4 ms·

Is that really the reason or is it that they can't get a doctor to write them an off-label prescription?

by vernie 5y ago

brandonmenc 5y ago
It's probably both, but why would a doctor risk losing their license over this? Yet another unintended consequence. Doctors are supposed to be able to write prescriptions for off-label use.
- sgt101 5y ago
  If they have reason to believe that it's beneficial. If they don't then they are being reckless.
cableshaft 5y ago
A friend of mine found a doctor to prescribe it but his pharmacy won't fill it. He is so pissed. He was only planning to take small doses here or there as he's a teacher and around sick kids all the time, as if it were like Zinc to hopefully help reduce the severity of Covid-19 if he does get it, but despite going through the effort and succeeding in finding a doctor willing to prescribe it (and my friend even signed a document saying he understands it's an experimental treatment and will assume any risks), his local CVS is refusing to fill it. My opinion is if you can get a proper doctor to prescribe it (by proper doctor I mean none of this "I got a medical exemption for wearing a mask from my Chiropractor" bullshit like is going on in Florida), a pharmacy shouldn't be allowed to decide not to fill it, as if they know better than your doctor.
- snovv_crash 5y ago
  The pharmacy probably doesn't want any liability so it's easier to just blanket-ban 'fad' medicine. And we make fun of the Chinese using rhino horn for erectile disfunction...
- mint2 5y ago
  Is your friend vaccinated?
  - cableshaft 5y ago
    Yes, he's been vaccinated since April, around the same time I got it.
- ashtonkem 5y ago
  > pharmacy shouldn't be allowed to decide not to fill it, as if they know better than your doctor. It sounds like you have a pretty misguided idea of how pharmacies and pharmacists worked before Covid. You’re describing a situation where pharmacists act at the behest of doctors who know best, when in reality pharmacists have always had some level of independent authority over what drugs get dispensed to whom thanks to their expertise. It’s part of the pharmacists job to watch out for bad prescriptions, both in terms of abuse (e.g. opioids) improper dosages, and unintended side effects and interactions between drugs. In some states pharmacists have their own ability to prescribe medicine on their own. I’m not sure exactly how much control a pharmacist should have over whether a valid prescription is filled, but the idea that they’re only expected to blindly fulfill the order of your doctor is not correct, and never was. In fact, they probably know more about the drugs you’re prescribed than your doctor does, as that’s their entire speciality. (Especially given the long and sordid history of doctors pushing drugs on the basis of pharmaceutical sales reps, doctors often actually know very little about what they prescribe).
  - nobody9999 5y ago
    >t sounds like you have a pretty misguided idea of how pharmacies and pharmacists worked before Covid. You’re describing a situation where pharmacists act at the behest of doctors who know best, when in reality pharmacists have always had some level of independent authority over what drugs get dispensed to whom thanks to their expertise. It’s part of the pharmacists job to watch out for bad prescriptions, both in terms of abuse (e.g. opioids) improper dosages, and unintended side effects and interactions between drugs. In some states pharmacists have their own ability to prescribe medicine on their own. Absolutely. I had to fire my doctor after he prescribed a sulfa drug to me, even though I'd made it clear that I have an allergy to sulfa drugs. In fact, I would never have known (well, until I became sick/dead) that the drug prescribed was a sulfa drug if the pharmacist hadn't known the drug involved and checked it against known allergies. He contacted both me and my doctor and a different drug was prescribed. In fact, it's entirely possible that I'm alive today thanks to the expertise and knowledge of the pharmacist.
  - cableshaft 5y ago
    Not really disagreeing that a pharmacist might know more about the drugs than a doctor. I wasn't warned about the potential side effects of Ciprofloxacin once, just told it was an "antibiotic" by the specialist I saw, and the pharmacist did clue me in about some side effects, which I promptly had some of the worst ones after a single pill. I might not have made the connection it was a bad reaction to the pills without their warning, at least not so quickly. I continued to have side effects off and on for years afterwards. I learned my lesson and now do my own research before just taking any medicine a doctor wants to prescribe now. But I still don't think pharmacists should be able to just override the decision of a doctor. Make sure the person is fully informed of potential dangers, side effects and correct usage, sure, but not override the doctor. The doctor has had an opportunity to examine and talk to the patient at length, multiple times over multiple visits, and know their history and specific needs, the pharmacist doesn't know any of that background and are most likely just making assumptions. I mean if it's literal rat poison or a dose guaranteed to kill the person is being prescribed, maybe they can hold off on fulfilling it and alert authorities, but otherwise? Opioids are a major problem, as there are addicts that cycle doctors to get multiple prescriptions so some doctors might not realize it's being overprescribed, but that's a matter of addiction and abuse and I don't know how a pharmacist is expected to know when it's being abused or not, unless they're getting them all filled at the same pharmacy. Again, they're not spending enough time with these people to know what their situation is. The most interaction I have with my pharmacist is "Picking up a prescription." "Verify your address please?" "My address." "Okay this has these side effects and you should only have it after a meal." "Okay thanks." Yeah that's totally enough for them to make a medical decision on my behalf. /s If anything, I think them deciding when to withhold medicine could make them MORE liable, not less, because they're inserting themself into the decision process. What if their withholding fulfillment of a prescription results in that person dying? If the doctor said yes and they said no, that seems to open up room for litigation to me.
- threeseed 5y ago
  > pharmacy shouldn't be allowed to decide not to fill it, as if they know better than your doctor They are legally required to make decisions about whether or not to fill it. They are not just some supermarket cashier.
  - unreal37 5y ago
    Pharmacists go to school 4-6 years to learn about drugs. But hey - they don't get to use any of that knowledge in their job... "Just give me the little white box in cabinet #2 please." Why do Pharmacists even study and train for up to 6 years if you don't want their opinion on how this drug will affect you?
- julianz 5y ago
  This "friend of yours" should probably get vaccinated then, because we know that works pretty well.
  - ashtonkem 5y ago
    Rumor has it that it’s even free!
  - cableshaft 5y ago
    He is vaccinated. He's been vaccinated since April. Breakthrough infections are a thing. He's also concerned about recent data from Israel about waning efficacy. He'd get a booster shot today if he could get it. Also thank you for what I presume is you insuinuating by putting "friend of yours" in quotes that you think I'm talking about myself. I've been vaccinated since April and I have been a lot more careful about this virus than at least probably 90% of the people out there, at least in the US. I still wear masks outside the house and avoid going indoors very often (I didn't do it at all until I was vaccinated). Hell, I wore masks on hiking trails outdoors while holding my breath when walking past others on the trail back in 2020, which was probably overkill in retrospect. I also only had food delivered, never even going through the drive thru, and didn't order anything that couldn't be heated in the microwave for 3 minutes to try to kill the virus since it was unclear whether it transmitted via surfaces back then (so no sushi, sandwiches, salads, ice cream, iced coffee, etc). Personally I wouldn't try to hunt down some of these alternative drugs, which I'm pretty skeptical of, but there seems to have been some mixed data on this one and I can at least understand why someone might want to give it a shot in reasonable and proven to be safe doses, especially if they have no choice but to be surrounded by it all day long (I work from home, my risk at work is nonexistent).

Is that really the reason or is it that they can't get a doctor to write them an off-label prescription?

by vernie 5y ago

Is that really the reason or is it that they can't get a doctor to write them an off-label prescription?

It's probably both, but why would a doctor risk losing their license over this? Yet another unintended consequence. Doctors are supposed to be able to write prescriptions for off-label use.

sgt101 5y ago
If they have reason to believe that it's beneficial. If they don't then they are being reckless.

cableshaft 5y ago

A friend of mine found a doctor to prescribe it but his pharmacy won't fill it. He is so pissed. He was only planning to take small doses here or there as he's a teacher and around sick kids all the time, as if it were like Zinc to hopefully help reduce the severity of Covid-19 if he does get it, but despite going through the effort and succeeding in finding a doctor willing to prescribe it (and my friend even signed a document saying he understands it's an experimental treatment and will assume any risks), his local CVS is refusing to fill it. My opinion is if you can get a proper doctor to prescribe it (by proper doctor I mean none of this "I got a medical exemption for wearing a mask from my Chiropractor" bullshit like is going on in Florida), a pharmacy shouldn't be allowed to decide not to fill it, as if they know better than your doctor.

snovv_crash 5y ago
The pharmacy probably doesn't want any liability so it's easier to just blanket-ban 'fad' medicine. And we make fun of the Chinese using rhino horn for erectile disfunction...
mint2 5y ago
Is your friend vaccinated?
- cableshaft 5y ago
  Yes, he's been vaccinated since April, around the same time I got it.
ashtonkem 5y ago
> pharmacy shouldn't be allowed to decide not to fill it, as if they know better than your doctor. It sounds like you have a pretty misguided idea of how pharmacies and pharmacists worked before Covid. You’re describing a situation where pharmacists act at the behest of doctors who know best, when in reality pharmacists have always had some level of independent authority over what drugs get dispensed to whom thanks to their expertise. It’s part of the pharmacists job to watch out for bad prescriptions, both in terms of abuse (e.g. opioids) improper dosages, and unintended side effects and interactions between drugs. In some states pharmacists have their own ability to prescribe medicine on their own. I’m not sure exactly how much control a pharmacist should have over whether a valid prescription is filled, but the idea that they’re only expected to blindly fulfill the order of your doctor is not correct, and never was. In fact, they probably know more about the drugs you’re prescribed than your doctor does, as that’s their entire speciality. (Especially given the long and sordid history of doctors pushing drugs on the basis of pharmaceutical sales reps, doctors often actually know very little about what they prescribe).
- nobody9999 5y ago
  >t sounds like you have a pretty misguided idea of how pharmacies and pharmacists worked before Covid. You’re describing a situation where pharmacists act at the behest of doctors who know best, when in reality pharmacists have always had some level of independent authority over what drugs get dispensed to whom thanks to their expertise. It’s part of the pharmacists job to watch out for bad prescriptions, both in terms of abuse (e.g. opioids) improper dosages, and unintended side effects and interactions between drugs. In some states pharmacists have their own ability to prescribe medicine on their own. Absolutely. I had to fire my doctor after he prescribed a sulfa drug to me, even though I'd made it clear that I have an allergy to sulfa drugs. In fact, I would never have known (well, until I became sick/dead) that the drug prescribed was a sulfa drug if the pharmacist hadn't known the drug involved and checked it against known allergies. He contacted both me and my doctor and a different drug was prescribed. In fact, it's entirely possible that I'm alive today thanks to the expertise and knowledge of the pharmacist.
- cableshaft 5y ago
  Not really disagreeing that a pharmacist might know more about the drugs than a doctor. I wasn't warned about the potential side effects of Ciprofloxacin once, just told it was an "antibiotic" by the specialist I saw, and the pharmacist did clue me in about some side effects, which I promptly had some of the worst ones after a single pill. I might not have made the connection it was a bad reaction to the pills without their warning, at least not so quickly. I continued to have side effects off and on for years afterwards. I learned my lesson and now do my own research before just taking any medicine a doctor wants to prescribe now. But I still don't think pharmacists should be able to just override the decision of a doctor. Make sure the person is fully informed of potential dangers, side effects and correct usage, sure, but not override the doctor. The doctor has had an opportunity to examine and talk to the patient at length, multiple times over multiple visits, and know their history and specific needs, the pharmacist doesn't know any of that background and are most likely just making assumptions. I mean if it's literal rat poison or a dose guaranteed to kill the person is being prescribed, maybe they can hold off on fulfilling it and alert authorities, but otherwise? Opioids are a major problem, as there are addicts that cycle doctors to get multiple prescriptions so some doctors might not realize it's being overprescribed, but that's a matter of addiction and abuse and I don't know how a pharmacist is expected to know when it's being abused or not, unless they're getting them all filled at the same pharmacy. Again, they're not spending enough time with these people to know what their situation is. The most interaction I have with my pharmacist is "Picking up a prescription." "Verify your address please?" "My address." "Okay this has these side effects and you should only have it after a meal." "Okay thanks." Yeah that's totally enough for them to make a medical decision on my behalf. /s If anything, I think them deciding when to withhold medicine could make them MORE liable, not less, because they're inserting themself into the decision process. What if their withholding fulfillment of a prescription results in that person dying? If the doctor said yes and they said no, that seems to open up room for litigation to me.
threeseed 5y ago
> pharmacy shouldn't be allowed to decide not to fill it, as if they know better than your doctor They are legally required to make decisions about whether or not to fill it. They are not just some supermarket cashier.
- unreal37 5y ago
  Pharmacists go to school 4-6 years to learn about drugs. But hey - they don't get to use any of that knowledge in their job... "Just give me the little white box in cabinet #2 please." Why do Pharmacists even study and train for up to 6 years if you don't want their opinion on how this drug will affect you?
julianz 5y ago
This "friend of yours" should probably get vaccinated then, because we know that works pretty well.
- ashtonkem 5y ago
  Rumor has it that it’s even free!
- cableshaft 5y ago
  He is vaccinated. He's been vaccinated since April. Breakthrough infections are a thing. He's also concerned about recent data from Israel about waning efficacy. He'd get a booster shot today if he could get it. Also thank you for what I presume is you insuinuating by putting "friend of yours" in quotes that you think I'm talking about myself. I've been vaccinated since April and I have been a lot more careful about this virus than at least probably 90% of the people out there, at least in the US. I still wear masks outside the house and avoid going indoors very often (I didn't do it at all until I was vaccinated). Hell, I wore masks on hiking trails outdoors while holding my breath when walking past others on the trail back in 2020, which was probably overkill in retrospect. I also only had food delivered, never even going through the drive thru, and didn't order anything that couldn't be heated in the microwave for 3 minutes to try to kill the virus since it was unclear whether it transmitted via surfaces back then (so no sushi, sandwiches, salads, ice cream, iced coffee, etc). Personally I wouldn't try to hunt down some of these alternative drugs, which I'm pretty skeptical of, but there seems to have been some mixed data on this one and I can at least understand why someone might want to give it a shot in reasonable and proven to be safe doses, especially if they have no choice but to be surrounded by it all day long (I work from home, my risk at work is nonexistent).