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-   -   Can a pharmacist switch your med? (https://www.neurotalk.org/medications-and-treatments/88467-pharmacist-switch-med.html)

Vowel Lady 06-02-2009 01:38 PM

Can a pharmacist switch your med?
 
This article indicates a pharmacist can switch your med...particularly a generic...

http://www.msnbc.msn.com/id/30627962/

mrsD 06-03-2009 01:36 AM

This article is somewhat misleading.

There ARE laws, but they do not REQUIRE pharmacists to give a generic.... they ALLOW them to. We've had such a law for over 20 yrs now in my state.

I use generics for my meds. They work fine. Even the thyroid.
Some people who are fine tuned on a particular drug, will notice a switch and others not. This remains controversial, and some believe it is a placebo effect. Placebo effects are very high in drug utilization.

The two largest reasons for generics are:
1) the insurances encourage them to lower costs
2) Brand name prices are so high many cannot afford them.

Many brand name companies actually make your generic. Most people don't realize this either.

This is a huge issue, and I could write all day on it.

Edit to add: switching from a brand name to an equivalent generic (and most reputable pharmacies only use AB rated generics), is not the same as switching drug THERAPY. One must understand this.
Pharmacists in US cannot change the drug to a different drug, only from within the same drug for price considerations.

If you want to learn if your generic is AB rated, go to www.fda.gov
and type in Orange Book into the search in the upper right. Then select the first option from that search...Orange Book home.
It will take you to the list of approved generics for each drug and who makes them and their rating in the US. You can search by generic name or brand name, and be sure to choose the correct button before searching. There is no direct internet link to the Orange book, so you have to do it this way.
This is what a typical search looks like for topiramate (Topamax)
Quote:

Active Ingredient Search Results from "OB_Rx" table for query on "topiramate."


Appl
No TE Code RLD Active
Ingredient Dosage Form;
Route Strength Proprietary
Name Applicant
076448 AB No TOPIRAMATE CAPSULE; ORAL 15MG TOPIRAMATE BARR
076448 AB No TOPIRAMATE CAPSULE; ORAL 25MG TOPIRAMATE BARR
077868 AB No TOPIRAMATE CAPSULE; ORAL 15MG TOPIRAMATE COBALT LABS INC
077868 AB No TOPIRAMATE CAPSULE; ORAL 25MG TOPIRAMATE COBALT LABS INC
020844 AB No TOPIRAMATE CAPSULE; ORAL 15MG TOPAMAX ORTHO MCNEIL JANSSEN
020844 AB Yes TOPIRAMATE CAPSULE; ORAL 25MG TOPAMAX ORTHO MCNEIL JANSSEN
076575 AB No TOPIRAMATE CAPSULE; ORAL 15MG TOPIRAMATE TEVA
076575 AB No TOPIRAMATE CAPSULE; ORAL 25MG TOPIRAMATE TEVA
077733 AB No TOPIRAMATE TABLET; ORAL 100MG TOPIRAMATE APOTEX INC
077733 AB No TOPIRAMATE TABLET; ORAL 200MG TOPIRAMATE APOTEX INC
077733 AB No TOPIRAMATE TABLET; ORAL 25MG TOPIRAMATE APOTEX INC
077733 AB No TOPIRAMATE TABLET; ORAL 50MG TOPIRAMATE APOTEX INC
078462 AB No TOPIRAMATE TABLET; ORAL 100MG TOPIRAMATE AUROBINDO PHARMA
078462 AB No TOPIRAMATE TABLET; ORAL 200MG TOPIRAMATE AUROBINDO PHARMA
078462 AB No TOPIRAMATE TABLET; ORAL 25MG TOPIRAMATE AUROBINDO PHARMA
078462 AB No TOPIRAMATE TABLET; ORAL 50MG TOPIRAMATE AUROBINDO PHARMA
076315 AB No TOPIRAMATE TABLET; ORAL 100MG TOPIRAMATE BARR
076315 AB No TOPIRAMATE TABLET; ORAL 200MG TOPIRAMATE BARR
076315 AB No TOPIRAMATE TABLET; ORAL 25MG TOPIRAMATE BARR
076343 AB No TOPIRAMATE TABLET; ORAL 100MG TOPIRAMATE CIPLA LTD
076343 AB No TOPIRAMATE TABLET; ORAL 200MG TOPIRAMATE CIPLA LTD
076343 AB No TOPIRAMATE TABLET; ORAL 25MG TOPIRAMATE CIPLA LTD
076343 AB No TOPIRAMATE TABLET; ORAL 50MG TOPIRAMATE CIPLA LTD
077643 AB No TOPIRAMATE TABLET; ORAL 100MG TOPIRAMATE COBALT LABS INC
077643 AB No TOPIRAMATE TABLET; ORAL 200MG TOPIRAMATE COBALT LABS INC
077643 AB No TOPIRAMATE TABLET; ORAL 25MG TOPIRAMATE COBALT LABS INC
077643 AB No TOPIRAMATE TABLET; ORAL 50MG TOPIRAMATE COBALT LABS INC
077627 AB No TOPIRAMATE TABLET; ORAL 100MG TOPIRAMATE GLENMARK GENERICS
077627 AB No TOPIRAMATE TABLET; ORAL 200MG TOPIRAMATE GLENMARK GENERICS
077627 AB No TOPIRAMATE TABLET; ORAL 25MG TOPIRAMATE GLENMARK GENERICS
077627 AB No TOPIRAMATE TABLET; ORAL 50MG TOPIRAMATE GLENMARK GENERICS
079162 AB No TOPIRAMATE TABLET; ORAL 100MG TOPIRAMATE INVAGEN PHARMS
079162 AB No TOPIRAMATE TABLET; ORAL 200MG TOPIRAMATE INVAGEN PHARMS
079162 AB No TOPIRAMATE TABLET; ORAL 25MG TOPIRAMATE INVAGEN PHARMS
079162 AB No TOPIRAMATE TABLET; ORAL 50MG TOPIRAMATE INVAGEN PHARMS
076314 AB No TOPIRAMATE TABLET; ORAL 100MG TOPIRAMATE MYLAN
076314 AB No TOPIRAMATE TABLET; ORAL 200MG TOPIRAMATE MYLAN
076314 AB No TOPIRAMATE TABLET; ORAL 25MG TOPIRAMATE MYLAN
076314 AB No TOPIRAMATE TABLET; ORAL 50MG TOPIRAMATE MYLAN
020505 AB No TOPIRAMATE TABLET; ORAL 100MG TOPAMAX ORTHO MCNEIL JANSSEN
020505 AB No TOPIRAMATE TABLET; ORAL 200MG TOPAMAX ORTHO MCNEIL JANSSEN
020505 AB Yes TOPIRAMATE TABLET; ORAL 25MG TOPAMAX ORTHO MCNEIL JANSSEN
020505 AB No TOPIRAMATE TABLET; ORAL 50MG TOPAMAX ORTHO MCNEIL JANSSEN
076311 AB No TOPIRAMATE TABLET; ORAL 100MG TOPIRAMATE PAR PHARM
076311 AB No TOPIRAMATE TABLET; ORAL 200MG TOPIRAMATE PAR PHARM
076311 AB No TOPIRAMATE TABLET; ORAL 25MG TOPIRAMATE PAR PHARM
076311 AB No TOPIRAMATE TABLET; ORAL 50MG TOPIRAMATE PAR PHARM
077905 AB No TOPIRAMATE TABLET; ORAL 100MG TOPIRAMATE PLIVA HRVATSKA DOO
077905 AB No TOPIRAMATE TABLET; ORAL 200MG TOPIRAMATE PLIVA HRVATSKA DOO
077905 AB No TOPIRAMATE TABLET; ORAL 25MG TOPIRAMATE PLIVA HRVATSKA DOO
077905 AB No TOPIRAMATE TABLET; ORAL 50MG TOPIRAMATE PLIVA HRVATSKA DOO
076327 AB No TOPIRAMATE TABLET; ORAL 100MG TOPIRAMATE RANBAXY
076327 AB No TOPIRAMATE TABLET; ORAL 200MG TOPIRAMATE RANBAXY
076327 AB No TOPIRAMATE TABLET; ORAL 25MG TOPIRAMATE RANBAXY
076306 AB No TOPIRAMATE TABLET; ORAL 100MG TOPIRAMATE ROXANE
076306 AB No TOPIRAMATE TABLET; ORAL 200MG TOPIRAMATE ROXANE
076306 AB No TOPIRAMATE TABLET; ORAL 25MG TOPIRAMATE ROXANE
076306 AB No TOPIRAMATE TABLET; ORAL 50MG TOPIRAMATE ROXANE
090278 AB No TOPIRAMATE TABLET; ORAL 100MG TOPIRAMATE SUN PHARM INDS LTD
090278 AB No TOPIRAMATE TABLET; ORAL 200MG TOPIRAMATE SUN PHARM INDS LTD
090278 AB No TOPIRAMATE TABLET; ORAL 25MG TOPIRAMATE SUN PHARM INDS LTD
090278 AB No TOPIRAMATE TABLET; ORAL 50MG TOPIRAMATE SUN PHARM INDS LTD
076317 AB No TOPIRAMATE TABLET; ORAL 100MG TOPIRAMATE TEVA
076317 AB No TOPIRAMATE TABLET; ORAL 200MG TOPIRAMATE TEVA
076317 AB No TOPIRAMATE TABLET; ORAL 25MG TOPIRAMATE TEVA
076317 AB No TOPIRAMATE TABLET; ORAL 50MG TOPIRAMATE TEVA
079153 AB No TOPIRAMATE TABLET; ORAL 100MG TOPIRAMATE TORRENT PHARMS
079153 AB No TOPIRAMATE TABLET; ORAL 200MG TOPIRAMATE TORRENT PHARMS
079153 AB No TOPIRAMATE TABLET; ORAL 25MG TOPIRAMATE TORRENT PHARMS
079153 AB No TOPIRAMATE TABLET; ORAL 50MG TOPIRAMATE TORRENT PHARMS
090162 AB No TOPIRAMATE TABLET; ORAL 100MG TOPIRAMATE UNICHEM
090162 AB No TOPIRAMATE TABLET; ORAL 25MG TOPIRAMATE UNICHEM
090162 AB No TOPIRAMATE TABLET; ORAL 50MG TOPIRAMATE UNICHEM
078235 AB No TOPIRAMATE TABLET; ORAL 100MG TOPIRAMATE ZYDUS PHARMS USA INC
078235 AB No TOPIRAMATE TABLET; ORAL 200MG TOPIRAMATE ZYDUS PHARMS USA INC
078235 AB No TOPIRAMATE TABLET; ORAL 25MG TOPIRAMATE ZYDUS PHARMS USA INC
078235 AB No TOPIRAMATE TABLET; ORAL 50MG TOPIRAMATE ZYDUS PHARMS USA INC
I find it is best to use the generic name when searching.

Kitty 06-03-2009 05:09 AM

Generic for Diovan
 
I take Diovan 80mg for HBP. It's expensive....about $90 for a month of meds. I found a generic (Valsartan) at a Canadian online pharmacy but cannot find it here in the states. :confused: Do you know if this has just not been approved here in the U.S. yet or if this will only be available through the online pharmacies? I can get about 3 months worth of the generic med for what I pay for 1 month of the name brand. :rolleyes:

Why do they make it so difficult???? :mad:

mrsD 06-03-2009 06:00 AM

In the US there are commonly legal wrestles when patents come up expired, or soon to be expired.

This is what is happening with Diovan:
http://www.fiercepharma.com/story/no...ent/2007-08-20

mrsD 06-03-2009 06:03 AM

Also in that article from MSNBC....it is misleading to say, you can request brand in your profile.

The insurance companies REQUIRE DAW dispense as written on the original RX every time you take one in. If that is not there, they will not pay the claim. They send in auditors to check this periodically and will withdraw money if their rules are not met
regarding DAW substitutions. This is not a law, but a financial penalty against the pharmacist and store.
Some people mistake this factor and make it sound like a "law", but it isn't.

MiaVT 07-08-2009 11:25 AM

I recently had an experience in which my Prior Authorization on a medication (Provigil) "ran out", according to my Medicare Part D Drug Provider. They informed the pharmacy that the GENERIC for this drug (not avail in this country) was RITALIN ER!!! I WAS SPEAKING TO A TECH IN ANOTHER COUNTRY -- and we could NOT comprehend each other well-enough for him to "get it" that this was an entirely different medication!!! SO, my Pharmacist then tells me to "come on down" and he'd give me the RITALIN ER.

UH -- NO!

This CLEARLY would have been a case of the Pharmacist, secondary to the recommendation of my Drug Insurance, changing to an entirely different class of drug! RITALIN treats ADHD. Provigil treats NARCOLEPSY!!!

PROVIGIL & RITALIN are not even CLOSE to being the SAME drug!!! They do NOT have the same ACTIVE ingredient!!! RITALIN is methylphenidate, an older POWERFUL AMPHETAMINE (in the same family as Concerta, d-amphetamine and caffeine) that affects the entire Nervous System. It is extremely Addictive!!! PROVIGIL's active ingredient is modafinal. Provigil only appears to effect the part of the brain that keeps you awake. Clinical trials have also demonstrated that Provigil does not cause nervousness or withdrawal symptoms in the way that traditional stimulants do.

What happened? Fortunately my Doctor's office is quick & efficient! They submitted an EMERGENCY (to be processed faster) Prior Authorization request to my Drug Insurance. The folks at my Medicare Part D Plan told me that the EMERGENCY request would expedite things greatly: 72 business hours minimum. This was Friday night.

I had NO MEDS. The following Wednesday the Ins Co, called & informed me I could NOW get my Provigil filled. The Prior Authorization is for 1 year.

I WAS reminded by my Pharmacy that if I wished to, I could PURCHASE the Provigil MYSELF. In reality, I could NOT. My ONLY income is SSD! The Provigil costs $663+ per month!!!

I'm just relieved that the Prior Authorization was APPROVED!!!

Mia

MdotDdot 07-08-2009 12:49 PM

Pharmacists can change your med for generics at any time. Many people notice problems when this occurs. You should have your doc write "Brand necessary" on scripts to prevent this change. US meds are priced based on patents and company profits. Sad fact we must all deal with. Most of the time, generics are considered safe--otherwise FDA would say no to them.

mrsD 07-08-2009 12:55 PM

I just find that amazing! Ritalin is a schedule II drug in this country and has strict dispensing rules. For example, you need
a NEW handwritten order for it. Provigil can be ordered over the phone, but Ritalin cannot.

I don't know what is going on in Vermont!

ProVigil and Ritalin are commonly used as stimulants for people on chronic pain management, or for other reasons. Medically doctors use both. But your pharmacist has no legal way of interchanging these. You would have to get a NEW RX order in WRITING to get Ritalin in any form in USA.

DejaVu 07-12-2009 11:57 AM

Pharmacists in Vermont are not allowed, by law, to change medication active ingredients. Ritalin (generic equivalent) cannot be legally dispensed in Vermont without a new written (paper) prescription presented for each 30 days worth of medication. There was either a misunderstanding over the phone btw. client/consumer and local pharmacist, and/or the pharmacist was offering to do something illegal.:)


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