Shocking GP has put me at risk - check your own repeat prescription!

[edam]

I am HORRIFIED (and frightened) by what my GP has done. I have epilepsy. Went to the pharmacy to pick up my repeat prescription for the antiepileptic drug on which, ultimately, my life depends. And the safety of my 2 year old ds.That's not an exaggeration.

Pharmacist put the scrip in a paper bag. Wasn't until I got home I discovered he'd dispensed a different drug - the generic version (like a supermarket own brand)instead of the brand name. The GP had done this without checking with my neurologist, without warning me, let alone with my consent.

Had to take the new drug last night as had run out of old supply - that's what I have a repeat prescription, FFS.

Today went to pharmacist, who told me Department of Health insists they dispense generics where available unless the prescription specifically says brand name. Because it's cheaper. Actually I knew this was a general rule, but never dreamt they'd do this with life-threatening conditions with no consultation with the specialist, or warning. My medicine has just come off-licence so generics now available. I've had to come home, phone my neurologist, and then call the surgery, and will have to go back to the pharmacy this afternoon and HOPE the pharmacist's order has come in. So I can take the drug which I am prescribed, which I have always been prescribed, and which my safety depends.

How dare they? How dare they change my prescription without talking to my neurologist? Epilepsy isn't something GPs handle, FFS, the neurologist is in charge.

If I wasn't a medical journalist, if I didn't know that generic anticonvulsants are NOT identical to the brand name, if I hadn't heard that late last year people with epilepsy were harmed by generics being dispensed (didn't think it applied to me as it was a different drug)... then my life would be at risk. And my ds's - what if I had a seizure and dropped him? Or injured him? Or left him unsupervised due to unconsicousness and he hurt himself? Or just bloody terrified him by having a seizure in front of him? Or died - it does happen.

If you have repeat prescriptions for a serious medical condition, please check your prescription before you leave the pharmacy.

I have no experience of epilepsy but find it shocking that a GP is allowed to make that kind of decision without consulting a neurologist first!

edam! Although I must say, I had no idea there was any difference between generic and branded drugs ? I've been gaily swapping between the two, however I don't have a life-threatening condition.
I went to pick up the drug I've had on repeat prescription for over 2 years, to find I'd been dispensed a completely different dose a couple of months ago. I rang the surgery, who said it must have been the pharmacists mistake, then when I went back to the pharmacy, they'd already sent the script away so had no evidence of what I'd been prescribed. After a bit of argy bargy, the dispensing chemists agreed to swap the drugs I'd been given with what I said I ought to have been given (3 x the stated dose!), which I was even more shocked about (although that didn't stop me making off with my drugs).
All seems a bit hit and miss (mind you, it's the only time it's ever happened to me).

This can also pertain to people w/hypertension! My dad was also switched to a generic to treat his hypertension - he must take a total of 6 different drugs, as he has coronary artery disease as well.

He had NO idea they were not identical to the brand name ones he had been taking. His eyes started bothering him. Typical, he thought, as a 67-year-old man who needs bifocals, and booked in to see an eye doctor.

When the eye doctor did the standard test to check pressure in the eye, Dad was off the chart.

His blood pressure was so high it was exerting extreme pressure on his optic nerve! He was a stroke (or another heart attack) waiting to happen.

He was immediately rushed to hospital, where it took 4 days of IV treatment to get his blood pressure back under control.

Bet that cost them more than if they'd just kept him on the bloody brand name stuff.

That's shocking, Expat and Frieda. Am off to the GP this afternoon to demand an explanation. She's asked me to bring in the drugs I was dispensed - I hope she isn't going to demand I continue to take them. Spoke to a prescribing adviser who works for a different area, who said GPs should NEVER switch patients without informing them. They say that I should be OK becuase 'there's no evidence' that the generic version of my drug is any different to the branded version. But generic version has only been on the market a couple of months, so they can't have any evidence that it is safe in practice, can they? I sure don't fancy being a guinea pig.

I happen to know something about the monitoring system for newly-licensed drugs, and that's far from imperfect. I want to know what monitoring system they have in place for the switch to generics. Bet it either doesn't exist or is hopeless.

I might see if I can write something about this - will take me a while to find out but when I do, would it be OK to CAT you, Epis and Frieda, for some more info? Don't feel obliged or anything, but it would be good to bring it to attention more widely and get someone to take notice that this is an issue.

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You can CAT me, edam, but my father is American and is covered under a universal healthcare plan for over 65s in the US, so it might not be relevant to what is happening in the UK - although they're doing the same thing, trying to cheap out on peoples' lives. The drug he was using is marketed as Accupril in the States, but I'm not sure what it is in the UK.

He, too, is on a repeat prescription for life and receives a 90-day supply of the drugs he used by post, so he gamely just thought it was the same thing and was taking it as usual.

Little did he know . . .

Of course, edam. I'd be happy to help if I can .

Not quite the same, but I was advised by the same GP to take a certain over-the-counter remedy for sinusitis ? good job I read the leaflet in the box, because it was contra-indicated for use with the long-term medication I'm on. Complete waste of £3.20, although it could have been worse, I suppose!

Frightening, isn't it? Frieda, Expat, I'll be in touch after I get back from holiday (off for a week now... although that's looking dodgy too suddenly. Not my day today).

Good news is, GP very apologetic, says it wasn't intentional, they know perfectly well they shouldn't mess around with anticonvulsants and wouldn't dream of switching me. It's because my prescription has always been written as the generic name - it was interchangeable with the brand name until May because there was no other version, Glaxo's drug was it. Now there is another version obviously you have to be far more careful about specifying the brand name.

I'm worried that the pharmacist originally tried to persuade me that generic was OK. Did some research which confirmed my initial suspicion that actually it wasn't. Turns out Lamictal (lamotrigine) is the trickiest anticonvulsant to get right in terms of dose and pharmacokinetics - basically you really don't want to mess with it, you want to take the same amount at the same time every day. Any alteration can change the effect it has on your brain (and your body). Apparently even a change in diet can affect it. So why did the Department of Health write to docs and pharmacists back in March to say 'there's a generic version coming out, it hasn't been licensed yet but we are sure it will be fine, make sure all your patients are on it?'!

I really think there's an issue here.

OMG, Edam, that's v scary - are you a freelance medical journalist? Can you write something pertinent?

Shocking edam. I suspect its because the people deciding the policy aren't up enough on the medical side. thank goodness you know as much as you do, but frightening for those that don't.

HM, yes I am and I will - when I get back from hols (if they happen, but that's another story). Have always thought the switch to generics had potential to cause patient harm. Drugs may have the same active ingredient, but very different manner of action, IYSWIM. And contain very different non-active ingredients - new one contained two food colourings that are common allergens. Great.

JJ, you are joking?! People deciding policy probably run this past tame in-house docs and their drug regulator who probably says 'hey, go ahead, but put in a clause saying GPs can do their own thing if they must, just to cover us. And then get the prescribing adviser at the PCT to harass any GP who dares inflate the prescribing budget by using the brand name'. It's only alert patients/bloody minded GPs that will spot this and stop it happening inappropriately.

Fine, if it's an antihistamine, it won't make a blind bit of difference. If its an immune-suppressing drug for a transplant patient, or an antihypertensive for a heart patient, or me, it bloody will. Spoke to a prescribing adviser who says Dept. Health think it's just drug companies are trying to persuade patient groups to kick up a fuss, when it's not necessarily inappropriate. Great, so DH won't listen to reason because they'll assume it's just 'daft patients conned by the drug companies'. Funny how they are happy to collude when drug companies get something wrong, but brush it off when they are right.

gosh thats quite worrying, i am on a range of medications and just lately they have all been changed from brand names to generics, which my gp assured me was ok, i wasnt happy ill admit.

i had a similar thing with my adreneline injection, they have changed it twice now, i only found out when i opened the boxes, the stuff inside is the same, but if you start to go into anaphalactic shock you really dont wanna to be trying to work out the difference between a mini-jet and an epipen.

my 4yr old son has congenital hypothyroidism and has to take thyroxine every day. without it he would have impaired brain development, metabolism, growth - everything. Used to be called Cretinism. With it he is fine.
He was swapped onto a generic without me realising, and on his next routine blood tests it showed that he had no thyroxine in his system. Whether it was a crap batch or he just couldn't absorb it no-one knows, but he was basically unmedicated (despite taking his daily pills) for FORTY DAYS.

I can't tell you how spitting mad I was about it. He is on branded thyroxine now and I'm watching his repeats like a hawk.

princesspeahead, thats interesting as i take thyroxine and have been switched to a generic.

PPH and spacecadet, I'm shocked and horrified. This is outrageous and is clearly going very, very wrong. I am going to take this up professionally.

please do edam.

This is really scary. Trying to think of people I know who take regular medication now...will ask them to check their prescriptions.

Am

spacey I'd really go for a blood check after you've been on them for 2-3 weeks. his tsh went up to NINETYFIVE and his T4 was nowhere. awful. after 3 weeks of being on the branded ones again he was pretty much back to normal (TSH about 9 so still a little high so we upped the dose a tiny bit).

edam I'd be delighted if you would. feel free to CAT me if you like...

pph, have been on generics for about a month now, am due a retest monthly anyway as am preg, they do the full works at the hospital, tsh, t4 and t3, my t4 was only 9 last time it was checked which is the low end of the scale anyway, will be interested to see what happens at next blood test.

ninety five, thats awful, your poor ds, he must have felt really ill.

the odd thing was he didn't produce any of the really obvious signs - wasn't lethargic, sleepy, cold, etc etc. But he was INCREDIBLY clingy and weepy and he did have an unexplained fever that came and went for 3 weeks. We thought it was a virus, and maybe it was, but maybe it wasn't. Or maybe it was, but the reason he couldn't shake it off was because his metabolism was running so slowly. Anyway he is back to his lovely bright independant smiley happy self thank god.

congrats on the pg as well - guess you are having very regular checks because of that then.
I'm 16 weeks - how far along are you?