"I want the actavis brand"

[Muse600]

when I float to certain stores, I get this statement a lot...

sometimes it's on a script by itself, other times it's on a pad from an urgent care center w' a z-pak

usually the patients are new the the pharmacy, and cash paying

they also ask "which brand do you have?" and if we don't have actavis, they don't want it

sup with that? makes 'em more high? better street value?

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[Doctor M]

when I float to certain stores, I get this statement a lot...

sometimes it's on a script by itself, other times it's on a pad from an urgent care center w' a z-pak

usually the patients are new the the pharmacy, and cash paying

they also ask "which brand do you have?" and if we don't have actavis, they don't want it

sup with that? makes 'em more high? better street value?

for zpak????? LOL

 

[All4MyDaughter]

I had a potential new customer go on an extended rant about not wanting any "crap drugs from India" after she got Dr. Reddy's fluconazole (IIRC) from Kroger. She wanted my personal guarantee that we didn't buy any drugs from India. When I told her I couldn't promise that, she walked. I'm not sure we wanted a customer that whacky or high maintenance...

 

[Doctor M]

I had a potential new customer go on an extended rant about not wanting any "crap drugs from India" after she got Dr. Reddy's fluconazole (IIRC) from Kroger. She wanted my personal guarantee that we didn't buy any drugs from India. When I told her I couldn't promise that, she walked. I'm not sure we wanted a customer that whacky or high maintenance...

Agreed...I buy the cheapest i can. be it from India, Canada, wherever, as long as its legal, im buying.

 

[All4MyDaughter]

Agreed...I buy the cheapest i can. be it from India, Canada, wherever, as long as its legal, im buying.

She only wanted "Made in the USA" stuff... um... GOOD LUCK.

 

[Muse600]

oops, I completely missed the drug!

the actavis brand refers to the promethazine w' codeine...they don't want other brands

 

[NaOH]

oops, I completely missed the drug!

the actavis brand refers to the promethazine w' codeine...they don't want other brands

Well, if it isn't purple, it just makes a mockery of the whole damn thing. If I wanted red drank, I'd just get a Hawaiian Punch.

 

[samuricool]

makes 'em more high? better street value?

Yes and I would presume so from the following.

The actavis brand of promethazine with codeine is what they use to make sizzurp, or the 'purple drank' as referenced by NaOH. The other brands dont get them as high.

 

[npage148]

Yes and I would presume so from the following.

The actavis brand of promethazine with codeine is what they use to make sizzurp, or the 'purple drank' as referenced by NaOH. The other brands dont get them as high.

I didn't know dye color altered the drugs' potency

 

[All4MyDaughter]

I didn't know dye color altered the drugs' potency

I wouldn't think so. It's probably an issue of perception or street value.

 

[Rx MPLS]

I've seen this request more often with non-CIIs, honestly. "I don't like the blue ones; they don't work! Only the yellow ones/brand name", etc. Though one customer getting fentanyl patches only liked one brand because another didn't stick that well...seems legit to me.

 

[BidingMyTime]

She only wanted "Made in the USA" stuff... um... GOOD LUCK.

I had a patient like that, she freaked out when she got a generic that wasn't made in the US. I showed her the bottle of the brand to prove that it also was not made in the US and it hadn't given her any problems. She was OK after it was explained that most drugs are not made in the US.....she really didn't know.

 

[Eichhoernchen]

I've seen this request more often with non-CIIs, honestly. "I don't like the blue ones; they don't work! Only the yellow ones/brand name", etc. Though one customer getting fentanyl patches only liked one brand because another didn't stick that well...seems legit to me.

Oh, the fentanyl not sticking well enough - I hear it all the time. And the Alprazolam pills not working when they're one color vs. the very well working blue or yellow pills or whatever.

 

[BidingMyTime]

Oh, the fentanyl not sticking well enough - I hear it all the time. And the Alprazolam pills not working when they're one color vs. the very well working blue or yellow pills or whatever.

The fentanyl patches really don't stick, I tell my patients to use some regular medical tape to hold them in place.

 

[Old Timer]

When they want the Actavis Prometh or the 602's or the oval alprazolam, I inform them directly they are exhibiting drug seeking behavior. Mr. Smith, I don't think you are a junkie, but this is what junkies do. I can't help you.....

 

[Ackj]

I once had a Mrs. White, and she only wanted white pills. I really don't think she meant it, but she took like 3 different things, and when the generic switched to something that was not a white tablet, they didn't work as well as the previous fill.

Another customer had an issue with a different generic for timolol eyedrops. He swore the new generic (from india) was defective since he couldn't get any drops out. The bottle just had to be pierced by tightening the cap, but he didn't know that because the previous one was already pierced and had plastic wrap around the cap. Even after we explained it to him and showed him how it worked, he still swore it was defective from "those damn indians."

 

[farmadiazepine]

i hate working in retail. this thread is simply the reason why.

i am all for consumer choice, but it depends on what you are talking about. when it comes to medications and things the consumer does not have the capacity to understand, they should not be given an option about which generic they can pick or brand vs generic or colors, shapes, etc. its asinine.

new york state is one of my favorite states for practicing pharmacy, one reason because of it's mandatory generic substitution law. all rx's whether it is written as brand or generic must be filled generically. there is absolutely no option for a customer to get a brand unless the physician writes down that its medically necessary. what an incredibly cost saving law.

 

[joetrisman]

Oh god. I have all the patience in the world when working retail, but I have no patience for brand vs generic conversations.

 

[Digsbe]

I had a potential new customer go on an extended rant about not wanting any "crap drugs from India" after she got Dr. Reddy's fluconazole (IIRC) from Kroger. She wanted my personal guarantee that we didn't buy any drugs from India. When I told her I couldn't promise that, she walked. I'm not sure we wanted a customer that whacky or high maintenance...

I had a patient call me at the pharmacy I used to work at and wanted me to tell her what country each of her meds were manufactured in. She ranted on the phone why it's wrong that they are outsourcing drug manufacturing jobs to other countries and didn't want anything from China. I pulled the stock bottles, one was from Israel and the other med from France (or Ireland, I can't remember). I told her this and she went on a racist rant regarding her medicines coming from Israel and then hung up.

As far as requesting manufacturers go I mostly see people asking for the blue Lortab since they are allergic to the white ones

 

[Momus]

I had a patient call me at the pharmacy I used to work at and wanted me to tell her what country each of her meds were manufactured in. She ranted on the phone why it's wrong that they are outsourcing drug manufacturing jobs to other countries and didn't want anything from China. I pulled the stock bottles, one was from Israel and the other med from France (or Ireland, I can't remember). I told her this and she went on a racist rant regarding her medicines coming from Israel and then hung up.

You can't argue with stupid XD

 

[Digsbe]

You can't argue with stupid XD

I wad fairly new as a technician at the time and began telling her how the drugs are FDA regulated and safe but then quickly gave up trying to reason with her since she was being unreasonable and wasn't going to tolerate my pharmacy's anti-American business model that placed patient health in the hands of the "evil Israelis" as she had said. You are right, you can't argue with stupid. I learned that doing so really only gives them a sense of validity. They are going to believe what they want because they want to believe it and no one is going to sway them.

Oddly enough she never transferred.

 

[NaOH]

This is the part of the thread where I would generally post a "I don't want to live on this planet anymore" image macro.

But I can't be bothered to. Not enough energy today.

 

[jawnly211]

activis for "sizzurp" or "drank"

watson for "norco" or "watson 540" and "vikes" or "watson 387"

 

[Sparda29]

Once when I was at CVS, we had a patient call up and ask if we could mix in some Sprite and jolly ranchers with their promethazine w/ codeine syrup.

 

[rxlea]

Once when I was at CVS, we had a patient call up and ask if we could mix in some Sprite and jolly ranchers with their promethazine w/ codeine syrup.

You did it, didn't you?

 

[Ackj]

You did it, didn't you?

He wasn't at a compounding pharmacy.

 

[Pharmavixen]

new york state is one of my favorite states for practicing pharmacy, one reason because of it's mandatory generic substitution law. all rx's whether it is written as brand or generic must be filled generically. there is absolutely no option for a customer to get a brand unless the physician writes down that its medically necessary. what an incredibly cost saving law.

That's similar to our practice in Ontario, where we must use generics unless the dr writes "no sub" or the patient specifies they want the brand name. For the public drug plan, the gov't only reimburses for the cheapest brand, so folks claiming "allergies to all generics" etc tend to be miraculously cured of said allergies or mysterious intolerances when we tell them what the copay is.

 

[Lnsean]

I've had a patient asked for a flu shot through the drive-thru at walgreens. I kid you not.

 

[rph3664]

I've seen this request more often with non-CIIs, honestly. "I don't like the blue ones; they don't work! Only the yellow ones/brand name", etc. Though one customer getting fentanyl patches only liked one brand because another didn't stick that well...seems legit to me.

IIRC, it was the Mylans that didn't stick very well. The nurses complained about that at the hospital too.

People will sometimes request a certain manufacturer because it does not contain a dye or other excipient ingredient to which they're allergic. I've also seen a child who was taking warfarin and was stabilized on a certain manufacturer (and for a child, I will DEFINITELY allow that) and someone else who discovered that the methotrexate from a certain manufacturer caused much less nausea.

But yeah, Watson 385s? Nope, not gonna fulfill that request.

 

[rph3664]

I've had a patient asked for a flu shot through the drive-thru at walgreens. I kid you not.

The community college in my old town had a drive-up flu shot clinic. The shots were given by nursing students.

 

[npage148]

've also seen a child who was taking warfarin and was stabilized on a certain manufacturer (and for a child, I will DEFINITELY allow that).

Some feel that Bio equivalence is less important for narrow TI drugs because of frequent TDM

 

[Jibby321]

Resurrection lives on!

 

[Sunshine98]

Anytime when the conversation starts out do you have this brand, color, shape or whatever....associates are instructed to say we don't sell by a particular brand, shape, color etc when it comes to controls or something that can be abused. What we have is what will be dispensed and once sold there is no refund. They try to ask if they can see it before hand, and the answer is no. That usually makes them walk away.

 

[CynicalIntern]

That's pretty fascinating that you have it in stock, since the Angry Pharmacist broke the news just today that Actavis no longer makes Promethazine with Codeine...

 

[sosoo]

I had a potential new customer go on an extended rant about not wanting any "crap drugs from India" after she got Dr. Reddy's fluconazole (IIRC) from Kroger. She wanted my personal guarantee that we didn't buy any drugs from India. When I told her I couldn't promise that, she walked. I'm not sure we wanted a customer that whacky or high maintenance...

the FDA recently closed down (shutdown) several Ranbaxy factories in India due to substandard quality. repeated failed attempts to keep products unadulterated. FDA is now boosting overseers in India due to poor quality control in India. so no the customer was not "high maintenance." she just dont want any "crap drugs from India." you should have more faith in your customers as they do read the news.

 

[wucool33]

That's pretty fascinating that you have it in stock, since the Angry Pharmacist broke the news just today that Actavis no longer makes Promethazine with Codeine...

Really?!?!?! That's great news!!! God I really can't handle another "I only want Watson, activis, and Dan Dan"!!!

 

[PharmDstudent]

the FDA recently closed down (shutdown) several Ranbaxy factories in India due to substandard quality. repeated failed attempts to keep products unadulterated. FDA is now boosting overseers in India due to poor quality control in India. so no the customer was not "high maintenance." she just dont want any "crap drugs from India." you should have more faith in your customers as they do read the news.

Good post! I really wish people had more faith... some of us actually care about our patients.

 

[sakigt]

the FDA recently closed down (shutdown) several Ranbaxy factories in India due to substandard quality. repeated failed attempts to keep products unadulterated. FDA is now boosting overseers in India due to poor quality control in India. so no the customer was not "high maintenance." she just dont want any "crap drugs from India." you should have more faith in your customers as they do read the news.

THIS.

Very VERY interesting read. http://features.blogs.fortune.cnn.com/2013/05/15/ranbaxy-fraud-lipitor/

 

[anon89]

For the fentanyl patches, you have to press and hold them down for 30 seconds. I had a rotation at a pain clinic and I always had to counsel on that.

 

[KidPharmD]

+1 on the fentanyl patches. Its a must-use counseling point for those patches. It also solves some of the sticking problems people occasionally have with the Mylan brand.

I also had a customer that didn't want any Ranbaxy products. Luckilly after the lipitor thing (man was that a hassle) we seemed to rarely have any of that particular brand. I think even the buyers at CVS realised how big of a risk that company was at the time.

 

[All4MyDaughter]

the FDA recently closed down (shutdown) several Ranbaxy factories in India due to substandard quality. repeated failed attempts to keep products unadulterated. FDA is now boosting overseers in India due to poor quality control in India. so no the customer was not "high maintenance." she just dont want any "crap drugs from India." you should have more faith in your customers as they do read the news.

Good necrobump on a post of mine from 2012... but I stand by what I said. You can't just assume "made in India" equals bad. There have been plants shut down in other parts of the world, and plants in India that had no issues. The customer just didn't like products from India.

 

[PharmDstudent]

Good necrobump on a post of mine from 2012... but I stand by what I said. You can't just assume "made in India" equals bad. There have been plants shut down in other parts of the world, and plants in India that had no issues. The customer just didn't like products from India.

LOL

 

[Ms.bk84]

when I float to certain stores, I get this statement a lot...

sometimes it's on a script by itself, other times it's on a pad from an urgent care center w' a z-pak

usually the patients are new the the pharmacy, and cash paying

they also ask "which brand do you have?" and if we don't have actavis, they don't want it

sup with that? makes 'em more high? better street value?

Z pak is a antibiotic to treat your upper respiratory illness and the "drank" they give is a cough suppressant with codeine to calm the pain

 

[Ms.bk84]

Anytime I get someone asking for a particular drug and is more persistent on that brand we put them on a watch list especially if they pay cash

 

[KimChiSlap]

Z pak is a antibiotic to treat your upper respiratory illness and the "drank" they give is a cough suppressant with codeine to calm the pain

Nice bump from 2014.
Sometimes, I feel like they are pretending to be coughing to get a Promethazine with Codeine, targeting a specific brand (has higher street value) otherwise why care about the specific color.
And the Zpak they may or may not pick up (depending if they have Medicaid that covers the whole thing) and may just toss the Zpak away.

 

[Ms.bk84]

I wouldn't think so. It's probably an issue of perception or street value.

Lol...
They see it in the music videos and follow their que Lol...
Many fail to know its true reason of use if they did they'd know its cause kidney failure if constantly overdosing yourself .....
Sleepiness is a symptom of overdose dummies

 

[Ms.bk84]

Nice bump from 2014.
Sometimes, I feel like they are pretending to be coughing to get a Promethazine with Codeine, targeting a specific brand (has higher street value) otherwise why care about the specific color.
And the Zpak they may or may not pick up (depending if they have Medicaid that covers the whole thing) and may just toss the Zpak away.

See and that's so true that's why pharmacies should flag people who ask for certain brand name drugs , they mix grape flavor into it and its a million dollar invention

 

[CetiAlphaFive]

The fentanyl patches really don't stick, I tell my patients to use some regular medical tape to hold them in place.

I know this is an OLD thread, but I feel like this has to be addressed:
A patient may have used or use duct tape, medical tape, Elmer's glue etc... to keep their patches on.

As far as I'm concerned, I'm always going to counsel a few things:

It's dangerous to use anything other than tegaderm & Bioclusive, etc... to keep fentanyl patches on.

You have to press patches on for 30 seconds for them to adhere properly.
You also have to shower or at least clean the spot regularly.

Some manufacturers will send off brand tegaderm to patients that contact them to complain that their patches don't stick.

Yes, it was reformulated. No, it's no longer a reservoir.

If I caught one of my RPhs telling people to use medical tape I'd still write them up.

 

[owlegrad]

I know this is an OLD thread, but I feel like this has to be addressed:
A patient may have used or use duct tape, medical tape, Elmer's glue etc... to keep their patches on.

As far as I'm concerned, I'm always going to counsel a few things:

It's dangerous to use anything other than tegaderm & Bioclusive, etc... to keep fentanyl patches on.

You have to press patches on for 30 seconds for them to adhere properly.
You also have to shower or at least clean the spot regularly.

Some manufacturers will send off brand tegaderm to patients that contact them to complain that their patches don't stick.

Yes, it was reformulated. No, it's no longer a reservoir.

If I caught one of my RPhs telling people to use medical tape I'd still write them up.

I'll bite. Why is it dangerous?

Sent from my SAMSUNG-SM-G920A using SDN mobile

 

[genesis09]

Actavis stopped manufacturing promethazine with codeine due to abuse. It hasn't been available since 2014. If you are too interested in what brand I have for a readily abused drug than I won't fill it.