Who should have done what? - Me and my GP

[JaneS]

I needed a repeat prescription for the pill I'm on. I would have taken the empty pack along with me, but as it happened I'd just taken the last one and DH binned in last night. So I didn't, though I know I am really not good at remembering long names. I know it's a progestogen of some kind, that's it.

The GP looked at my records, said 'what is this called' and tried to look it up in a book. He said he'd prescribe it using the data in my records, which was the special doctor's code, but he wanted to know the brand name and couldn't remember it right now. He didn't find it but thought it was Marvalon.

I took the prescription to the pharmacist and she gave me something I've never had before, which is called Gedarel.

I guess it doesn't much matter, no reason one contraceptive shouldn't work as well as another, but is it unreasonable to be a bit that the doctor

a) didn't know the name of what he was prescribing/what had been prescribed and

b) prescribed me something new, apparently without realizing he'd done so?

I've got a nasty feeling I'm at fault too here for not bringing the old pack in, but not too pleased with the GP either.

Yes, terrible isn't it winter. It's almost as if I'm assuming he has some kind of training I don't, and a record on the screen in front of him. What was I thinking?

well - thanks for the warning. It should be fine - it says on the pack to use extra protection for 7 days, I think most of them say that don't they?

Changing between brands of the same generic pill isnt the same as swapping between pills with different active ingredients.

I take 3 different medications over the course of the week and I can only remember the name of one of them.

Hmm.

I think everyone who takes medication should keep a list of what they take somewhere safe or know what they take. I don't care if you can't pronounce it properly as long as you vaguely know the name (either the generic name eg. Ibuprofen or trade name eg. Neurofen) works for me.

Meeting me in A&E on a Saturday afternoon when you need an urgent anaesthetic because you have broken your leg and telling me you take 2 blue pills and a green and yellow one but don't know what any of them are for isn't really terribly helpful.

Oh and if you are on medication for high blood pressure which has worked and brought your BP back down to normal you still have high blood pressure.

My own family (non medics) however don't seem to be able to grasp these concepts so I suspect IABU.

If youchange brands of pill you need to miss the usual 7 day break OR wait until 7 days after starting the new pill for it to be effective.

If the OP has actually been prescribed a different brand of the same pill then this is not an issue but it is if they are totally different. Therefore if there is a chance (which there is if your dh remembers different pills than you have) that you have a different one and you don't want to get pregnant then make sure you follow this advice!

'Meeting me in A&E on a Saturday afternoon when you need an urgent anaesthetic because you have broken your leg and telling me you take 2 blue pills and a green and yellow one but don't know what any of them are for isn't really terribly helpful.'

But that's not the same. I could tell you it's a progestogen. I don't know which one.

Not quite sure where the high blood pressure comes in - I though they checked your blood pressure when you went on the pill in case it rose, not fell?

There's a point at which I think this goes beyond lay knowledge.

Oh and telling your doctor you are on 'the pill' is all you would need to do if you went in as an emergency so you don't need this information in your head for that reason. Different for most other medication when dose and type are essential to know.

I always find it wierd though when people are happy to take tablets without knowing what they are but each to their own!

LRD
BP doesn't come into your scenario at all.

I was just having a mini-rant as the situation where people seem incapable of remembering what medication they take infuriates me. I'm not quite sure why the GP couldn't work it out from the practice records but I'm no GP expert.

(BTW yellow dinosaur if I am going to try to prescribe for a patient who only knows that they are on 'the pill' as LRD has discovered life isn't always very straightforward)

LRD bog standard progesterone only pills are sold as - cerazette, femulen, micronor, norgeston and noriday.

The pill you have been given is, I think - a combined pill and contains both oestrogen and progesterone.

I don't know enough about you, your health, what you were actually taking or current pill practices to know if this could cause you a problem but if you really were taking a progesterone only pill before you have changed pill type.

That was meant to be " I think Gedarel"

It is definitely a combined OCP.

Thanks gasman.

I don't remember words well, I ought to keep a better record (and someone suggested writing the name in my diary, which I've done now).

I'll have a look at the active ingredients on this to see if there is oestrogen in there too - I'm not meant to be on certain combined pills as there's a possible risk, so I may have to go back and check.

I do feel a bit nervous that although I'm so glad people with medical training are commenting, I should be able to go to the GP and not have to worry whether or not he's prescribed the right thing. I'm kicking myself that DH threw the packet away now.

you need training to remember a single word printed on a pack that you use every single day? I think kindegarten is that way ======>

OP - if you dont remember the name of your pill do you remember the dosing schedule? Did you have to take it at the same time of day?
Did you have to take it every day or could you take a break once a month?

Those things would help you determine if it was a combined pill or a progestogen only pill.

If it is Gederal it definitely has oestrogen in it (I've just looked it up in the BNF for you).

I can't comment on the GP thing (I amn't one) but if you are concerned ask them when you go in to explain to you what the problem was/is.

Writing it in your diary is a really good idea.

writer, I'm dyslexic, but thanks so much.

eviscerate - yes, I manage fine. Different kinds of memory, you see. I also know it's a progesterone-only pill, as I've said a few times. I just didn't know the name of it. Incidentally, I also knew it wasn't Cerazette because I have an old packet from that lying around (I keep packets for the ones I've tried and not liked).

I see from the pack it's a combined pill too, thanks gasman. I think I will give them a call on Monday and ask about that. I expect it's ok, it's just there's a note on my file saying this GP surgery isn't comfortable prescribing me Microgynon (another combi pill, if I'm right), and I'd like to know what the differences are.

I could be wrong, but it seems as if the problem isn't so much that he needed to know precisely which progesterone-only pill I was on, and I couldn't say - it was that he's switched me from a progesterone-only pill to a combined pill (or the pharmacist has, but I guess to do that they'd have had to misread the prescription).

Tba, I'd rather know what I'm taking than the brand name, because then perhaps I could understand why some are ok to prescribe me and others are not.

Sorry, that should as I've said to the doctor a few times.

I wasnt trying to imply that you couldnt remember to take the tablets, just that the way that you take them would tell you if it was combined or progestogen only.

Are you sure it was progestogen only before? Marvelon is a combined pill.

Sure - just thought I should explain because I know it can sound a bit odd.

I am sure it was progesterone only. The GP I saw previously (the guy this time was a locum) wanted to try me on progesterone only that wasn't Cerazette, because she didn't feel comfortable prescribing me microgynon. She said that microgynon is associated with risks for people who have a condition a bit like mine, and I would be better with a progesterone-only pill. I know she put a note on my file, because she showed me. She explained it at some length because I was fairly keen to stay on Microgynon if possible, as it worked well for me.

Marvelon is I think what the doctor suggested it might be - but I am not sure if I'm remembering that rightly. What I am sure is that he looked in his book for some time and told me he couldn't find exactly which brand it was I'd been prescribed previously.

I suppose it's possible there's something in Microgynon that's not in other combined pills, which would mean I could have them. I'll check on Monday.

WOODT - I'm a bit confused. I've downloaded the patient information leaflets for Gedarel and Marvelon from www.medicines.org.uk and they're shown below:

Marvelon:
Each tablet contains: 150 micrograms of the progestogen desogestrel, and 30 micrograms of the oestrogen ethinyl estradiol. Marvelon also contains the inactive ingredients: dl-alpha-tocopherol, potato starch, povidone, stearic acid, aerosol and lactose.

Gedarel:
The active substances are ethinylestradiol and desogestrel. One film-coated tablet contains 30 micrograms ethinylestradiol and 150 micrograms desogestrel.
The other ingredients are: Tablet core: Potato starch; stearic acid; all-rac-alpha-tocopherol; lactose monohydrate; magnesium stearate; silica colloidal anhydrous; povidone K 30. Tablet coating: Hypromellose; Macrogol 6000; propylene glycol.

I don't know if these leaflets are out of date or if I've found the wrong tablets (I noticed I've got a coated version of Gedarel, whilst Marvelon is uncoated, but that seemed to be the only version there with the same levels of active ingredient) but, to me, it doesn't look as thought the inactive ingredients are the same.

LRD - glad you're starting to get to the bottom of it and hope your regular GP is back on Monday and can explain whats going on :)

Thanks Tangle, I hope so too!

Tangle - the in-actives won't change the contraceptive effect and the ones that differ are not those which usually cause a bad reaction (they both contain lactose which is can be poorly tolerated)
Film coatings only really effect how easy the medicine is to swallow and to protect it during the packaging stage (the ones which effect how it works are the enteric coatings or modified release coatings)

Doctors are suppose to prescribe my active ingredients rather than brand name anyway.

delustionsofadequacy - thanks. My point was mainly in response to WinterofourDiscountTents, who'd stated upthread that Marvelon and Gedarel where identical. Interesting (although I guess it shouldn't be surprising) to know that there are in-actives that are known to cause problems. Does make me wonder why they're still seemingly quite common (then again, no doubt money will be at the bottom of it - so maybe it doesn't!) :)

Sorry just came across this - there is (or so I'm told by numerous pharmacists) a manufacturing problem with both marvelon and mercilon and therefore if you are prescribed either of these the replacement is gedarel (though in different strengths).

Your doctor actually did you a favour by giving you a prescription for the active ingredients (if he did) as I've had terrible problems going back and forth getting prescriptions reissued.

So glad I found this thread, went to the GPs for repeat prescription of Marvelon which they sent to the pharmacy and when I went to collect it yesterday they have given me gedarel, was going to do some investigations but assumed as Marvelon has severe supplier issues they had changed it but pleased to see it is the same product (essentially), have had issues on every other pill I have been on so hoping this will be okay.

JaneS is there anyway you could cut the name off the packet now you have it and put it in your purse, useful to know if ever there was an emergancy, can't think of a pill related emergancy but you know what I mean!

And thanks for the thread again!

Hi - I usually have Marvelon but none of the local chemists can get hold of it. I have been given Gedarel and told that it is the same drug and Marvelon, just a different make, ie Nurofen and Boots Ibuprofen.