By Colleen Moroney, 2015 Pharm.D. candidate, University of Pittsburgh School of Pharmacy, and Sue Skledar, R.Ph., MPH, FASHP, clinical specialist, University of Pittsburgh Medical Center Health System Formulary Management and Drug Use Policy and associate professor, University of Pittsburgh School of Pharmacy
When you receive a prescription from your doctor, you may be uncertain how much of the cost will be covered by your insurance. You may wonder, “Can I afford this medication?” Sometimes the answer to this question may be hard to find. More
By Jeremy A. Ebert, Pharm.D., PGY1 Pharmacy Practice Resident, St. Rita’s Medical Center, Lima, Ohio
Aspirin has been used since ancient times to relieve pain and inflammation. Today, aspirin is often recommended for patients who have suffered heart attacks or strokes. But what are the risks you should be aware of? More
By Lori C. Dupree, Pharm.D., BCPS, President of Clincomm Consulting, LLC, Lexington, S.C., and a consultant pharmacist with Neil Medical Group; and Brittany Samples and Erin Weaver, 2014 Pharm.D. candidates, Wingate University School of Pharmacy, Wingate, N.C.
Did you know that your medicine cabinet might contain a potentially dangerous medication? This medicine is a pain and fever reducer that many people take regularly. Its’ generic name is acetaminophen, but you may know it by its brand name: Tylenol®. More
By Terri Albarano, M.S., Pharm.D., Clinical Marketing Manager, Specialty Pharmaceuticals / Nutrition, Baxter Healthcare Corporation
Over the last two years, you may have seen news stories about outbreaks of fungal meningitis that were occurring across the country. This national health care scare was traced back to contaminated epidural steroid injections made by the New England Compounding Center (NECC) in Framingham, Mass. This tainted medication had been injected into the spinal cord area of people, usually to treat back pain. More
By Jacqueline L. Olin, M.S., Pharm.D., BCPS, CPP, CDE, Associate Professor of Pharmacy, Wingate University School of Pharmacy, Wingate, N.C.; and Laura MacCall, a 2014 Pharm.D. candidate, Wingate University School of Pharmacy
Inhaled medicines are used for treating breathing problems such as asthma and chronic obstructive pulmonary disease (COPD). Unlike medications that are swallowed, inhalers are designed to get the medicine directly to the lungs. More
New Changes in Regulations for Certain Prescription Painkillers
By Han Feng, Pharm.D., PGY2 medication safety resident, Johns Hopkins Hospital, Baltimore
Have you heard about recent changes related to the regulation of certain prescription painkillers? Based on reports of dependence, abuse, and deaths, the Drug Enforcement Administration (DEA), a U.S. federal law enforcement agency, decided to classify tramadol as a controlled substance and increase regulation of hydrocodone combination products, such as Hycodan, Lorcet, Tussionex, and Vicodin.
What is a controlled substance?
Controlled substances are drugs that have potential for abuse or dependence and are regulated by the federal government. The DEA relies on a drug “schedule” to classify and restrict use of certain medications and substances. Schedules range from I to V.
Schedule I is the category for drugs and substances with no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse. For drugs and substances approved for medical uses, Schedule II is the most restrictive category with the highest potential for abuse or dependency. Schedule III - V medications have lower potential for abuse and risk of dependency.
What can I expect when I go to fill a prescription for tramadol?
With the new changes, prescriptions for tramadol may be refilled up to five times in six months after the date on the prescription. Prescriptions can still be called in, faxed, or sent electronically to the pharmacy by your doctor’s office as long as the office follows the DEA rules on sending prescriptions by these methods. Prescriptions may be transferred from one drug store to another, but can only be transferred once. There may be additional requirements based upon your state’s laws. Ask your pharmacist for how the new DEA ruling might affect your tramadol prescription.
What can I expect when I go to fill a prescription for hydrocodone combination products?
Refills of hydrocodone combination products will require a new prescription for each refill. Many states do not allow hydrocodone combination product prescriptions to be called in, faxed, or sent electronically to the pharmacy. If you have questions about filling a prescription for hydrocodone combination products, contact your pharmacist.
What if I still have refills left on my previously written prescription?
The DEA requires that all tramadol prescriptions must be filled according to the new regulations beginning August 18, 2014. Prescriptions written prior to August 18 must also follow DEA’s new restrictions. If your current prescription was written more than six months ago or was refilled more than five times, a new prescription will be required. Additional state-specific regulations may affect how you can refill your prescription for tramadol.
New regulations for dispensing hydrocodone combination products will take effect October 6, 2014. Prescriptions written prior to October 6 and those that have refills may continue to be filled as written on the original prescription or until April 8, 2015—whichever happens first.
If your current prescription is more than six months old or has been refilled more than five times, a new prescription will be needed. Additional regulations in your state may affect your prescription for hydrocodone combination medications.
The views expressed in “Pharmacist’s Journal” do not necessarily represent the views of the ASHP.