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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 take.

We provide more details about each of these below.

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.

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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.

Potential Interactions

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.

Insurance Coverage

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.

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