Veterinarians write prescriptions for pet meds with a purpose, it's no accident that a specific drug and or dosage is chosen. Would you change a prescription your doctor gives you to another drug or change a dosage to save a few bucks, or because you read somewhere on the internet that you should do it? Your pharmacist, by law, can't simply say, "I have another drug idea," at least not without a doctor's permission. However, it seems, various suppliers on line and in stores are making decisions they're not supposed to make regarding our pets, as reported by Veterinary Practice News, and others.
There's been anecdotal evidence for som time. Now, more than one-third of Oregon veterinarians surveyed reported cases in which retail or online pharmacists changed the prescribed dose of a medication for an animal patient or substituted a different product without the doctor’s authorization, according to the Oregon Veterinary Medical Association.Some veterinarians even described cases in which an animal died or was euthanized.
The survey documented instances in which pharmacists did not follow the doctor’s orders, including changing a prescribed insulin product to a less expensive insulin, substituting a drug with one not indicated for the species, and filling a prescription at 10 times the prescribed dose or at subtherapeutic levels.
- “A veterinarian diagnosed an older dog with epilepsy and prescribed 15 mg of phenobarbital twice daily. When the client arrived at the pharmacy to pick up the prescription, the pharmacist (reportedly) told her that the dosage was too high and that she should reduce it in half. With the subtherapeutic treatment, the dog continued to suffer from seizures, until several weeks later when the veterinarian discovered the problem upon a recheck. The dog was euthanized.”
- "A veterinarian prescribed itraconazole (Sporanox) to treat ringworm in a cat. However, the retail pharmacy did not carry Sporanox but dispensed a compounded product that is unreliable and poorly absorbed in cats. The client elected to continue using the compounded product but experienced a treatment failure.”
The problem of pharmacists making unauthorized changes or otherwise misunderstanding veterinary prescriptions will only worsen, owing to a confluence of events:
-Independent pharmacies have given way to pharmacies owned by national chains, which, according to the National Association of Chain Drug Stores, now fill more than 72 percent of prescriptions in the United States each year. A common perception is that pharmacists who work for chains doing high-volume dispensing are less likely to develop the long-time personal relationships with patients and doctors once common with pharmacists working under independent ownership.
-Chain pharmacies, including Costco, Walgreens, Wal-Mart, Target and Kroger have aggressively entered the veterinary pharmaceutical market. But pharmacy education has not kept up. Knowledge of veterinary pharmacology is not required to become a pharmacist, and while many of the drugs are identical as used for people. Dogs, cats, birds, lizards, and other pets are decidedly not people.
-Legislation pending before Congress would promote the shift of veterinary prescriptions out of clinics and into “human” pharmacies. The Fairness to Pet Owners Act, or H.R. 1406, requires veterinarians to provide pet owners with prescriptions whether requested or not, along with a written notice that they may fill the prescription elsewhere, not making the bill (despite the name) really fair to pets or pet owners (though most pet owners are unaware of the potential new law).