Pharmacist prescribed wrong dosage

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Hi, I have epilepsy and my pharmacist gave me 200mg instead of my usual 500mg on my repeat prescription. I have been feeling really ill lately, like I'm going to have a seizure and didn't realise until I looked at my medication that I have been taking less than my normal dosage. Am I being unreasonable to complain? I think I should seek medical attention too.

Your prescription is 500mg. You received that. The fact you made assumptions and didn't check what you were taking isn't the pharmacist's fault.

This has happened to me. I take 75mg thyroxine. I received 1 box 25mg and 1 x box 50mg. Like you the pharmacy didn't flag up / explain why it was dispensed like that. Rather then just blindly taking 1 pill, I checked each of the boxes and just made sure I took 1 of each.

You need to take responsibility here for not checking. If this is something you're not capable of (not saying that is the case) you should request a dosset box.

It hasn’t been dispensed incorrectly, you just seem to have no idea what you’re supposed to be taking and can’t even be bothered to read the labels.
If the pharmacist was a locum he/she would have no idea what size tablets you normally receive unless it specifies it on the prescription, also, when I used to get a repeat prescription it was often made up by the pharmacist a day before I picked it up and would just be waiting on the prescription shelf and I would be served by a shop assistant in the chemist, it’s up to me to read the dosage instructions. I’ve more than once had my medication made up of smaller amounts when there has been a shortage of the higher dosage and anyone on medication without the mental capacity to take it safely by themselves would have a health visitor or carer to help them so that is a stupid analogy to make and a complete cop out due to your own lack of responsibility.

I have the same set up with thyroxine. Take one of each strength to make up my dose. Neither the pharmacist nor the GP explained this proactively, I used common sense, read my medication (and the instructions) and then asked. You should always take ownership of your own health.

YANBU, but how you posted this originally was really confusing

Medical negligence claim here I come

However this makes you look a bit of a dick.

@lindorballs - really? Admittedly my experience of prescribing is predominantly with hospital pharmacies. I have always prescribed a dose rather than a specific strength/formulation unless crucial to the type of drug.

What should have been done in this case?

Presumably the GP was contacted and approved dispensing of different strength if it was the case of that or go without?

I take 75mcg of a medicine daily. I thought it was odd that my GP has prescribed this very exactly as 1x 50mcg and 1x 25mcg daily, instead of just stating a dosage and allowing the pharmacist flexibility to whether to supply as 50+25 or 25+25+25. But maybe not, if others on the same medicine are easily confused (which can come with the related issue).

*Medical negligence claim here I come
*
This is where you lost all sympathy from me OP. Please don't bother wasting everyone's time and money. The pharmacist should have explained things to you but you also have a responsibility to check your own medication! It doesn't even seem like you know what dose you're supposed to be on! And you keep going on about people without mental capacity etc, most people without the capacity to sort out their own medication have someone that does it for them.

You sound totally clueless about your own medication. It is your responsibility to check what you are taking. There is no medical negligence.

Just read the labels next time. They've not been negligent, they've not hidden the dosage or only provided you with a lower dose. Not only have you not been hurt by this, so do not have a case, all they'd have to say if you found an ambulance chaser lawyer is 'we did tell them'.

I read everything, as does the OH. When he brings me medication because I CBA to get up and get it myself when he's tall enough to reach the cabinet without tiptoeing, not only does he read the box/check the blister packs to be certain they match, as he gives them to me, he repeats exactly what they are just in case he's made a mistake. And we'll both do the 'the time is/was x o'clock, at 8 in 24 hrs/x times a day, that means the next dose is not before y o'clock' both at the time of taking the first dose and immediately prior to taking the subsequent.

It's just what you do when you take long term medication (or have a history of allergic reactions - you always doublecheck in case somebody has forgotten in prescribing that you're allergic to that class of meds). Read the boxes, read the patient information leaflets (as they change from time to time) and CHECK what you are taking.

Fleabag hospitals have different rules. It’s to do with how community pharmacists reclaim the money for the medication they dispense. They would need to get any amendments approved by the prescriber and ideally a new prescription issued in most cases. In a hospital the pharmacist can just dispense whatever they like to meet the prescription.
I actually work in a GP practice not a pharmacy (as a prescribing pharmacist) and literally had a patient a couple of weeks ago where this exact situation occurred. I phoned the patient and explained I was going to give them a prescription for 300mg + 200mg tablets because 500mg were unavailable. I told them exactly what they needed to do and made sure the instructions on the prescription explained they needed to take both strengths. Communication by both the GP and pharmacist sound like they were less than ideal here but it sounds likely that you were given the correct tablets so you would not have grounds for a medical negligence claim. A more productive way forward would just be discuss this with your pharmacist so they can learn and improve their communication next time.

One other thing to consider, when an electronic prescription is dispensed and then collected by the patient rather than a physical paper script taken in and waited for, the person handing over the package may not be the person who prepared and made up the prescription - and that person may not even be on duty when the patient collects so would not necessarily know to advise that a combination of strengths have been dispensed. And, it’s entirely possible the pharmacy contacted the surgery when they found there were no 500mg tablets available, and got permission to dispense the combination doses

PP that would be the same for any repeat prescription, whether paper or electronic.

You definitely need to complain, anti epileptic meds can vary significantly even by brand for the same dose due to the 'pressing' when the tablets are manufactured. The pharmacist is at fault for not ensuring the correct tablets were dispensed and for not ensuring you understood that you needed to take two different tablets instead of your usual one. I hope you feel better soon OP x

OP, was it a pharmacist who gave you the tablets or the assistant,.have you managed to sort this out and spoken to a doctor yet about what you should do hope you are ok

They did not prescribe the wrong dosage.

I am a vet and I must say, when I am in this situation I DO write on label "please note change in tablet size" and sometimes leave a note for whoever is dispensing to owner. But that's purely because I know there are a load of numpties out there who cannot and will not take responsibility for themselves.

Yes they could have (should have) said something but take some ownership OP

Unless you have learning difficulties, severe mental health issues or cognitive difficulties I'm not sure why you would be able to make a negligence claim? It's not anyone's fault you didn't read the strength of the tablets and the dispensing labels, or didn't bother learning what dose of medication you were on in the first place.

I’m going to have a pedantic rant. The pharmacist didn’t prescribe the medicine, the doctor did. The doctor prescribed the medicine, the pharmacist dispensed it.

(I know some pharmacists can prescribe, but that deson’t Seem to be the case here)

Also the foil strip for epilim 200 is silver, for 300 it's blue and it's purple for 500 if my
Memory serves me right, and the tablets are completely different sizes, so how the op didn't notice I don't know....

I hope the medical negligence comment was a flippant one.

Doctor prescribed medicine, pharmacist dispensed it. Should they have communicated this to you? Probably. However, the dosage is printed on the box, on the leaflet and on the blister pack (unless it was in a bottle, but it would still have been printed there).

Playing devils advocate here, but if you have been managing your meds for years it’s not unreasonable to expect you to have done so. I didn’t realise that lack of meds could cause confusion with epilepsy but surely on the first day of the new tabs you would have realised something was different?

Ring the GP, out of hours service and ask their advice. I hope you feel better soon.

and didn't realise until I looked at my medication that I have been taking less than my normal dosage

Do this first, and foremost, when you next pick up your prescription.

A few weeks ago I noticed I was dispensed 10 mg amitriptyline tabs and I was supposed to receive 100 mg ones! Pharmacist owned up to her mistake but really?!

As someone who takes medication daily (some that would potentially kill me/cause irreversible damage if taken wrong) I really think you need to use this as a lesson. You need to find out what mg of meds you need to take daily. You shouldn’t be assuming you are on 500mg or maybe 1000mg. You should know. You also need to get into the habit of checking the medication.
It’s kind of irrelevant if it’s the pharmacy’s fault or not because the consequences are 100% yours (regardless of any potential law suite)
I wouldn’t complain to the pharmacy because it’s 50/50 blame. I would speak to them to let them know that this has happened though

A few weeks ago I noticed I was dispensed 10 mg amitriptyline tabs and I was supposed to receive 100 mg ones! Pharmacist owned up to her mistake but really?!

They don't make 100mg ones 😳

It doesn't sound like a dispensing error to me, you were given the right medication and the correct amount.

Agree it would have been helpful for the pharmacist to explain how to take them.