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Avatar universal

Renewal with competely different medications

In these trying times, do we need yo completely use up our old pain perscriptions before filling prescriptions  new types and dosages. My PMP casually said he wouldn't wait until the last minute ...  which I find hard to believe.
10 Responses
Avatar universal
There is no reason to wait.  My doctor ordered a month of Fentanyl patches, they didn't work for me after a week my arm was going numb. He ordered a different prescription that day , there was no issue with my insurance or anything picking it up.  As long as it's a completely different prescription not the same , there should be absolutely no issue. When I was trying to find the right dose and script I went through quite a few different types and believe or not very expensive drugs that just got thrown away. Because they just had bad reactions for me. With some of them my insurance made me go through the cheaper drug first sometimes, but that depends on your insurance company.  But if it's the same type drug you can usually pick it up 2-3 days before you are out of your last prescription.
I hope I answered the question you were looking for.  Good luck with your pain care hope to see you again real soon.
547368 tn?1440541785
I think your question is regarding new prescriptions rather than our every month, same opiate refill. Am I correct? Or am I misunderstanding our question?

Grreatful always provides good suggestions and answers. I do agree with him. About a year and a half ago my than new PMP changed my opiates completely. I had almost 3 weeks left of my "old" prescriptions. I took them (and told him I would) for 2 weeks before I filled my new RX. This did this for two reasons. It saved me money (co-pays) and gave me some leeway when I'd have to obtain monthly fills going forward. Some providers forget that some of us live on SS Disability - or in other forms of low income situations. Co-pays can be horrific on maintaining a monthly budget. My co-pay is $45. It'd be tough to do that twice in one month - $90.00 is a lot of money to me. If you have several meds a month the co-pays can be killers!!

Additionally I reside in an area  where Hurricanes are a reality. All of us must have several days (my PMP suggests a week) of opiates ahead - in case a Hurricane hits and we are unable to keep our appt or worse. Because I didn't fill my first prescription right away as I could have done I know have a bit ahead. If my appt had to be canceled or missed - it's a comfort to know I wouldn't be completely out of pain meds.

All the years I've been in PM I've tried never to use all my opiates before getting another fill. After saying all this - it is true that the DEA frowns upon any meds ahead. So what are we to do? I'm comfortable right where I am. Each of us have to make the decision of where we are comfortable.

I hope something Grreatful and I have offered has been of help. What are your thoughts my friend?

Warm Regards,
~Tuck
Avatar universal
I think it's always best to go straight to the pharmacy after your Drs visit. This is what I do. Most pharmacies will not fill a pain prescription before 28 days. I see my Dr every 28 days so this works out well for me. If you see your Dr every 28 days too and wait a few days to get your script filled then it will throw everything off on your next visit. You won't be able to get your script filled that day because it will be too soon.
If you're asking this question because you get your check on a certain day of the month and can't get your scripts until then I understand what you mean. If that's the case then maybe you can work out something with your Dr. to have your appointments the day of or the day after you get your check. He would have to give you less pills some months and more pills other months because we have 7 months with 31 days. I'm not sure how that would work with your insurance. If this is what you meant then do talk to your Dr. He sounds like a really nice and caring man who will work with you.
I agree with Tuck. If there's anyway we can have a few days worth of extra pills it's really a good idea to do so. Month before last there was flooding in my Drs town so they had to reschedule everyone who had an appointment that day. My Dr knows I always have an extra pill or two every month because I bring my bottle with me. If I had not had extra medication I would have been in trouble because I had to wait 3 days to get in. I was so worried about the other patients wondering if they had extra medication too.
I hope we've helped with your question. If we haven't and misunderstood please let us know.
547368 tn?1440541785
Hi Remar,

I use to do just what you are doing. I'm happy that it works well for you.  I use to take my RX to the pharmacy as soon as I left my PMP appointment too. I knew I could see my PMP in an urgent situation. I had good insurance and life was as good as it gets if you're in Pain Management. Things changed, PMP changed, the opiate phobic climate emerged - and insurance changed.

My current PMP sees patients every 27-31 days - once a month. That's it. He schedules according to his active lifestyle. He lives on an Island - and loves it. If you don't have a few extra meds and you're scheduled on day 31 you can imagine how difficult that can be. Delaying the fill of the new opiate he put me on was the smartest thing I did. I take my RX to the pharmacy about two weeks after my appt. It's worked well for me.

That's the key - what works best for each of us - and still keeps us legal with the DEA. If I'm understanding fntn's question - the answer is - what works best for his situation.

Warm Regards,
~Tuck
2 Comments
Hi Tuck. I'm still confused about how this works. Will waiting 2 weeks to get your script filled put you ahead with having extra pills in case of an emergency? I see my Dr every 28 days and he gives me the same amount no matter how many I have left in my bottle. Usually it's only 3 or 4 because it's the end of the month. If I were to wait 2 weeks to get my script filled I would be completely out of my meds. When you waited 2 weeks that first time weren't you out of your meds? Or, are you saying you did this with a completely new medication?
Yes Remar. Because I used most of my old (another opiate) RX before filling the new (opiate) when the change was made - I have some leeway.

Of course my insurance and pharmacy keep me on the usual 28-29 day fill. It still works well because I see my PMP between fill dates and not the day of the scheduled next fill date. I don't receive any more - it just gives me a safely net should an appt be delayed. I hope I make sense! :o)

~Tuck
Avatar universal
I ended up waiting until the last two days remaining and there was no problem with the new perscription. Probably should have gone in earlier, but that's where we are now days, afraid to actually take care of ourselves due to the crazy rules and restrictions. Sad that we are heading to a world of constant suffering for chronic pain patients, the margins slowly erode.
Avatar universal
I still don't understand how this works. You did say in your first post that if it were with a completely new medication. Are you saying you went almost a full month without your old medication and then had it filled right before your new medication? Or, you already had the script for the next month but your Dr put you on a new med? I can understand that because it would put a person ahead with their old meds just in case of an emergency. I'm so sorry to sound like a dummy.
I do agree with you. Many of us are afraid to take care of ourselves because of these new rules. We hear stories here on MH about people following every rule and still getting let go from PM. We shouldn't have to live in fear every single day.
1 Comments
I was finishing out the previous prescription. I always refilled on the last day or the day before, never earlier. I do Holidays often, so there is extra medication if I need it ,,, but only if the crazy situations were to arise.
Avatar universal
Are you saying that your Dr changed your medication or increased it?
I'm going to send you a PM.
1 Comments
Remar,

I think fntn is talking about a change in the Opiate. Is that right fntn?

When I had that acute episode a neuritis last summer my PMP told me verbally I could increase my opiate to one extra per day. He said he'd write a new RX when he saw me in 2 weeks. He did -  but the pharmacy would not allow for the extra tablet I took per day on his verbal order. As far as they were concerned they went according to previous fill dates and not the date on the new RX. It was a mess! I couldn't refill the increase RX until I I reached the "normal" refill date on the former dose. I gave up trying to explain it to my pharmacy. I was in too much pain to argue.

When they did fill the increase (one more tablet a day) - it red flagged me! They also red flagged the PMP. That was from 4 tablets to 5 tablets per day! Crazy huh??

Apparently we are not allowed to have acute flares. Sad Sad Situation!

~Tuck
Avatar universal
Yes, my PMP switched my opioid medication SA and LA types. I still had a couple of weeks left on the old perscription and he told me to go ahead and fill the new perscription immediately. But I didn't want to trigger any red flags myself, so I waited until I finished off the old perscription. I'd been on those types of opioids for two years, time to rotate.
Avatar universal
Now I understand. I didn't know your Dr had completely changed your meds.   I still had about 3 weeks left of my old med when my Dr switched me over to a new one. I got the new one filled the day I saw her and there were no red flags because it was a different med. You could have gotten your new one filled right away, as long as there was no problem with your insurance. There shouldn't have been because they were different meds. I'm sure you were ready to get on the new ones and that's what your Dr wanted you to do. I'm sorry we didn't understand your question right away or we, I know I would have, told you to get the new ones filled right away. I'm really hoping your new meds give you more relief. Let me know when you get a chance.
547368 tn?1440541785
Fntn,
That's how I did it when I was switched. However I did/do have about a 4-5 days left of the old RX when I had the new one filled. It gives me about two weeks from the time I see my PMP (and he writes me a monthly fill RX) before I have to actually go to the pharmacy and fill that monthly supply.

I hope this works better in controlling your pain. You deserve to have good pain management. You're in my prayers!

Remar,
I don't have "extra" per say. Think of it as seeing your PMP is the middle of your refill fill cycle - instead of at the end of  the month when you have only a day or two of meds left for the month. That's what it really is.

However even when I filled the new opiate I was red flagged (according to the Pharmacist) because it was an opiate refill five days early - even though it was a completely different opiate - a change. The Pharmacist told me this - and he said not to worry he took care of it. He had to do something in order to actually fill the RX. It made no sense to me as it was a change, a new RX. That apparently doesn't matter with the DEA - or government watchdogs. I was still, unjustly red flagged. I was only a few days "early" in the fill - and you could clearly see the RX was written 2 weeks prior to fill date. I explained that with my PMP permission I finished much of the old RX. The pharmacist disappeared for 20-25 minutes before he reappeared and said he had taken care of it - made it work. He could now fill my new RX.

It makes no sense to me. What an unfair system.

~Tuck
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