Prescription Advice

[Doug]

Hi,
We are still playing with my INR, it was 1.5 last Monday, so the doctor had me double up on the warfarin. The cardiologist uses an INRatio, so I got my first chance to see one in action.
When I left the hospital, they prescribed Warfarin 2.5 mg tablets once a day as directed. When the doctor had me double up for the last week I asked my pharmacy to refill my prescription. The pharmacy refused because it is too soon (funny thing is they had no problem refilling the hydrocodone a little early though.)
How do you get your prescriptions for warafin written so you can adjust the dosage as directed by the doctor and not have a need to have several outstanding prescriptions at the pharmacy?

 

[Bina]

Simplest is the ask the doc for a second prescrip.
Mine is 2mg and 3mg which allows me to make up all kinds of dosing if needed, and has kept me on only one pill per day.
Don't take any crap from the pharmacist, I told him along time ago to not mess with me and my meds because I will be on them for life and I know what I am doing, and if he had a problem with that he could call my doc.
He shut up after that.

 

[catwoman]

Doug:

Sounds like you're going through insurance, since the pharmacy wouldn't refill it yet.
You'll find that you may need a couple of different strengths on hand, to adjust your dosage according to INR.

I've been on warfarin 6.6 years. My family doctor writes my Rxes at my annual physical. I've been going to him for about 25 years. When I wanted to change from trademark to generic warfarin, he was hesitant, but agreed since I have my own tester. (I didn't notice any difference in INRs with the change.) At that time I told him I had read in the AARP magazine that one way to cut your Rx bill was to -- when possible -- get Rxes filled for double the amount and halve the tablets. He agreed and said he regularly does that for patients.
So he has written Rxes for 90 tablets of 1mg, 2mg and 10mg to be refilled 3X. (I've stopped getting the 2mg tabs filled.)
My dosage has varied over the years, but it stays in the range of 5-6.5mg. I can get the Rxes filled twice a year and that should keep me in tablets, at least the 10s. I may need one more refill of the 1s. I spend about $40, maybe $50 if I get an extra refill of the 1s, per year for my warfarin this way.

 

[Ross]

Make sure the doctor writes on the prescription or calls it in as "Take as needed". If you find that 5mg tablets work for you, have your doctor write or call in double the monthly quantity so that you can split them in half as you need too. In other words, rather then 30 for a months supply, have him call or write in 60.

If your doctor is putting take one tablet daily, that's why your running into trouble with the insurance company. They see that your only given 30 tablets per month, so unless 20 days have passed since you refilled, they'll automatically reject the request. I had to call my insurance company and raise heck for the same reason. Poor girl that took my wrath said that it's not the humans fault, but how it's entered into the system. They realize that Warfarin is a variable dosed drug.