Pharmacy wont let me refill because its too soon?? anyone heard of this

[LittlePrincess]

If the prescription is *completely different* than the previous one, then this shouldn't be a problem. For example, if your previous prescription was for 20mg XR and your new prescription is 30mg XR, then you shouldn't have had a problem filling it.

However, if your previous prescription was for 20mg XR (30 caps) and your "new" prescription is also for 20mg XR (30 caps), this is considered kind of a "refill" in a way since it's the same prescription technically. Hope this makes sense.

Were the XR and IR tablets written on two different prescription slips or the same one?

[Hutch1ns]

If the dosage changes at all, you need to tell the pharmacist to indicate to the insurance company that there is a change in dosage. They will let it go through.

I haven't come across a state that has a law that specifies the frequency of how often a class II controlled substance can be filled. I know in my state that we can only get it filled for a maximum of 30 days unless the reason is specified on the script for it needing to be filled longer and then the maximum is 60 days.

CHAPTER 94C. CONTROLLED SUBSTANCES ACT


Chapter 94C: Section 23. Written prescriptions; requirements and restrictions


Section 23. (a) A written prescription for a controlled substance in Schedule II shall become invalid 30 days after the date of issuance.
(b) A written prescription for a controlled substance in Schedule II shall not be refilled and shall be kept in a separate file.
(c) The pharmacist filling a written prescription for a controlled substance in Schedule II shall endorse his own signature on the face thereof.
(d) In regard to a controlled substance in Schedule II or III, no prescription shall be filled for more than a thirty-day supply of such substance upon any single filling; provided, however, that with regard to dextro amphetamine sulphate and methyl phenidate hydrochloride, a prescription may be filled for up to a sixty-day supply of such substance upon any single filling if said substance is being used for the treatment of minimal brain dysfunction or narcolepsy; provided further, that subject to regulations of the department and the board of pharmacy, prescriptions for implantable infusion pumps consisting of Schedule II or Schedule III controlled substances may be filled for a maximum of 90 days.
(e) All prescriptions for controlled substances shall be kept for two years by the pharmacy and shall be subject to inspection pursuant to the provisions of this chapter.
(f) No prescription for a controlled substance shall be refilled unless the original prescription provides for such refilling and unless the number of refills has been specified in said prescription.
(g) Unless otherwise prohibited by law, a prescription shall be: (1) written in ink, indelible pencil or by other means; or (2) transmitted electronically; and (3) signed by the prescriber. A prescription may be transmitted electronically with the electronic signature and electronic instructions of the prescriber, and shall be transmitted directly from the prescriber to the pharmacy designated by the patient without alteration of the prescription information, except that third-party intermediaries may act as conduits to route the prescription from the prescriber to the pharmacy.
(h) Clinic pharmacies operated by a health maintenance organization licensed under chapter one hundred and seventy-six G and licensed pursuant to section fifty-one of chapter one hundred and eleven may refill prescriptions which have been previously dispensed by another health maintenance organization clinic pharmacy, provided that prior to dispensing a refill, the pharmacy refilling the prescription verifies the appropriateness of the refill through a centralized database.

http://www.mass.gov/legis/laws/mgl/94c-23.htm

State is Massachusetts incase your wondering.

[LittlePrincess]

Actually, now that I think about it... The OP brought up a really important issue that we have to deal with and tbh, I don't even know the exact *laws* pertaining to our schedule II meds.

For example....
1. How often can the doc actually write a prescription?? (Assuming you're staying on the same prescription month-to-month) I mean, how many days in between each script must there be?

2. Now, when going to *fill* that same prescription, how many days since your last "refill" must you wait? (Still assuming you're on the the same prescription month-to-month)

If anyone in Texas (or anywhere if this is a national thing) happens to know, that would be awesome!

[dlmay277]

Found great info about this on these sites:

http://www.uspharmacist.com/index.as...age=8_1237.htm

http://pn.psychiatryonline.org/cgi/content/full/43/1/2

[gh342000]

Originally Posted by LittlePrincess

However, if your previous prescription was for 20mg XR (30 caps) and your "new" prescription is also for 20mg XR (30 caps), this is considered kind of a "refill" in a way since it's the same prescription technically. Hope this makes sense.

Actually, a refill is when there is more than 1 filling from a single prescription. I receive 3 scripts on the same day for the same prescription to fill every 30 days. The doctor does this because my insurance only covers 30 days at a pop. All three prescriptions have the same date on them and they are valid for 6 months from the date written.

If I take in a prescription today for 30 pills and then 5 days from now take in another prescription, there is no law that says I can't do this. In fact I could fill all 3 prescriptions at one time, the problem is that I would have to pay out of pocket for 2 of them.

[gh342000]

Originally Posted by LittlePrincess

Actually, now that I think about it... The OP brought up a really important issue that we have to deal with and tbh, I don't even know the exact *laws* pertaining to our schedule II meds.

For example....
1. How often can the doc actually write a prescription?? (Assuming you're staying on the same prescription month-to-month) I mean, how many days in between each script must there be?

2. Now, when going to *fill* that same prescription, how many days since your last "refill" must you wait? (Still assuming you're on the the same prescription month-to-month)

If anyone in Texas (or anywhere if this is a national thing) happens to know, that would be awesome!

#1 - There is no required number of days between prescriptions.


I will give an example. I was badly hurt in an auto accident and was prescribed Percocet 2.5mg taken every 6 hours after the surgery. It was not working so the doctor 2 days later wrote another script for Percocet 2.5mg. He was increasing my dose by double.

2 days later, the pain still wasn't under control so the doctor wrote me a script for Percocet 7.5mg. The reason he didn't write more of the 2.5 was because I would be exceeding the maximum Acetominophan dose per day.

The pharmacist did give my wife some grief when she tried to fill the third prescription in 6 days, but he called my doctor to verify and then gave my wife the pills.



#2 - Zero days, the wait is generally an insurance issue for they tend to only pay for 1 script every 30 days.

[LittlePrincess]

Originally Posted by gh342000

#2 - Zero days, the wait is generally an insurance issue for they tend to only pay for 1 script every 30 days.

Unfortunately this just isn't true in the case of controlled meds. For example, if I walk in with a 30 day script for 20mg Adderall, I can't walk in the very next day with another 30 day script for 20mg Adderall. Unless the doctor changes the prescription (changes the dose for example), two identical CII prescriptions may NOT be filled back to back. There is some kind of waiting period... The OP mentioned 28 days, but I'm wondering if it's like this all across the country.

[LittlePrincess]

Originally Posted by gh342000

Actually, a refill is when there is more than 1 filling from a single prescription. I receive 3 scripts on the same day for the same prescription to fill every 30 days. The doctor does this because my insurance only covers 30 days at a pop. All three prescriptions have the same date on them and they are valid for 6 months from the date written.

If I take in a prescription today for 30 pills and then 5 days from now take in another prescription, there is no law that says I can't do this. In fact I could fill all 3 prescriptions at one time, the problem is that I would have to pay out of pocket for 2 of them.

Yeah, I see what you're saying here too, but again- this is NOT the case for controlled substances. And I'm not even talking about insurance. Just the laws.

If my doctor wrote me three scripts for the same prescription of ADDERALL, for example, I definitely could not do what you just described. First of all, CII scripts in Texas are only valid for 7 days (this varies from state to state). Furthermore, I would NOT be allowed to fill all three at the same time. Now, the doctor may write me 3 identical scripts all at the same time and post-date two of them, so that I have to wait a certain number of days (28-30 days?) in between each filling.

[dlmay277]

Thats what my doc does, post-dates them... he did 28 days. I think that they cant wait for 30 just because of February....

[Hutch1ns]

Originally Posted by LittlePrincess

Unfortunately this just isn't true in the case of controlled meds. For example, if I walk in with a 30 day script for 20mg Adderall, I can't walk in the very next day with another 30 day script for 20mg Adderall. Unless the doctor changes the prescription (changes the dose for example), two identical CII prescriptions may NOT be filled back to back. There is some kind of waiting period... The OP mentioned 28 days, but I'm wondering if it's like this all across the country.

There is no law pertaining to that. The Major Brand pharmacies will tell you that you cannot do it and that it's against the law, but what they tell you is completely fictional. I have yet to see a state that has a law against the frequency of filling a Class II controlled substance. What I'm telling you may seem suprising and false, but I can assure you that in just about every state (all the ones I've seen) there is no law against the frequency that they can be filled. CVS will feed you bs after bs but the truth is there is no law against it. Your insurance may not pay for it, but that doesn't mean that you cannot go around the insurance and pay for it out of your own pocket. They likely are too ignorant and stupid to listen to you, but you can plead your case to them anyways and if they still refuse then you can speak to the head pharmacist and then after that try a different pharmacy. Finally, call a lawyer if you still can't get any pharmacy to abide by the law. Pharmacist cannot refuse to fill prescriptions based on any personal beliefs or opinions, only if there is a severe risk to the patients health. If they feel there is a risk to your health, they can consult with your Doctor. If the Doctor tells them to fill it then they must fill it (atleast in Mass, but there are a couple conservative states that allow pharmacists to refuse.)

[LittlePrincess]

Hutch, I believe you, but it just seems so bizarre. Again, I'm not talking about insurance coverage at all... that's just confusing matters. hehe

Anyway, I find it strange that physicians may write prescriptions for only 30 days at a time, and if you are to collect more than 1 prescription, they are backdated.... yet techincally I can just walk into a pharmacy day after day collecting a 30 day CII script (assuming I have a physician that is willing to write me one every day).

For some reason I thought there was some kind of patient database to prevent patients from going to multiple doctors and therefore getting multiple CII prescriptions.

In an earlier thread I talked about how strict the pharmacy was on me getting a box of Sudafed and they told me I could only have so many pills per 30 days... they took down all my info, put it in the database, yada, yada. Again, it seems EXTREMELY bizarre to me that they don't have AT LEAST that same close eye on people coming in filling CII prescriptions.

[gh342000]

Originally Posted by LittlePrincess

Anyway, I find it strange that physicians may write prescriptions for only 30 days at a time, and if you are to collect more than 1 prescription, they are backdated.... yet techincally I can just walk into a pharmacy day after day collecting a 30 day CII script (assuming I have a physician that is willing to write me one every day).

My scripts for Adderall are for 100 pills. That is 100 days of pills. What would the difference be if I filled (3) 30 day scripts in 3 consecutive days.

Originally Posted by LittlePrincess

For some reason I thought there was some kind of patient database to prevent patients from going to multiple doctors and therefore getting multiple CII prescriptions.

Actually, there is no real control for this the way that you think. But, if you fill enough you may get noticed by the authorities. For instance, a doctor I know is an Oncologist. He has patients that use Fentanyl and lots of it. He as a doctor has been visited and so have his patients because they are out of the norm when it comes to dosing and amount of medication that they get filled. Apparently the Fentanyl suckers are closing watched.

Originally Posted by LittlePrincess

In an earlier thread I talked about how strict the pharmacy was on me getting a box of Sudafed and they told me I could only have so many pills per 30 days... they took down all my info, put it in the database, yada, yada. Again, it seems EXTREMELY bizarre to me that they don't have AT LEAST that same close eye on people coming in filling CII prescriptions.

I have to agree with you on this one. The limit for pseudoephedrine is ridiculous. The idea is to keep the meth labs at bay. Everytime my kids have a cold I have a very very hard time finding the kids pseudoephedrine liquid. None of the pharmacies around here are stocking it anymore. In fact I had to get a prescription from the pediatrician for the equivalent of sudafed liquid for kids.

[gh342000]

I just remembered a funny story about pseudoephedrine.

One day I was filling a Dexedrine script for my daughter I didn't have to sign anything for Dexedrine, but had to sign for the 2 bottle of kids pseudoephedrine. I wanted to get 3 bottles but they said that is beyond the limit and they couldn't sell it to me. I wanted to buy 3 because the kids Sudafed is almost impossible to find in my neck of the woods.

She asked me why I wanted 3 bottles, this coming from the pharmacy clerk not the pharmacist. It really ****ed me off. Then she went on tell me that I should be careful giving this to children because it has a stimulant effect and will cause sleeping problems. First I asked here if it is any of her business why I want 3 bottles? I looked at her and asked her if she knew what my prescription that I just filled was, she didn't???

The rules for pseudoephedrine are ridiculous.

[LittlePrincess]

Originally Posted by gh342000

My scripts for Adderall are for 100 pills. That is 100 days of pills. What would the difference be if I filled (3) 30 day scripts in 3 consecutive days.

Well, it varies state to state obviously... Here in Texas, the state law is that the physician may only write a CII prescription for UP TO a 30 days supply. So when I made that statement earlier, I was referring to the more stringent law. Sorry for the confusion.

[Hutch1ns]

Originally Posted by LittlePrincess

Well, it varies state to state obviously... Here in Texas, the state law is that the physician may only write a CII prescription for UP TO a 30 days supply. So when I made that statement earlier, I was referring to the more stringent law. Sorry for the confusion.

Does it have the same thing as Massachusetts and that the only exceptions to it are Adderall and Ritalin which allow for a 60 day supply? My insurance won't let me do 60 days so I can never do it, but if I change insurances (Blue Cross Blue Shield HMO Blue + Masshealth secondary) I'd definately take advantage of it.