Wife has ear infection. Doc calls in RX for polymyxin-b. Apply 2 drops in ear.
Pharmacy fills with polymyxin-b eye drops.
Google states ear drops are combo hydrocortisone, polymyxin-b, and neomycin. Pharmacy says only polymyxin specified and eye drops can go in the ear. I state they should have informed me they did not have the RX and I could have shopped around.
Am I overly sensitive ?

I do not think that you are at all "overly sensitive."

They definitely should have informed you that they were going to substitute an "equivalent" medicine.

I would have gone someplace else.

For reasons like this, I tell my prescribing doctor NOT to send the prescription directly to a pharmacy; give me a hard copy and I'll handle it from there.

quote:

Originally posted by V-Tail:
They definitely should have informed you that they were going to substitute an "equivalent" medicine.

The thing is, it's not a "substitution" or an "equivalent". It's exactly what the doctor prescribed. Per the OP:

-Doc calls in RX for polymyxin-b (only)
-Pharmacy fills with polymyxin-b (only)
-Google states ear drops are combo hydrocortisone, polymyxin-b, and neomycin


So the pharmacy is following what the actual doctor ordered, not what "Doctor Google" says, by dispending solely polymyxin-b, as prescribed.

If the doctor intended for her to get the combination of polymyxin-b/hydrocortisone/neomycin, he would have specified that medication.

I would confirm with your doctor if what they gave you is okay. They may have filled the active ingredient correctly but the other additives in the solution may render the drug useless for your ears. I imagine eye drops are made for more sensitive interactions with the eye compared to ears.

Rogue -- my post might have been wrong. It was my reaction to the OP, based on a most unpleasant experience that I had with a pharmacist, that might not be applicable to OP's situation.

My story: After being hit with Guillain Barré Syndrome, I had flashes of nerve pain in my feet. The doc said that Lyrica might help, so we tried that. No joy, it did not do the job.

Doc said we should discontinue the Lyrica and try gabapentin. I went to pick up the new prescription (gabapentin) on a Friday, after work. Pharmacist copped an attitude and stated that she would not fill the prescription. Reason: I was already on Lyrica and gabapentin was too similar and in her offshore wisdom ("educated" outside of the U.S.), I should not be taking both.

I told her that the Lyrica was not doing the job, doctor had told me to discontinue it and substitute the gabapentin, so I was not going to be taking both.

She was adamant, refusing to fill the prescription, and it was after doctor's closing hours on a Friday, so no joy for the weekend. Pissed off does not even begin to describe my reaction.

I went to a different pharmacy and when I realized that the pharmacist there was of the same ethnicity as the first know-it-all, I thought I was fucked, but I told him the story anyway.

He was rather upset, stated firmly that the first pharmacist had no business, none whatsoever, second-guessing the treating physician. He contacted the first pharmacy and demanded that they FAX the prescription information to him, told me to go run an errand or something and come back in twenty minutes. I did so, and when I returned, he had the new gabapentin ready for me, and just cautioned me to be sure not to take both that and the Lyrica. Over and done with.

My reaction when I read the original post in this thread was, "here's another pharmacist thinking that s/he is smarter than the prescribing doctor." I guess I was shooting from the hip, because of my extremely unpleasant experience.

polymyxin-b ear drops
Pharmacist had wiggle room and he used it to sell what he had on hand.
The ear drop application indicated another product. I like the idea of getting a physical RX. I also need to change CVS branches.
I guess I can't expect professionals to behave like it anymore. Everyone is just passing the time.
I seriously think expectations were higher back when I was working. Actually they probably were not at the end of my tenure. I can remember when customers and account managers started to accept that reason for an outage was a "glitch". No further action or explanation was required.

Our kids had tons of ear infections. We had crap insurance at the time. Those little bottles at the time were crazy expensive it came out to something like $43k a gallon.

Since you were not given a physical prescription, you need to check with the doc to see what exactly he ordered (called in). Talk to the doc (i.e., what's written in your medical records), not the pharmacist. Polymyxin B is never used as a stand alone drug to treat outpatient eye or ear infection. It's always in combination with one or two more drugs. There are several different combo formulations of Polymyxin B for the eye, one of them has identical combo as the one for the ear, which is (Polymyxin B /Neomycin/ Hydrocortisone). I'm going to call it P-N-H here for easier discussion.

The P and N are antibiotics to treat the infection, and the H is steroid to reduce inflammation. The drug concentrations are even the same for both the eye and ear formulations. The difference is in the dosing. For eye infection, it's 2 drops every 4 hours (or 6 times a day). For ear infection, it's 4 drops every 6 hours (or 4 times a day).

Thanks for the replies.
It would be similar to sending the wife to the gun store to get .35 cal. ammo for a revolver and being sold 9mm.

RE: 12131 explanation

I don't recall the drug names, but we were prescribed the same drug name on separate occasions for ear infection & pink eye, IIRC.
I too had to google, as we only had the bottle, not the box with the dosing instructions.

First I'd seen the same drug issued for different applications (eye/ear).

quote:

Originally posted by oldbill123:
Thanks for the replies.
It would be similar to sending the wife to the gun store to get .35 cal. ammo for a revolver and being sold 9mm.

From 12131's post, sounds more like sending the wife to get some 9mm WWB & she comes back with Wolf Steel Case.

Electronic prescriptions are what is current medical practice which avoids doctors writing, forged prescriptions and errors.
Typically ear drops would be N-P-H optic.
Eye drops are N-P-H ophthalmic.

quote:

First I'd seen the same drug issued for different applications

Wasn't Viagra created for helping hair growth and they found it made an excellent ED medication, that would be two uses for the same problem, lack of growth. I've also heard it's used to treat high altitude sickness... so it's a threefer...

quote:

Originally posted by HRK:
I've also heard it's used to treat high altitude sickness...

Sounds like it'd be quite handy for high altitude mountaineering... Pop a Viagra, and not only do you not have to worry about altitude sickness, you can also just jam your little friend into a snowdrift like an ice axe to slow yourself if you start sliding off the face of Mount Everest.

quote:

Originally posted by SIGfourme:

Electronic prescriptions are what is current medical practice which avoids doctors writing, forged prescriptions and errors.

Problem with electronic Rx is that it is sent to a specific pharmacy. Cost for the same med will vary around here, so I want to be able to check prices. Some common things, like Lisinopril, Metoprolol, Amlodipine, Cipro, etc. are FREE at Publix, even without insurance. Other things, like some statins, are ten times more costly (no exaggeration) at Walgreen than at some other pharmacies.

Also, I don't know which direction I might be traveling for work on a specific day, and I want to be able to take the Rx to someplace on my route.

As far as handwriting and legibility, that's not a problem with my Doc's office; the hard copy that they give me is computer-printed.

quote:

Originally posted by SIGfourme:
Electronic prescriptions are what is current medical practice which avoids doctors writing, forged prescriptions and errors.
Typically ear drops would be N-P-H optic otic.
Eye drops are N-P-H ophthalmic.

There is no "optic" in antibiotic eyedrop formulations, but the term would be nearly the same as ophthalmic.

I do both electronic and paper prescriptions. We have a small in-clinic pharmacy for the very common meds which we enter into the system and dispense. No narcs, though. For prescription meds that have to go out, we write paper Rxs.

had my ears pressure washed a few years back and after the nurse got through the doc came in and looked and said the inside looked a little irritated from me poking in there before going to the pros and so the doc wrote a prescription for an antibiotic drop.... went and got it... smallest bottle in the universe.... $185!

quote:

Originally posted by Blume9mm:
had my ears pressure washed a few years back and after the nurse got through the doc came in and looked and said the inside looked a little irritated from me poking in there before going to the pros and so the doc wrote a prescription for an antibiotic drop.... went and got it... smallest bottle in the universe.... $185!

That was probably Ciprofloaxcin. My ENT prescribed that for me for an ongoing infection in my right ear a few years back. I asked him about the cost and he said it was pricey, around two hundred bucks. I told him to prescribe something else. He said ..."hold on" and came back with several sales samples the Rep had left in his office. I tried it for several weeks and it didn't work as well as Neomyacin (sp) at a third of the cost. yeah, they were teeny little bottles.

No longer supply paper RX at my clinic. Drug abusers figured out how to "scrub" the written prescription then write in their own weekend cocktails of narcotics.

So looked at security, watermarked paper - that is a significant cost. So, made the decision of only digital RX. Don't like it - you're welcome to find another provider.

Andrew

quote:

Originally posted by El Cid 92:
No longer supply paper RX at my clinic. Drug abusers figured out how to "scrub" the written prescription then write in their own weekend cocktails of narcotics.

So looked at security, watermarked paper - that is a significant cost. So, made the decision of only digital RX. Don't like it - you're welcome to find another provider.

Andrew

Makes sense, all the scripts my doc does are electronic, he does them while you're sitting there in the room, great idea.

Not sure why anyone would want a paper copy, you have to drive to the pharmacy, hand it over, wait for it to be processed then go back and pick it up.

And as you said, way more secure...