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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by zonked on June 17, 2011, at 9:25:40
.. why we in the US get our prescription pills in amber-colored bottles (or sometimes the manufacturer's bottle), while nearly everywhere else seems to get their meds in boxes of blister packs?
It doesn't matter. Just curious. =)
-z
Posted by Phillipa on June 17, 2011, at 11:04:16
In reply to Does anyone know..., posted by zonked on June 17, 2011, at 9:25:40
Amber protects the ingrediants of the medications I think. As to why some countries use blister pacs no idea? Hope some weighs in on this. Phillipa
Posted by Terry8 on June 17, 2011, at 14:17:42
In reply to Does anyone know..., posted by zonked on June 17, 2011, at 9:25:40
I'd always had the vaguely cynical idea that it had something to do with American pharmacists wanting to be seen as still having something to do with the magical compounding process (even if it is just counting pills into a bottle) rather than being perceived as very educated store clerks. I figured Europe was more forward-thinking, somehow. It's always annoyed me that when I have a long-term supply of a medication that I stop taking, I can't donate the remainder to a charity health organization. Again, I have some vague notion not really based on fact that if we used the blister packs here, it would be okay to donate unopened meds to needy health clinics because they'd be clearly untampered with. (Maybe there are more complex restrictions I don't really understand, though.) But you piqued my curiosity, and I found an interesting explanation (just one fellow's opinion) here:
http://www.healthcarepackaging.com/archives/2009/03/is_a_tipping_point_near_for_un.php
(Under the section "History challenges unit-dose packaging")
One other thought: there seems to be some subtle move toward the European pre-packaged system in the US, or at least for some on-patent drugs. When I'd pick up a month's supply of Pristiq or Provigil, they'd come in a ready-to-dispense white bottle of 30, with the manufacturer's name on it. The pharmacist would just slap the dispensing sticker on top; no amber bottle filled from a giant pharmacy bottle. (But perhaps this only applies to RXs with silly names starting with P.)
Posted by jono_in_adelaide on June 17, 2011, at 21:30:45
In reply to Does anyone know..., posted by zonked on June 17, 2011, at 9:25:40
Most countries have moved to patient packs in blister packaging, because there is less room for error by the pharmacist, or by the patient (who has 8 different meds all in amber coloured bottles)
The US however, passed laws in the early 70's requiring child resistant bottles, and the laws have never been altered to take into account the fact that blister packs are intrinsicly child resistant
Posted by zonked on June 17, 2011, at 22:24:14
In reply to Re: Does anyone know..., posted by Terry8 on June 17, 2011, at 14:17:42
>
http://www.healthcarepackaging.com/archives/2009/03/is_a_tipping_point_near_for_un.php
>Fascinating stuff.
> One other thought: there seems to be some subtle move toward the European pre-packaged system in the US, or at least for some on-patent drugs. When I'd pick up a month's supply of Pristiq or Provigil, they'd come in a ready-to-dispense white bottle of 30, with the manufacturer's name on it. The pharmacist would just slap the dispensing sticker on top; no amber bottle filled from a giant pharmacy bottle. (But perhaps this only applies to RXs with silly names starting with P.)
This happens to me sometimes when the quantity of pills prescribed meets or exceeds the quantity in each manufacturer's bottle. (Seemingly at random). If there's a balance, in other words, the manufacturer's bottle has 90 tablets and I am prescribed 120, I get the remainder in the regular amber bottle. This has happened with both brand and generic drugs... it makes sense; the pharmacist doesn't have to count the tablets. (Or DO they? hrmmmm.)
I actually prefer to receive my meds this way - less room for error and the manufacturer's bottles often include cotton balls (or in Nardil's case, both brand and generic, these little canister-like things which presumably absorb moisture.) I ask my pharmacist to include the little canister-like things in my amber bottles just in case.
Dispensing errors are more common than one might think. One time, I received a bottle of "temazepam" which was actually mirtazepine! (I always check the pills against the description on the bottle if they look different to me.) Now just think, if I was taking something that interacted negatively with mirtazepine, what might have happened. (I stopped using that pharmacy immediately.)
Another time, a Walgreens put the wrong strength Lamictal in the bottle. (I also stopped using that Walgreens immediately.)
I fear for seniors, people who just don't (have time to) pay attention, and intellectually low-functioning patients. Deaths and serious medical complications due to dispensing errors are more common than they should be.
Nobody's perfect, but I do agree with the author - using blister packs could cut down on dispensing errors. Jono is right, blister-packs are inherently childproof, and whatever legislation governs these regulations should be amended. Is this high on Congress' to-do list? No, and I understand why but hopefully this issue will be addressed at some point.
-z
Posted by Terry8 on June 18, 2011, at 9:09:53
In reply to Re: Does anyone know... » Terry8, posted by zonked on June 17, 2011, at 22:24:14
> This happens to me sometimes when the quantity of pills prescribed meets or exceeds the quantity in each manufacturer's bottle. (Seemingly at random). If there's a balance, in other words, the manufacturer's bottle has 90 tablets and I am prescribed 120, I get the remainder in the regular amber bottle. This has happened with both brand and generic drugs... it makes sense; the pharmacist doesn't have to count the tablets. (Or DO they? hrmmmm.)
>
The pre-packaged ones that I got had a silver foil seal across the top that needed to be punctured (and then usually some cotton or those little desiccating vial things underneath) so there's no way the pharmacist was counting for those. It seems I've been lucky, though: I've never been given a wrongly filled prescription (or that I know of, at least). Having heard your experiences, I think I'll be more cautious about comparing the tablets against the description for new RXs in the future.
Posted by zonked on June 18, 2011, at 9:40:16
In reply to Re: Does anyone know... » zonked, posted by Terry8 on June 18, 2011, at 9:09:53
> The pre-packaged ones that I got had a silver foil seal across the top that needed to be punctured (and then usually some cotton or those little desiccating vial things underneath) so there's no way the pharmacist was counting for those.Same here, come to think of it. :-)
>
It seems I've been lucky, though: I've never been given a wrongly filled prescription (or that I know of, at least). Having heard your experiences, I think I'll be more cautious about comparing the tablets against the description for new RXs in the future.Not a bad idea. Especially if it's a new Rx, or the pills look different than list time. Most of the time, it's just a different generic, but it never hurts to check before you leave the pharmacy.
-z
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