After you leave the doctor’s office, you may
find that there is an issue with the drug you were prescribed. You may be
wondering whether you have to make another trip to the doctor or if your
pharmacist could just change your prescription. The answer to this question
depends on what state you live in, but there are generally a few things
pharmacists are allowed to modify.
A pharmacist can change your doctor’s
prescription in these ways:
- Therapeutic Substitution:
Switching out a prescribed drug with another drug in the same class.
- Generic Substitution: Giving out a
cheaper generic version of a brand name drug.
- Pharmaceutical Compounding:
Changing the form or taste of the drug to make it easier for the patient to
We provide more details about each of these
What Is Therapeutic Substitution?
Therapeutic substitution occurs when a
pharmacist switches a prescribed drug for a different drug from the same class
that has the same clinical effect. This type of drug switching (also called
therapeutic interchange) could save a patient money, avoid side effects, or
provide medication more quickly in the case of a shortage.
Your pharmacist may or may not be required to
get your doctor’s approval before conducting therapeutic substitution. It
depends on the specific drug and what kind of switch is occurring, as well as
the laws of your state.
Risks Associated with Therapeutic Substitution
There are some types of medications that are
not good candidates for therapeutic substitution. For example, antidepressants, cardiovascular
medications, and epileptic medications should not be changed since doctors work
closely with patients to find the right type of drug and exact dosage required.
Pharmacists may substitute medications without
notifying you beforehand. If you do not want your drug to be substituted at the
pharmacy, ask your doctor to note that on the
prescription by writing DAW (dispense as written), “medically necessary,” or
“may not substitute.”
Can a Pharmacist Change a Prescription to Generic?
Your pharmacist can often change a brand-name to a generic drug to save
you money. They may do this automatically, or they may call your doctor for you
and get an updated Rx. If your doctor prescribes you a name-brand drug that
you’re struggling to afford, ask your pharmacist for a generic version.
Could You Save Money by Switching to a Generic Drug?
Can a Pharmacist Change My Dosage?
A pharmacist cannot change the dosage of your
prescription without talking to your doctor and getting their approval.
However, the pharmacist may decide how best to dispense medications. For
example, if your doctor prescribes 50mg of a drug to be taken daily, your
pharmacist could give you 25 mg tablets and instruct you to take two daily. Or,
they could give you 100mg tablets and tell you to split the pills, if the medication is safe to split.
What is Pharmaceutical Compounding?
Pharmaceutical compounding refers to the process of changing a medication so that
it is easier for a patient to take. This may include changing the form from
liquid to tablet or vice versa, adding a flavoring, changing the method of
administration, eliminating inactive ingredients (such as allergens), or
adjusting strength or dosage.
In short, pharmaceutical compounding is a way
of customizing a patient’s prescription to fit their unique needs. When
compounding, a pharmacist will work with you and your doctor to find
the best solution.
What If My Medication Isn’t Working?
If you find that a drug your doctor prescribed
is not working for you, a pharmacist cannot override a doctor’s prescription.
You should see your doctor and have a discussion about the medications you are
taking. It’s important to understand why your doctor prescribed a particular type
or brand of drug.
Here are a few scenarios where you might need
to modify a prescription.
Your doctor may have missed a potential drug or supplement interaction that your pharmacist catches. This is why it’s important to always inform your doctor and pharmacist of all drugs and supplements you’re taking.
There are also technology tools (like the free virtual Medicine Chest available from ScriptSave WellRx) that can automatically alert patients to potential adverse interactions for the medications they have been prescribed.
Adverse Side Effects
If you start to develop uncomfortable or
dangerous side effects, let your doctor know immediately. Some side effects can
be life-threatening. Be sure to carefully read all the information about your
prescribed medication and report side effects as soon as they occur.
You may find that your insurance company doesn’t cover a certain brand name or type of drug.
In some cases, pharmacists can automatically substitute a drug that is covered
by your insurance formulary.
Always Check Your Medication at the Pharmacy Counter
The next time you get a prescription filled,
carefully check the medication that’s dispensed to you. Make sure the name and
dosage match what your doctor wrote on your prescription. If it doesn’t, ask
your pharmacist what has changed and how it will affect you. In many cases,
pharmacists will automatically switch to a generic drug to save you money.
If you must have an expensive brand-name drug,
know that there are several ways to save on prescription costs.
Manufacturer coupons and patient assistance programs are available to patients
who qualify. ScriptSave WellRx also offers a discount drug card to anyone, free of charge.