When working with nursing homes, assisted living, there are times when drugs are returned. Loose tablets cannot be returned. Each blister cell has the lot # manufact, exp date, etc. This also avoids errors in giving the medication since every pill is LABELED. Nothing is changed or substituted, just repackaged for convenience and safety. We don't do every drug..most (about 70%) come from our parent facility which is a huge manufacturing (FDA approved) facility.

Where I work we provide service for the whole state. It is HUGE...this operation.

We purchase drugs in the largest wholesale package available and repack them into blisters of 30. These can be cut up, or handled any way necessary by
the nurses. The drugs are put into amber and air tight foil. Our repack room is basically for low volume drugs or "shorts", things we run out of. Still it is a huge task.

Brand Plavix comes in 30 ct and 90 ct bottles. Loose tabs. Even those, when we do use them are repackaged. However, the Apotex brand comes in huge bottles of a 1000 (or it might have been 500-- I can't recall).

The only things we do not repackage
are tablets that are HUGE like Fortamet, and Fosrenol, or Nifedipine XL90.
We don't have "cells" large enough for these.