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RigelOrionBeta t1_jcl8325 wrote

I have NEVER received a prescription where the label's recommended dosage matched what the doctor recommended.

I have a prescription that says to take it every 8 hours, every day. My doctor said to take it once every day, or when I was feeling symptoms.

I had another medication that said to take it twice a day, before and after bed. My doctor said only take it once, in the morning.

I brought this up with my doctor, and they said to ignore the label. What if I forget? So now I need to note my dosage myself? It's ridiculous.

Why is this so difficult? Why doesn't the pharmacy just know what my dosage should be based on my prescription? Do doctors and pharmacists not communicate at all?

By the way, some of the deaths due to taking wrong dosages are also due to cost. Patients will take less than recommended to cut drug costs.

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SwankyPants10 t1_jclco0z wrote

This makes no sense, the directions on your prescription label would be exactly what the doctor prescribed on the prescription. If they aren’t, then what the doctor is telling you to do and what they are writing on the script are not lining up.

There are often multiple dosages, frequences, etc in which a medication can be taken. This is why the prescribed dose often does not match what you may see on manfacturer monographs or online.

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artemisodin t1_jclgrmc wrote

Absolutely this. The label will have what your doctor prescribed. Sometimes doctors may request a different frequency than normal, in which case a pharmacist will call and clarify. The doctor may agree and change the prescription, but what is on the label is what the doctor wrote or adjusted to verbally.

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RigelOrionBeta t1_jclke5j wrote

I'm just saying what my experience is. It's never been the same. I have been on four different medications, never has the label matched the doctors spoken recommendation. This is across two different states in the US. Makes no sense.

I understand that dosages vary for a lot of reasons for medications, but it makes no sense why the label would ever differ from what the doctor prescribed, and yet for me it always does.

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MoobyTheGoldenSock t1_jcmp55u wrote

Let the pharmacist know when you pick it up. They will call the doctor and clarify.

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qleap42 t1_jclbsut wrote

That sounds like something you would have to discuss with your pharmacist about. Many times pharmacists know more about the drugs than doctors do. But dosage and frequency are usually set by the doctor. If the doctor says otherwise I would talk to your pharmacist to see why they had it different.

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RigelOrionBeta t1_jcllq2o wrote

I have honestly just always figured the medication label simply states what some "default" dosage should be. I know that sounds ridiculous and incredibly dangerous, but I would argue so is private health insurance, tying healthcare to employment, and so much else about the US healthcare system.

I'll talk to my pharmacist about it then. Thanks!

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Ukgamer125 t1_jclup7a wrote

Not sure about US labelling requirements but here in the UK that would not be acceptable, the label should state the directions exactly as prescribed including “when required” if it’s to be taken only when needed. Would definitely recommend talking to the pharmacist.

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Drakka t1_jco0cll wrote

Same in US. No-one out here free-styling directions.

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ShrapNeil t1_jclk79h wrote

I worked in pharmacy for years, filling prescriptions and interpreting those doctor’s orders into a label. This is, frankly, negligence on the part of the pharmacy. If we made mistakes like this, or even subtle mistakes, they were sent back to be fixed. Your meds are probably being filled by an overworked pharmacist, working without staff, and cutting corners. That or your doctor is actually sending the scripts to the pharmacy with entirely incorrect instructions, which actually did happen quite often, as well as doctors prescribing strengths that didn’t exist.

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RigelOrionBeta t1_jcll7m5 wrote

Yeah, no doubt pharmacists are overworked, I don't blame anyone really, but do blame our incredibly ridiculous healthcare system.

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ceruleanpure t1_jcmybpu wrote

  1. I have had MD prescribe stuff for patients, that, as I’m typing the order in the computer, the computer has a hard stop and I have to chose a different timing or strength. This results in a call back to the MD to argue about policies for patient safety.

  2. Sometimes we do get an order for “one a day or as needed”. The computer ALSO hard-stops this. It’s either a “scheduled med” (once per day) or a “prn med” (as needed). You cannot have both; the system won’t let you.

So; whereas sometimes docs and sometimes pharmacists do make mistakes; I’m more likely to blame the computer system for all of the hard-stops and system policies that cannot be overridden. Don’t get me wrong!! Hard stops are good when they catch something stupid dangerous, but they are also annoying for easy/okay overrides.

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Vegetable-Editor9482 t1_jcmfib0 wrote

I wonder if this is a regional regulatory thing. In California the label and my doctor's instructions always matched; now I'm in the Midwest and they often don't.

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RigelOrionBeta t1_jcmg4og wrote

I lived in IL when I was taking two prescriptions and it happened. Also lived in the northeast, when it happened.

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matycauthon t1_jcms5z2 wrote

Sounds like you go to poorly ran pharmacies or your prescription is written that way and your doctor for whatever reason doesn't change it. I've never had an issue like that in any of the states I've lived in.

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sevksytime t1_jcnlu03 wrote

Yeah that’s not normal. Your doctor isn’t writing you the correct dosage and frequency for you.

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szpaceSZ t1_jcnw00i wrote

> So now I need to note my dosage myself? It's ridiculous.

Don't the pharmacists write the doctor's prescribed dosage onto your card-boxes the medicine comes in?

That's what happenes here (Central and western Europe).

The printed obstruction have a section "recommended dosage, if not otherwise prescribed by your doctor".

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Drakka t1_jcnzoxi wrote

Yes, whatever the doctor sends over to the pharmacist is what is placed on the bottle. The only time this changes is when the dose is incorrect and the pharmacist calls to get it changed. OP either has a dr that is giving incorrect directions to them in person and it is getting corrected later (happened today for my wife’s ear-drops) or is giving verbal directions as to what they want them to take and putting directions on the prescription different so that OP can get a longer day supply for one copay. (Technically illegal).

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Drakka t1_jco09v3 wrote

I bet when you go talk to your pharmacy you will find out that your prescription from the doctor reads the same as the directions on your bottle.

Retail pharmacists in the US aren’t going to, and cant, freestyle your directions.

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