Should I complain about this pharmacist's error?

[Wendi]

I'll try to be brief. I was prescribed an antibiotic, and picked up the prescription at the drugstore. After I got home, I checked one of those online drug interaction checkers, because I had forgotten to ask about an over-the-counter drug I am taking, and wanted to be safe. The online drug interaction checker indicated an interaction between the antibiotic and another prescription drug I've been taking for years. Concerned, I called the pharmacist, who said there was no problem with taking them. (Also, this drugstore chain has all my Rx records.)

 

A few days later, I began having some unusual problems. I called the doctor's office and asked the nurse if these problems could have anything to do with the antibiotic. She scheduled an appt. for me to see the doctor.

 

It turns out there IS a potentially serious interaction between the antibiotic and my other medication. The antibiotic apparently interferes with how my liver metabolizes the other medication, which can potentially result in dangerously high levels. Thankfully, my symptoms were not dangerous, and I have stopped the antibiotic and switched to a different one. However, if I had continued to take the antibiotic, I could have had some serious health problems.

 

Should I call the pharmacy? Write a letter? Should I also say anything to the nurse practitioner who prescribed the antibiotic, despite the fact that my records state (and I confirmed verbally) that I am taking the other medication?

 

Wendi

[Jean in Newcastle]

I'm not sure. Usually I've seen things like that handled by them telling you that there is a chance that in some people x could happen and that you should tell them if you have y symptoms and/or have your liver enzymes checked regularly. The fact that you asked and they didn't tell you the potential side effects is worrisome to me.

[Danestress]

I would think of it as giving them information that they need.

 

I am surprised that both don't have software that identifies potential drug interaction problems. If they do, and if it missed this one, they need to know that. But even if they don't, I would want to know if I were the nurse or the pharmacist, and I wouldn't think of you as "complaining" at all.

[Greta]

Should I call the pharmacy? Write a letter?

 

Yes! Whichever you feel more comfortable doing, but this definitely needs to be brought to someone's attention. Especially since you asked about this potential interaction. There is no excuse.

 

Should I also say anything to the nurse practitioner who prescribed the antibiotic, despite the fact that my records state (and I confirmed verbally) that I am taking the other medication?

 

Yes! When health care professionals make mistakes like this, people can die. You making a fuss about this might save someone else from going through what you did or something much worse.

[Greta]

I checked one of those online drug interaction checkers, because I had forgotten to ask about an over-the-counter drug I am taking, and wanted to be safe.

 

Would you mind posting a link? This has made me realize that I need to be more careful about what prescriptions I and my family take!

 

ETA: Nevermind, I found one. http://www.drugs.com/drug_interactions.html

Edited March 25, 2009 by GretaLynne

[JFSinIL]

I would think of it as giving them information that they need.

 

I am surprised that both don't have software that identifies potential drug interaction problems. If they do, and if it missed this one, they need to know that. But even if they don't, I would want to know if I were the nurse or the pharmacist, and I wouldn't think of you as "complaining" at all.

 

I HEARTILY AGREE! They need the wake-up call to be more attentive!!!!

[Stacia]

Yes! Whichever you feel more comfortable doing, but this definitely needs to be brought to someone's attention. Especially since you asked about this potential interaction. There is no excuse.

 

:iagree: I think you should mention it (preferably in writing, so there is a record of it) to both the pharmacy & the dr. office.

 

I think it is esp. imperative to contact the pharmacy (higher up the chain) because I would think (or hope) that drug interactions (and answering customer questions about them) is a major point in their pharmaceutical training.

[Tree House Academy]

I am not sure. I think you should have been made aware of the possible interaction. However, I take a drug that is metabolized in the liver as well and when I take Tylenol, it elevates my liver enzymes. As long as I am careful and don't take too much, I am fine. However, I KNOW this and that makes all the difference. So, yes, you should have been told. I put it on the sholders of the doctor more than the pharmacist. The dr prescribed it. The pharmacist should have had the info there, but he is the second line of defense, not the first. The doctor made the possibly dangerous mistake here, IMO.

[Sandy in Indy]

I am not sure. I think you should have been made aware of the possible interaction. However, I take a drug that is metabolized in the liver as well and when I take Tylenol, it elevates my liver enzymes. As long as I am careful and don't take too much, I am fine. However, I KNOW this and that makes all the difference. So, yes, you should have been told. I put it on the sholders of the doctor more than the pharmacist. The dr prescribed it. The pharmacist should have had the info there, but he is the second line of defense, not the first. The doctor made the possibly dangerous mistake here, IMO.

 

:iagree: I think the dr. should have been aware of the possible interaction. The pharmacist should also have been aware AND it should have been somewhere in the literature about the new med (if you actually got that). I wouldn't put the problem all on the pharmacist's plate.

 

A nicely worded letter to both of these health professionals would be appropriate, IMHO.

[MBM]

I agree with others that your doctor is at fault here, too, as well as the pharmacist.

[lionfamily1999]

It seems odd that the info was not available with the drug. IOW, whenever I've had to get medicine for myself or the kids, it always comes with a booklet, drug specific, that lists possible side effects, possible reactions to other drugs, things you should or should not eat/drink while taking it, and everything else you might want to know.

 

Maybe one letter, cced, to the pharmacy, the doc's office, and the manufacturer.

 

The ball was dropped a couple of times on that one. Kudos to you for finding out on your own!

[bettyandbob]

Unless you are seeing multiple docs and not telling each what drugs you have been prescribed (ie your internist should know if you have been prescribed synthroid by an endocrinologist or birth control by a gynecologist). Every doc I go to asks if I'm taking anything whether prescribed, OTC, Herbal, vitamin, or supplement.

 

So, assuming the doc had your health history, he made a big mistake and needs to be told.

 

I see the pharmacist as the second defense in this case. Yes, the pharmacist should have picked up the error. Most chain pharmacies have a computer link in the chain so they can check drugs you've gotten at any one of their outlets. Yes, the pharmacist needs to be told and you need to get information on the pharmacy's check points. Is it their policy to cross check for drug interactions? what internal audits do they have for the process.

 

Ultimately, you need to be responsible too. And you were. Most people don't understand that we cannot count on doctors and pharmacists to not make mistakes. Most people do not understand we need to give docs as much information as possible to help avoid mistakes.

[Staci in MO]

I'm a pharmacist, and if I did this to someone, I would SO want to know. And like the others said, your doctor needs to know as well.

 

There are so many things that could have happened in this situation. First of all, pharmacy software these days flags things as potential interactions that really aren't, so much so that it's becoming counter-productive. This doesn't make it okay that it was missed by any means, but pharmacists spend all day listening to their computers "cry wolf."

 

Also, some doctors have, in my opinion, a very cavalier attitude toward drug interactions. Part of this is understandable. Most potential drug interactions never come to fruition. But that's little comfort to the one person who does have a problem.

 

Regardless of where things broke down, you need to let them know. Both the doctor and the pharmacy. A nicely worded letter will get your point across and wake everybody up a bit.

[Harriet Vane]

:iagree: I think the dr. should have been aware of the possible interaction. The pharmacist should also have been aware AND it should have been somewhere in the literature about the new med (if you actually got that). I wouldn't put the problem all on the pharmacist's plate.

 

A nicely worded letter to both of these health professionals would be appropriate, IMHO.

 

:iagree:

 

It's not complaining. Bringing this to their attention will fix it firmly in their mind, and this problem will hopefully not happen to anyone else. It's worth fussing a little in order to make sure others will not risk the same adverse reaction.

[Only me]

I think they should be aware of their mistake so that it doesn't happen again. This kind of thing worries me.

 

Just last week my oldest dd was prescribed a cough medicine. The doctor wanted her to have an expectorant as well as a few other ingredients. My dd hates cough syrup. She would much rather swallow a pill. On my way to the pharmacy I realized that Mucinex has the same ingredients as the cough syrup. I asked the pharmacist about it and he said they were completely different medications. The cough syrup didn't have expectorant in it at all. I was stunned because that's the ingredient that her doctor wanted her to have the most.

 

I called the doctor and it turns out that another patient had the same problem. It turns out that the original cough syrup was not being made any more and we were given the generic form instead. The problem is that the generic form has different ingredients (in this case no expectorant).

 

This worries me because neither the doctor or the pharmacist picked up on this. The pharmacist wouldn't have told me unless I brought it up. I know it's not a huge deal that it was missing the expectorant. I just gave her another pill for that. What concerns me more is what if it was the other way around? What if the generic form had drugs not found in the original form and we weren't told about it. I would think that would have the potential of causing problems.

 

I always read the literature that comes with the meds but many people don't. They may think they are getting one thing and get another.

[Laurie4b]

I would write to both the pharmacist and the doctor. I would see what their response is. I would also consider contacting their supervisory boards. It's not a personal thing--it's a preventative thing for other patients. Someone could die from mistakes like these and what especially concerns me is that you were asked and were told it's okay.