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No refill on lamactil prescription, running out 3 days before I see the doc


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I've been titrating up on Lamactil to 100mg. My medication is prescribed by a general doctor; I see the therapist as often as I can, but she doesn't have the power to prescribe anything, and I don't see her until the 24th (the day I also see the general doc). Due to my shitty work schedule combined with my doctor's availability, I can't get in to see the doc before I run out of pills. I run out 3 days before I see her. Unfortunately, my prescription is No Refill... I feel like they basically ration my meds so I HAVE to come in to get my prescriptions renewed every month. Considering my work schedule, that makes things really fun!

 

So, I'm debating -- take the full dose and run out 3 days beforehand, or drop back to 50mg until I get my prescription? The refill will be for 100mg (probably) so I won't really be able to titrate myself back up. Unless maybe I can break the pills in half. Is temporarily going down and then going back up again in 2 weeks my best option, even if I have to split pills?

 

Obviously the pharmacist is powerless to do anything.

 

I know that this is stuff I should ask the doc but I don't have access to her. It's a public health clinic since I'm pretty poor. I just want to gather opinions based on other peoples' experiences with Lamactil, so I can decide which is the lesser of evils. I've heard of some pretty awful side-effects from going off cold turkey, and I'd really like to avoid them. I've been mostly stable on a 200 mg Seroquel + 100mg Lamactil combination, and I'd like to keep things that way.

Edited by Bubble
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You have other choices.

  • You can call the pharmacy and tell them what is going on. Most pharmacies around here will give you a few pills to tide you over for a few days. Usually not more than 3 or 4 days but that's all you need.
  • You can call the pharmacy and see if they'll call the doctor and get a refill authorized over the phone.
  • Call your doctor and explain what is going on. They already know you have an appointment. He/she might call you in a refill or give you an Rx for a few extra days.
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You have other choices.

  • You can call the pharmacy and tell them what is going on. Most pharmacies around here will give you a few pills to tide you over for a few days. Usually not more than 3 or 4 days but that's all you need.
  • You can call the pharmacy and see if they'll call the doctor and get a refill authorized over the phone.
  • Call your doctor and explain what is going on. They already know you have an appointment. He/she might call you in a refill or give you an Rx for a few extra days.

 

 

I'll go to the pharmacy tomorrow (it's a few blocks from where I work) and see if they could give me 3 days of pills or call the doc. I didn't really think the pharmacy could do anything, but I don't see why not to try.

Edited by Bubble
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Yeah, try the pharmacy. Otherwise try to get into see any doctor you can.  Maybe a walk in clinic. Last resort would be to go the ER.

 

As for full dose and run out early vs split the pills... If none of the above have worked and there's no way you can get more pills, I would split them yes. 

 

I ran out of Lamictal when I was skiing in the alps and it was an absolute nightmare. I just stayed in the chalet the whole weekend. I was dizzy, had feelings of dissociation/unreality. It was extremely unpleasant. 

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Can you call your DR and ask for a refill?  You wouldn't have to pay for that.  I'd tell her you see her the 24th, but will run out of meds 3 days early if you continue on the prescribed dose.  I do this if needed and not one DR makes me go without meds (meaning they will call in refills to the pharmacy).  Or if that DR isn't there, is there one covering for her?

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pharmacies call doctor ALL THE TIME

it is what they do, obtain permission to refill

 

mine does it regualarly 

 

I don't think you want to go off Lamictal cold turkey

and if you do there is a chance you would have to restart at the beginning

start at the beginning again

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Yeah, Lamictal is a dangerous drug to mess around the dosages with. You could have seizures among other things. I hope you got to see the pharmacist and that they could help you. For what it's worth, the pharmacy I go to (Walgreen's) has called my psych nurse several times to get refill authorizations, and it's never been a problem.

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Hi, I just wanted to update and say that I went to the pharmacy. They gave me 2 days' worth of medication (the most that they could) and are calling the doctor. Unfortunately, due to the turnaround time, I won't find out if she gave the o.k. to renew my prescription until Monday. I didn't know that asking at the pharmacy was even an option, so thanks to everybody who suggested going there.

 

The risk of seizures is exactly why I was extremely worried about running out of my medication. My current job is fast-paced and very physical, so there's no way I would be able to go to work with the sort of withdrawal symptoms I've read about.

 

The reason she was rationing my medication is partly because I was a suicide risk for a while, partly because I was titrating up, and partly because with the combination of meds I'm on, I guess the risk of side effects is enough of a concern for her that she wants me to have regular blood-work done. She also wants to regularly monitor my weight, blood-sugar, and cholesterol levels because Lamactil+Seroquel+Depo Provera is a perfect storm of weight-gain-inducing medication. I have a bad habit of never going back to the doctor unless I need a new prescription, and of putting off having blood labs done.

 

After a few months, I've only gained about 10 lbs and stayed there (although it has been really difficult). I think I'll be ok. There's no history of diabetes in my family. I think that after this refill, she may give me a few refills of the Lamactil.

Edited by Bubble
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pharmacies call doctor ALL THE TIME

it is what they do, obtain permission to refill

 

mine does it regualarly 

 

I don't think you want to go off Lamictal cold turkey

and if you do there is a chance you would have to restart at the beginning

start at the beginning again

yep.  I put all of my RX's on an auto refill. They usually start out having 3-4 refills. When it runs out, the pharmacy contacts my Dr.  I don't even know that it has run  out!.  They just tell me when to pick it up. Nice.

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Missing 3 days is bad, but I have had migraines where I couldn't keep anything down for 4 or 5 days, and I didn't have to totally re-titrate from the start, just start at a slightly lower dose for a few days. My pdoc knew there would be days I couldn't take it because of migraine, though.

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