Pet Health Pharmacy


Samantha Hammer
 

I know this is a pharmacy that a lot of you have used with success. Before my vet wrote me out a prescription, I called and talked to Laura at the pharmacy, and she seemed knowledgeable about pergolide, the dosages they offered, and the conversion rate of pergolide mesylate (she said it was 1.31 mg pergolide mesylate = 1 mg pergolide). My vet wrote the prescription for 1mg pergolide tablets (prascend), but also wrote that substitution of a compounded medication was "desired and appropriate" or something like that. However, when the pharmacy received the prescription, they called the vet and didn't seem to know how to handle what she had written. It seemed pretty clear to me. She was very perturbed. With her permission, here is what she wrote back to me:

"My practice manager just called me that the pharmacy with the written script called the office with some issues. He was confused as to how to approve the script as they don't carry Prascend tablets and he couldn't do the mg calculations for the product that they carry. The pharmacist, or representative, was demanding that our technicians calculate dosages for Wrangler using their compounded product, rather than making their own adjustments. I find this to be alarming. As a pharmacist, if they have a product they recommend as a substitute, they should readily understand the comparable dosages to compare with approved doses.... especially with pergolide. As we discussed the script was written in a way to allow for substitutions for a comparable compounded product. If they are unable to offer or recommend a comparable product that this illustrates an issue. The dosage of pergolide is 1mg orally per day. If you'd like to start Wrangler on 1/2 mg a day for 2 weeks before you begin the full dosage that is fine. If their pergolide mesylate requires a higher dosage then that is a substitution they will have to recommend, as I am authorizing the dose at 1mg every 24 hours for Pergolide. Best of luck with this pharmacy."

and

"I'm happy to help if I can, but I was very much perturbed when [the vet's practice manager] mentioned that they demanded our technicians dose over the phone!"

I did ask her to write it for the 1.2mg of pergolide mesylate...But, I agree, the pharmacy tech (not the one I originally spoke to) sounds disturbingly lacking in knowledge.

Thoughts? I'm going to call Laura at the pharmacy tomorrow and see what she has to say, but I might end up going with my vet's more expensive pharmacy that will also compound.
--
Sami Hammer
September 2018
Catalina, AZ
Wrangler Case History: https://ecir.groups.io/g/CaseHistory/files/Sami%20and%20Wrangler  .
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=70688  .


Samantha Hammer
 

Just to clarify, I've been following the other topics on here, including Lynn's helpful note in her post:

When switching to or from Prascend, make sure to get the vet to write the script as "x mg of pergolide as pergolide mesylate" ,  rather than "x mg of pergolide"
But if my vet wrote that a substitution of compounded pergolide is appropriate, is there some legal reason the pharmacy can't just figure that out?

--
Sami Hammer
September 2018
Catalina, AZ
Wrangler Case History: https://ecir.groups.io/g/CaseHistory/files/Sami%20and%20Wrangler  .
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=70688  .


Samantha Hammer
 

Oops, I think maybe that was a quote originally from Jaini. Sorry!
--
Sami Hammer
September 2018
Catalina, AZ
Wrangler Case History: https://ecir.groups.io/g/CaseHistory/files/Sami%20and%20Wrangler  .
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=70688  .


Eva
 

As a pharmacist I'll say - you cannot write for a branded product which has no substitutions and expect to get a substitution - even if you write a note - it would need to be clarified.  Pharmacists cannot guess at the intention of the proscriber.  And you wouldnt want them to.  Your vet did not write as Jani recommended above.  "x mg of pergolide as pergolide mesylate".  Perhaps the Vets local pharmacy has worked with this vet before and knows how to clarify for legality - but by law the pharmacy cannot do what the vet wrote.  It sounds like the pharmacy tried to clarify and most likely it was a tech talking to a tech which further confused the issue.  If you are calling Laura RPH back most likely she can help clear things up for you.  Once things get ironed out you probably won't have further issues - just guessing because I don't know this pharmacy at all but IMO these things usually work out.  Vets are not used to dealing with pharmacys or the laws which must be followed.  This has caused me distress for my own animals in the past
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Eva and Anske
October 2017 Corvallis OR
Case History Anske 9yo Friesian Mare https://ecir.groups.io/g/CaseHistory/files/Eva%20and%20Anske


celestinefarm
 

Sami, I agree with what Eva said. My own vet faxed in a Rx to Pet Health I had called him about for a renewal of pergolide for Tipperary, which he wrote one set of numbers and then the instructions for me to dose didn't match the numbers. They attempted several times to call him about it and then called me to ask me to try and reach him and have him call them(he's a single practitioner and doesn't call back on weekends unless you are calling on his emergency line). They told me flat out that they understood what I wanted, but the actual Rx didn't say that and they could not fill it until the Rx was properly written. 
My vet agreed we should be happy with a pharmacy that straight by the book.
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Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History


Samantha Hammer
 

Thanks Dawn and Eva. I agree, I think the techs talking to techs did complicate it a bit. I did try to ask my vet to write it as recommended by Jaini in an email to her, but I guess she wasn't comfortable writing it directly for the compounded version, rather than Prascend. Oh well, it all got worked out, and I should get the meds later this week. And now I'll just be asking for refills, which should be much easier!

Laura at PHF was super helpful!
--
Sami Hammer
September 2018
Catalina, AZ
Wrangler Case History: https://ecir.groups.io/g/CaseHistory/files/Sami%20and%20Wrangler  .
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=70688  .


Eva
 

I'm glad you got everything straightened out:)  sometimes vets don't understand that pharmacists have to follow the human laws. 

--
Eva and Anske
October 2017 Corvallis OR
Case History Anske 9yo Friesian Mare https://ecir.groups.io/g/CaseHistory/files/Eva%20and%20Anske