Am i unreasonable to make a complaint to the pharmacy.

[Treebaubles]

We only have one pharmacy in our village. My DD(17) has had her Sertraline upped from 50 to 75mgs. I took the prescription there and they said they don’t do this dose. I asked if they could do it as 50+25 mgs which I know the Sertraline is available in, but they said they won’t do that.
I drove to the next village and that chemist was absolutely fine to dispense it as 50+25. WIBU to put in a complaint to the first chemist?

Absolutely.
Ring them and ask them again why they would not do this as another chemist did it no problem?

what was their solution, just ‘no’ ?

It's really up to the pharmacist at each location to decide if they can do it or not. Dispensing 2 boxes of meds instead of 1 costs double the amount for the pharmacy but they would only get paid for one item as that is how it's written on the script. It's unfortunate that the prescriber wrote it incorrectly. It's them you should be complaining about

Yes, they just said no. I thought maybe they didn’t have those doses so I asked if they could order them in? And they said they don’t do it like that.

@jomaIone how should the prescriber have written it?

Ds is prescribed 50mh tablets to take 1.5 tablets a day.

The dispensing pharmacy can only dispense what is written on the prescription so actually the one who gave it as two different doses technically in the wrong.

1 x 50
1 x 25

I would complain. Did you speak to the actual pharmacist? If not I would now, if you did I would ask how you are supposed to fulfil the prescription. I have to take 50mg of a medication one day and 75 the next. I have 50mg and 25mg tablets to allow this to happen
edited to add my prescription has 50mg x 28 and 25mg x14 as two seperate items. You may need to get your doctor to amend it to two separate prescriptions of 50 and 25 if it’s just one

I was prescribed the same and my pharmacist told me I had to buy a pill splitter and make my own 25mg tablets. I CBA and just took 2 tablets every other day, then asked to go up to 100mg at the next review. Maybe the 25mg are particularly difficult to get hold of?

They're not supposed to dispense in amounts different to what the prescriber has written and could get in trouble for it.
I had all sorts of issues with this while there were various medication shortages in the last few years.
If the prescriber writes tablets, they can't give you capsules etc etc.
I expect the second pharmacy had someone higher up that was able to authorise it or allow it off record, and the first didn't?
No point complaining as they actually did the correct thing, and I think that you should ask the Gp to write it on the prescription if you want the medication to be prescribed in 2 doses

Depends on whether they said they didn’t have it in stock or refused to order it in the future. If you needed it fulfilling this side of Christmas and they didn’t have it in stock then saying they couldn’t is fine, if they said they were unwilling to order in the dose in the future I would complain

How weird. Ok, I’ll email the pharmacy and ask them to clear up the issue eg. What the doctor should write on the next prescription in order for it to be dispensed. Or maybe I’ll just have to travel to the other pharmacy for this one prescription. The other pharmacist didn’t even question it which I why I found it so strange.

The second pharmacist may have been a prescriber, and the first may not. This would mean the second pharmacy would have been able to legally alter the strengths. The first pharmacy could have called the GP for authorisation, but this is likely a lot more hassle than it's worth. It's poor service, but I don't think worthy of a complaint.

Actually it's the GP who is mainly at fault, they prescribed a medicine that doesn't exist. Why haven't you considered making a complaint to them?

The lad I spoke to at the first place wasn’t a pharmacist, but the second one was. Maybe that was the difference?

Could you speak to them about if they can accommodate you ready for the next refill? At least they have some notice so can get it in? If not, then it seems like you have to make this new pharmacy your regular.

Because 75mgs is a recognised dose which the second pharmacy dispensed?

I’m not being purposely difficult, just asking, why can’t your DD just break the 50 tablet in half for the 25 part of the dose? I know it’s less convenient and I’m not saying you shouldn’t get it sorted if possible (which it seems to be as the second d pharmacist was able to dispense). My DH takes various tablets daily a sometimes he has to take half a tablet (depending on how it is dispensed on that particular month).

But it’s not an available tablet so the prescriber should be prescribing what is available. For a drug like setraline he should know but otherwise he can easily look it up.

he needs to prescribe either enough 50mg tablets for one and a half or a box of 50 and a box of 25

^^… correction…
Or maybe, according to PPs, it’s not about what is dispensed that month but how it is prescribed that month…?

At the end of the day, the first pharmacy can refuse to issue prescriptions if they don’t feel eg the patient will understand or take the medication correctly- it can be confusing to remember which dose is which and avoid overdose.

The second pharmacy were happy to take that risk and prescribe the prescription but that doesn’t mean the first pharmacy was in the wrong. You’re allowed to not have your name attached to something you’re not comfortable with in a work context - pharmacies have to check prescriptions and understanding etc.

According to the BNF Sertraline comes in 25, 50, 100, and 150 mg tablets. The prescription needs to specify what is needed, in this case it would specify a month’s supply of 25 mg and 50 mg tablets so the prescriber was the one at fault, not the pharmacy.

It's a recognised dose, but it isn't a prescribable strength. A 75mg tablet does not exist. If a GP writes 'sertraline 75mg tablets, take one daily' that is the legal prescription. It cannot be legally dispensed, because it isn't physically possible. The GP needs to write 'sertraline 25mg tablets, take one daily' and 'sertraline 50mg tablets, take one daily'. The second pharmacist may have been able to adjust the prescription if they had a prescribing qualification.

my dd could absolutely break them in half, but then she’d have needed the GP to write a prescription saying 50mg x 75(ish) , 1.5 to be taken a day. So now that I know that, I have asked the pharmacy to clear up what they would prefer to have on the prescription. I just assumed 50mg + 25 would be the most obvious thing to do rather than cutting one in half. That made more sense to me. And the second pharmacist gave it so it was ok with him. My DDs Doctor is the CAMHS dr, based about 40 minutes away and to get an appointment or new prescription at this time of year takes a lot of phoning and bit of a trek. Which I would have done obviously, but thankful I didn’t have to. Now I know that it’s maybe not the done thing, I’m even more grateful the second pharmacist did it for us. I’ll let the dr know next time, that there’s an issue with that strength.

Because the GP hadn't prescribed 50mg tablets. They had prescribed 75mg, and the original pharmacy couldn't dispense anything against that because it's not a thing. Sorry not trying to be an asshole, I know you're trying to help.

And yes, there is a massive difference between prescribing and dispensing. Prescribing is the act of writing the instruction to issue the medicine, and dispensing is actively supplying the box of medicine to the patient. Historically, GPs would prescribe and pharmacists would dispense. It is more complicated now, as a lot of pharmacists can also legally prescribe and dispense (and there are also dispensing doctors rurally). But in general, when you go to a high street pharmacy, they will be dispensing a prescription, not prescribing.

I'm confused as to how they can prescribe it as 75mg tablets/capsules when that doesn't exist in the select/drop down menu when prescribing.

It should have been prescribed as 50mg one daily, and 25mg one daily- I usually add a note that the total daily dose is 75mg- meaning you only have one charge to pay and not two ( assuming that you pay, if not it makes no odds to you but clarifies the situation)