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Old 07-30-2004, 12:44 PM   #1
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Refills and Red Flags???

Reading an earlier post scared me.
Last month(and previous months) when I went to see my doc she gave me my prescription for oxy. It was a week before I would run out but this saved me a trip to pick it up.(I didn't ask she just did it) I always take my prescriptions straight to the pharmacy because I don't like carrying them around..I'd hate to lose one. No one said anything and I didn't think it was a problem as long as the doc wrote the perscription. Now I get mine 3 months at a time with a specific fill date on them. My bt meds I call in every month. I always call 3 days before it's due(because that's what they said to do) and my doc always writes it the day I call. So I go pick it up and fill it right then just to have it taken care of.

Am I going to be red flagged for this? I always thought as long as the doc ok'd it then the pharmacy had to go along. I assumed(I know...never assume) the doc did this so I wouldn't worry about running out of meds...there's always an overlap. Should I be worried???? Thanks-Mush

 
Old 07-30-2004, 03:09 PM   #2
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Re: Refills and Red Flags???

I've had it go both ways in situations like this. I've been to the big name pharmacys, like Walmart and Target, those are the ones that have given me the most problems. Those places have problems, in my opinion, because they have so many different people working there. You get all these people and their own little ways of doing things, so when you go in after having someone else handle things, if the first person's done something the wrong way, it reflects poorly on you and that's the times that you REALLY get stuff stirred up. If one person there lets you get a script a week early no problem and next time you come in because you think that's ok, and you get a person that NEVER fills things early, then not only do you get on their bad side for trying, they see that you have "a history" of doing that and instantly they go for the throat.

Then sometimes you get the opposite. At the Ma and Pa places I've been to, you have to "proove yourself" a little more than the big chains. I remember the first few times I went into the pharmacy I'm using now. I'm a 22 year old male, I'm tattooed and pierced so I guess in their minds I look the part of the average junkie. (I'll try to hold back the resentment on that one ) So, after going in a few times, not showing any worry about them calling my Doc, I think that they caught on, and since then, they haven't given me ANY trouble at all. Sometimes I worry, because my PM Doc and I are still trying to find the right med for me, so some months I will get 3 or 4 different pain meds and in different doses, but as of yet, the phamacy hasn't shown that they have any concern.

I'd say if you're having any problem with a pharmacy, don't go there. Their job is to provide you with a service. You're there for a legit reason and as long as you have the means to back it up, with your doctors help, the pharmacy has NO right to give you trouble. If they do give you a hard time, have them call your doctor or tell your doctor and have them call the pharmacy and work it out that way.

Good luck,
Jon

 
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Old 07-30-2004, 03:11 PM   #3
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Re: Refills and Red Flags???

One thing I didn't take into account, your state apparently lets you call pain meds in over the phone. In my state, I have to take the script up to the pharmacy to fill it. This may change how things work overall, I'm not sure.

~J

 
Old 07-30-2004, 03:54 PM   #4
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Re: Refills and Red Flags???

I was doing the same thing,i would go to the pharmacy when i got my script,because it was convienant.[oxy.] i'd go two days early,one day,just because it happened to be the day i saw my doc. after a few months,then one,two or three days early add up! My pharmacist said one day,hey,you got your oxy. filled a day early last month,two days early the month before,etc. he said"you should have a 4 day supply still,i said,no,actually i have a 5 day supply,but my doc. is right around the corner,so i figured while i'm in the area,also i said,hey,i'll come back,no big deal,he said,no,i'll fill it this time.I think he was seeing how i reacted.Even though some insurance companies allow you to fill your med. 3-5 days early,doesn't mean the pharmacist is going to fill them.

 
Old 07-30-2004, 09:29 PM   #5
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Re: Refills and Red Flags???

Just a quick note regarding what Fandango said:

Yes, refill situations, brand new RX's and stuff like that each rely on the indy state's rules. The state in which I am currently, PA, you can have a Class 3 drug (anything w/Hydrocodone, etc) simply called in to a pharmacy by your doc, whether it be a fresh script or a refill, but if you're getting a Class 2 (anything w/Oxycodone, Dilauded, MSContin, etc) then you MUST get a hand-written script in person from the doc to then take to the pharmacy, even if you've had the same exact script for several months (as in same med, dosage, ct). Accordingly, the Class 2 meds can have no built-in refills ordered with a new script, while any Class 3 med can.

FYI - for those who don't know, Class 2 is as high as you go while still being legal (Class 1 being Heroin, Cocaine, Marijuana,etc).

 
Old 07-30-2004, 10:53 PM   #6
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Re: Refills and Red Flags???

Hey gang,

I wouldn't worry too much if you are not dr shopping. Most people who have specific dates to fill on their meds have abused the system in the past or its a rule at the pain clinic. It all is up to your relationship with your doctor. In America a person should be able to fill the scripts a few days early as long as the dr is ok and it is not excessive. Sometimes its not convient to wait thirty days exactly and no one should have to. Remember , it is a dangerous medicine. A day or two should be no issue and the pharmicist will usually be ok. You know if you are pushing the limit. My ins will fill 7 days early but there is no need unless something like a dose change occured. As long as we are doing the right thing a few days should be no big deal. CVS runs ads to call a day early. You get flagged for numerous attempts to refill early. Then you will get the fill on or after on your scripts.

GL

 
Old 07-30-2004, 11:30 PM   #7
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Re: Refills and Red Flags???

How can I explain this, if your doctor writes just for BT's and gives you a lot less than what you'd even take in a month you are ok. Lets say a full script is 60 a month , one every 12 hours, but he only gives you 30 still written at 1 every 12 hours then you have no problem at all.

See what I'm getting at? My doctor (one before my PM) used to give me a prescription that were for a month but under the limit of what you could humanly take in one month, the prescription was for 90 pills, 1 taken every 6 - 8 hours, which really was only 3+ weeks if I took them as indicated, a full months worth if taken as directed would of been 120 pills. So in essance I could refill those every 3 weeks and no flags go up.

OK I Just confused myself but I hope you get what I mean.

Now when I was on vicodin the doctor wrote enough for exactly 28 days or 168 pills I think it was, 1 every 4 hours, if I even tried to fill one of those more than 2 or so days early then yes a red flag would go up not only at the pharmacy but with my insurance.

BTW you are lucky my PM makes me go to see him every 4 weeks to get a new prescription, he writes them for 28 days exactly and that's it. It would nicer if I only had to go every 2 or 3 months but alas the trip is worth it and only takes up a bit of my time.

 
Old 07-31-2004, 04:56 AM   #8
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Re: Refills and Red Flags???

I am just rather curious as to what dates your docs put on your Rxes.i know with my pm,if i see her early, there are always two dates on the Rx, the date she wrote it and the fill date.so legally I cannot even get the rx filled until the actual date.I was kind of under the impression that all PMs did this so there wouldn't even be a question of even getting an early refill on your meds.I always drop the Rx off the day before it is due and they fill it first thing in the morning the on the actual 'fill" date.Don't your rxes have an actual fill date on them?just wondering.Marcia

 
Old 07-31-2004, 07:14 AM   #9
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Re: Refills and Red Flags???

Hey Mush, The thing about gettingflagged by a pharmacy is you may never know. I was fortunate that my wife was abe to look at my profile and remove the flag from another location. I have had 2 cases in 11 years where a pharamcist questioned how long the meds should be lasting the way they were written. My doc would give me a new script each week and never madfe a fuss over how many days it lasted, But the first time a pharmacist called and questined and said the way these are written it's a 20 day supply, He medietely backed down and said fill it on thje 20th day. "My first experience with withdrawal.:

The second time was when a pharmacst called my secnd surgeon and said thet you shouldn't take Percocety and Ultram together, I flat out knew I was taking the Ultram to potentiate the percs, But as oon as the pharmacist questioned him, back down and said tear it up. My first experience with Ultram withdrawal.

The bottom line is a pharmacist can refuse any script he wants. Even if the day supply is correct , even if the script is wriiten properly. If the pharamacist feels it's unsafe for whatever small minded reason he can refuse any script he wants or hold it untll it can be confirmed by the doc. The lst thing any doc wants is some pharmacist reporting him for prescribing practiced s or any agency investigating his prescribing.

PM docs now have to be togher and stand up to this crap by properly charting everything, all the surgeries,, injuries, other methods tried and failed and with the right docum,entation, he can be your advocate and hopefully not fear a major inmvestigation where he is shut down as every chart is hauled out of his office. During this time every patient is screwed, He can't prescrivbe if he has no chart to log it in.

There is no gaurenteed way to keep from getting red flagged, Eventually you run across some pharmacist that compares his dieing mothers dose of meds to what you are taking or what worked for him when he had surgery. I would like to carry a hammer should I ever see a pharmacist eyebrow even raise a mm. I don't take chances for conveinance. 30 days is 30 days, It's better than docs that have you refilling on the 31st day and you start every month with nothing left, hoping to find your script before you start experincing withdrawal from the LA's that terminate quickly, like OxyC. By the 14 or 15th hour your not looking too good or feeling to good while trying to find enough meds on hand to fill your script.

CYA because the doc will cover his own.
Take care, Dave

 
Old 07-31-2004, 10:09 AM   #10
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Re: Refills and Red Flags???

i havent read all the replies so forgive me if this has already been said.
It sounds as though you only filled your oxy early that one time...and the rest have been filled on the date your doc says to fill them on (the ones you get months in advance). In my opinion...i wouldnt worry about one time. And the BT meds...i wouldnt worry about 2 or 3 days early. I usually fill mine at 29 days just in case. my doc doesnt have a problem with this...he actually trusts me to tell him honestly when I need to fill my meds. Its been this way for over 2 yrs.
For this reason and several others, i fill my meds at a hospital outpatient pharmacy...the same hosp. my doc has clinic at. So that if they have any questions they can just page him. but there has never been a problem and they go out of their way to help me.

 
Old 07-31-2004, 11:36 AM   #11
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Re: Refills and Red Flags???

My pharmacist (mom and pop) told me that insurance companies allow him to fill up to 5 days early due to weekends and holidays. My doc originally had my script written for 25 days. I could get it filled as early as the 20th day if I needed to. Doc changed the script last month to reflect the 30 day period. I'm assuming the earliest I can get this filled now is the 25th day. These are my BT meds. My LA's I always wait until the 30th day to fill. My LA is Duragesic (fentanyl) and I change every 2 days, so if I had to wait an extra day, it wouldn't be too bad. My pharmacist always makes sure he has my meds on hand when it is time for me to get them filled. Honestly, you would think the pharmacist would stay out of it. I mean if the scripts are all coming from the same doc every month, what right do they have to question your doc. Now, if they are seeing scripts from several different docs then sure flag it or call someone. My point is, only one doc is rx'ing my C2's and has been for a long time so why should anyone have the ability to question him? I hope that made sense.

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Old 07-31-2004, 11:57 AM   #12
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Re: Refills and Red Flags???

Fandango--I have to call my doc and then go pick up the prescription and take it to the pharmacy.

We've been going to the same pharmacy for 7yrs and unfortunately we are there at least once or twice and month. My youngest was very sick as a baby and we spent alot of time there.lol The pharmacist who has been there the whole time just left for a new job. It seems the new people they brought in already know me on sight and the new pharmacist is extremely nice. I hope this continues.
My last prescription was written on the 18th eventhough I wasn't due until the 25th. The one's written 2 months out have a 'to be filled on' date.
I guess I'll be more careful about getting my bt meds closer to the fill date. I'm always worried that I'm going to call the docs office and she'll be on vacation for a week or something scary like that!!LOL

Thanks for your input.-Mush

 
Old 08-01-2004, 01:51 PM   #13
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Re: Refills and Red Flags???

Quote:
Originally Posted by tyler7
...... Class 2 is as high as you go while still being legal (Class 1 being Heroin, Cocaine, Marijuana,etc)....
Marijuana is not a class I substance.

 
Old 08-01-2004, 01:57 PM   #14
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Re: Refills and Red Flags???

It is interesting to see diffrent states having diffreent laws on prescription refills. anything that is a CII is not refillable in any state. Some states allow CIII refills, and some do not. New york for example would take a script for hydrocodone (a 3) as a normal perscription but a RX for xanax had to be written on a triplicate RX, and there are no refills. In Nevada they allow refills of any drug except a CII, and I have gotten my 2mg 120 ativans every 25 days no prob. it is better to go when it is convient, not on the date.

 
Old 08-01-2004, 02:33 PM   #15
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Re: Refills and Red Flags???

OK, let's get this class system straight. To the best of my knowledge, (disclaimer ) Heroin is a class I in every state and federally. Cocaine is a class II medication federally, due to its topical analgesic potential in hospital settings. Marijuana is a class I drug in some states, and a class II med in others by state statute (most definitly California is a CII state). However Marijuana is a Class I substance nationwide by federal law, which can and is enforced by federal DEA agents, regardless of local and/or state law to the contrary (i know, its confusing). Other federal Class I drugs are methamphetamines, and some barbituites and some steroids. The full list of FEDERALLY scheduled drugs is online at [url]http://www.usdoj.gov/dea/pubs/scheduling.html[/url]

Rember that individual states have their own, often conflicting, schedule of drugs. But the federal law is the overriding law of the land, and the feds can and will enforce the federal law, regardless of state laws.

Last edited by wirry1422; 08-01-2004 at 02:34 PM.

 
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