he has had the stock before you get it. Are your meds all sealed or handled by hand into a jar, so are you saying the only covering is your jar, that is very wrong if so ,you don't know who or what have been handling your med and how many times.

Pharmacists have licenses just like doctors, nurses, etc. They use gloves and instruments. You aren't allowed to put a med "back" once it has left the pharmacy.

The date on the bottle is called a "use by" date. It cannot exceed the expiration date on the manufacturer bottle. They change it because they are moving the drug. But actually they don't know much about when drugs really expire. Manufacturers only test them for a set time period which means they can only "guarantee" the drug for that duration. The drug could be good years after that. Since the article below was written they have tested ~315 drugs.

"Most of what is known about drug expiration dates comes from a study conducted by the Food and Drug Administration at the request of the military. With a large and expensive stockpile of drugs, the military faced tossing out and replacing its drugs every few years. What they found from the study is 90% of more than 100 drugs, both prescription and over-the-counter, were perfectly good to use even 15 years after the expiration date.

So the expiration date doesn't really indicate a point at which the medication is no longer effective or has become unsafe to use. Medical authorities state expired drugs are safe to take, even those that expired years ago. A rare exception to this may be tetracycline, but the report on this is controversial among researchers. It's true the effectiveness of a drug may decrease over time, but much of the original potency still remains even a decade after the expiration date. Excluding nitroglycerin, insulin, and liquid antibiotics, most medications are as long-lasting as the ones tested by the military. Placing a medication in a cool place, such as a refrigerator, will help a drug remain potent for many years."

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You say you only get a years expiry date on you refills so they could be years old when you are supplied . I told you in a post you did not answer my Lexapro has expiry date is 0-6 2016 , I can send a photo if you like. You are giving out wrong info again
all A-D.s in tablet form should be stored at room temp, Some LIQUIDS should be fridge stored like insulin

No, what she said is it is a "use by" date. All prescriptions that physicians write in the US are only valid for one year from the date they are written. The "use by" date is not a date of expiration for the med itself.

AAAAANNNNDDDD you didn't read my reply. The lexapro is good long after 2016 according to the military/FDA study. Sheesh. You'll have to look up UK laws on expiration vs use by to find out how that date is determined.

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Why bring the military into the thread , we are not in the armed forces we are mental , you cannot just throw a curve ball like that I don't give a flying F+++ what the military say. Use by date means don't use after this date , sell by date means don't sell after this date , you where going on about a year on your scripts from the chemist in a thread before ,now you say we can use them till we feel like in this thread. jesus what with you telling posters to put meds in a damp fridge instead of room temp like it says on the box , you are way off base with your info .

You still didn't read it. You asked how the dates are determined in the US. They are arbitrary. The military initiated a study which concludes many, many meds haven't lost potency after 15 or more years which means (I repeat) the dates are arbitrary. They aren't any less arbitrary in the UK. You have a computer. Do your own googling for a change.

I didn't say anything about storing anything in a fridge. That was a quote from the Harvard article.

Master of absurd arguments you is.

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