Monday, March 27, 2017

A Different Kind of Oxycodone

Ms. Waldo hands me a prescription from her dentist. It's for Percocet 5/325, quantity 30.

"Does the dentist know you're taking Oxycodone?" I ask, knowing that she gets 30mg, quantity 150, every month.

"I don't know," she replies. "Is there a problem?"

"This likely won't go through on your Medicare insurance because you're already taking Oxycodone 30mg several times each day," I reply. Somewhere, somehow, I know @PharmacistSteve's ears perked up.

"Yes it will! This is from my dentist! My Oxycodone is from my physician!"

I'm amazed at her expertise so I try to process the claim. Medicare kicks it back with a message about exceeding recommended quantity limits.

"As I feared, Medicare won't pay for it. I can try our in house discount and see..."

"UNBELIEVABLE!" she retorts. A guy over by the eggs on aisle five turns around, shocked. "Why?!"

"You're taking five tablets of 30mg Oxycodone every day. The additional Oxycodone in the generic Percocet will push you over their daily limit of Oxycodone in a patient your age. Besides, it really isn't going to help that much..."

She cuts me off. "UNBELIEVABLE!" The guy over at the eggs hears it again. Apparently this scared him because he rushes off. And all I can think about is the guy from The Princess Bride.

"What do you mean it isn't going to help?! This is for my dental pain! My other tablets are for my back pain," she says, angrily.

"You're taking 150mg of Oxycodone every day. An extra 5mg to 15mg of Oxycodone in the Percocet each day isn't going to help much. Your pain will be addressed by the..."

She cuts me off again, "UNBELIEVABLE! How do you explain that this Percocet is helping me?"

"It's probably the Tylenol in it. Tylenol is great for mandibular pain."

"NO! Tylenol doesn't do anything for me! It's a different kind of Oxycodone."

Yes, fans, with God as my witness, that's what she said. It's a different kind of Oxycodone. All those years of pharmacy school. Thousands of dollars of tuition being paid back and I missed that lecture. I feel cheated.

"No, it's the same Oxycodone," I state. You'd think I'd know since I'm the pharmacist. It says so on my name tag.

"UNBELIEVABLE!" she spits out again.

Reluctantly, she accepts the discounted cash price. Reluctantly, I dispense the 15 tablets of generic Percocet: the one with the different kind of Oxycodone in it. 


Rav said...

What I find unbelievable is that the physician is prescribing such high doses. And the dentist didn't ask what else she is taking before prescribing percocets.. I hope she is getting adjunts and exercising that back since we know opioids don't work and cause more harm.

Anonymous said...

I can't believe you filled the damned thing. I'da called the dentist & made re he was aware of the other oxy rx & suggest he void the rx. In my experience,the pt. never informs the dentist of other pain meds.

Depeche said...

Really...since we know opioids don't work. Really? I hope you aren't another MD letting your patients suffer in hell you say...opioids don't work. There's to many like you already. Frauds with a licence.

Unknown said...

I probably would not have filled it and documented my refusal. In my humble experience patients never tell the dentist that they're already on chronic pain meds.