Unused Medication

[jeanjeannie50]

I took Sotalol for a short time recently and before I could use a new batch that had been delivered, I was changed back on to Flecainide by my EP. This morning I took the packets of Sotalol (120 tabs) out of the cupboard intending to take them back to the pharmacy, but knowing that they would go straight to be destroyed I just couldn't bring myself to do it! Such a waste!

You are probably all aware that any unused medication returned to the pharmacy has to be destroyed, even if you've never used any of it and it only arrived at your house that day, the same happens at all nursing homes. Once you have accepted the medication from the delivery man or pharmacy, it has to be destroyed if you return it.

I just can't believe what a waste of money this is and to be honest I wish I knew someone that had to pay for their prescription Sotalol that I could give the pills to, but then of course I can't do that as it's against the law to do so.

What are everyone's thoughts on this?

Jean

[BobD Volunteer]

I do agree but this is why doctors normally will not issue more than one month supply of any drug Same thing happens when people die. One really can't do much other than take them to the pharmacy.

[jeanjeannie50 in reply to BobD]

Just such a waste though! My pharmacy should know me well enough by now and I hope they see me as a normal person, that they can trust. I hadn't even taken the packets out of the paper bag they were supplied in.

[CDreamer in reply to jeanjeannie50]

Unfortunately they cannot take the risk and I for M reassured by that but I accept it is a huge waste of resources.

I can't think of a better system though.

[jeanjeannie50 in reply to CDreamer]

The only solution I can think of is to hand them personally to someone who takes the same pills and perhaps also has to pay for them. Of course at the moment to do this is against the law, but it would save them from being wasted.

I can remember years ago, going to my GP and if he had any of the pills he was going to prescribe he would give them to you.

Or perhaps the pharmacy that dispensed them could take the pills back if you assured them you'd not so much as opened a box.

[CDreamer in reply to jeanjeannie50]

The administration, storage etc of doing something like that would also be a big expense, labour costs would cancel savings I think you would find.

As I say, although none of us like waste, I really would not be happy with the safety issues for reusing meds. We had a consultant pharmacist consultant come talk to us about our how we could help make savings and the biggest one was don't stock pile meds or continue taking prescriptions for meds you know you aren't going to take.

[PeterWh in reply to jeanjeannie50]

Yes it has been illegal for years. This also applies to simple things like paracetamol. However years ago in one office I worked in the advice was if you give someone some medicines (eg a couple or paracetamol; cough medicine, etc, etc) then you are breaking the law. However if you leave them on your desk or in an open drawer and THEY pick them up (ie you don't hand them to them) then it's perfectly legal. Don't know if this is still the case.

[Hidden]

One thing I'd never do is flush them down the loo. There are some pretty powerful drugs we use, lord knows what would happen if they got into the water is sceptic tank/cess pit etc! Can't imagine what Bisoprolol would do to fish!

It is a waste though, especially with expensive drugs.

Koll

[jeanjeannie50 in reply to Hidden]

PeteWh's response has made me re-think. As I really wouldn't like to be given someone else's recycled medication.

[PeterWh in reply to jeanjeannie50]

Didn't set out to spoil your suggestion. It's actually very magnanimous of you to admit that rather than sitting in silence.

[Mrspat]

I understand that unused medication can be donated to developing countries via a pharmacy or GP surgery that participates in the scheme. Look up Action Aid on the Internet. I should say that I have no personal knowledge of the scheme. Still a cost to the NHS but at least the medication isn't wasted.

[jeanjeannie50 in reply to Mrspat]

I looked up Action Aid and it pointed me to another site. It does look as though some of the medication returned could go to poorer countries.

[baba]

In my limited experience "medicines reviews" by pharmacies are now being used as a profit making scheme. They are paid by the NHS per review.

[jeanjeannie50 in reply to baba]

I had a medicine review with my pharmacy and to be honest it was a waste of time. They made no suggestions and really just wanted to know that I was happy with my medications. Have you had something queried with yours?

[PeterWh in reply to jeanjeannie50]

Mine, 18 months ago, probably saved me from having liver failure. Also the pharmacist was the person who alerted me to the fact that quite a number of the medicines us lot take require regular periodic blood tests.

[jeanjeannie50 in reply to PeterWh]

That's interesting. My pharmacist didn't mention anything about blood tests, but perhaps I wasn't on medication that needed them. The review was certainly worthwhile for you.

[baba in reply to PeterWh]

I agree pharmacists are highly qualified and medicine reviews probably worthwhile when on lots of medicine, to alert people to need for blood tests, interactions etc but hardly required when only one drug prescribed.

[PeterWh in reply to baba]

Disagree. They don't just look at interactions they also look at when your blood tests were last done (and the results if you have them), what symptoms or problems you are having, etc.

For multiple ones they are not only looking at interactions but has a person been given tablet B to counteract a side effect of A then tablet C for other side effect of C whereas tablet D could replace the lot!!!

Simavastatin was the problem for me and without doubt my liver function (or non dunction) would have ended up much worse than 4 times over.

How many people have regular tests when taking statins, NOACs and many others. I asked a number of people (probably 8 to 10) and not one knew about this. One guy was only on a statin but went to his GP who said no need to do any tests. He then produced leaflet which said to test!!

[baba in reply to jeanjeannie50]

Mine was similar had been prescribed new drug and pharmacist didn't add anything useful.

[seasider18 in reply to baba]

When did pharmacies start doing medicine reviews? It does not happen in our area (East Sussex) My prescriptions have a medicine review date for each one prescribed but I assumed that my GP does it. The date often jumps forward and I assumed that my GP changes it after I have had an appointment with him although medications have not been discussed.

[PeterWh in reply to seasider18]

I believe all pharmacies do them. Some maybe more proactive and some passive.

As for the reviews done by GP it is a requirement of the new computer systems that GPs revalidate the medicines. The theory is that your own nominated GP is supposed to do this and then that allows you to request a repeat prescription and for another GP to approve and issue.

[seasider18 in reply to PeterWh]

The pharmacy we go to is part of a small chain and the staff including the head pharmacist and his assistant float around between them.

Nowadays with the prescriptions requested online sent electronically to the pharmacy they presumably are not signed.

If I look at my online medication records at the surgery they show as being requested by non medical staff. Perhaps the GP scans through them to approve them.

My wife had two repeat requested items issued last week and the review date had changed from August 2017 to October 2017 without having seen anyone.

[PeterWh in reply to seasider18]

The prescriptions are signed electronically and that signature is unique. The company I worked for (not medical world) introduced electronic approvals about 18 years ago.

Electronic Prescription requests can be made by the patient, admin staff, nurses, trainee doctors, GPs and other doctors. Every prescription has to be approved, as a minimum, by a GP or doctor except that some specialist nurses can prescribe certain medicines. The ID of the approver is embedded in the prescription. Different CCGs have different rules regarding revalidation. Around here that's every 6 months but GPs are allowed to prescribe 8 weeks worth.

[seasider18 in reply to PeterWh]

I get 8 weeks worth here in Sussex as we did when we lived in Edinburgh 10 years ago.

[Nannie-C]

Sadly a lot of people just ask for next lot of medicines without actually checking what they need. Been in many houses over the years where there are enough unused medicines to last couple of years!! Trouble is when you don't pay for them so the cost may not enter your head

[jeanjeannie50 in reply to Nannie-C]

Yes, I agree. I worked at a nursing home and the amount of medicines that had to be destroyed was just crazy. Sometimes the pharmacy delivery person would leave drugs on the nurses desk outside my office. A nurse would come down and say that the person they were for had died that morning. Those untouched drugs still had to be destroyed.

[PeterWh]

I certainly would refuse recycled medicines. Certain charities used to take medical supplies and medicines for reuse overseas providing these were direct from pharmacy or hospital but I don't if these are still the case .

Storage conditions is a big issue as most need to be stored between 5oC and 25oC. This summer (mainly in the south) the temperature was high 20s or 30s for days on end. How many people made sure their medicines were stored at the correct temperature? I moved mine from their normal storage place for that reason. However when the temperature reached 30oC and someone's house was locked up all day the inside temperature would have reached over 35oC and quite possibly 40oC.

Electronic issuing of prescriptions has saved millions of pounds per year because of not over issuing or duplicating prescriptions.

This story is 15 years old now but is a good but extreme example of waste. When an old lady died and her things were being sorted the medicines found fitted into three very large suitcase. It was investigated and one lot of tablets she had not taken any of those prescribed for over 10 years. It was assumed she didn't get on with them but probably the GP said she had to take them so in order not to offend GP she kept ordering repeat prescriptions but never took them. She also ordered in advance of running out and no proper checks had been kept so effectively she was prescribed 14 or 15 months supply every 12 months (just getting the supply a week early every time is prescribed every 8 weeks means patient receives extra 7 weeks in the year. That's before people don't complete courses.

When I was prescribed flucloxacillin at the hospital minor injuries unit this summer I had to take 3 times a day for 1 week (21 tablets). However nurse came back with box of 28. I queried this but she said hospital only receives boxes with 28 in so I was prescribed 33% extra.!!!!

[jeanjeannie50 in reply to PeterWh]

Hmm, to be honest I'd never thought about those recycled drugs being reissued to me. Don't think I'd like it either.

[Hidden]

I always hang on to any ' superseded' drug as i have sometimes had to return to it !

[PeterWh in reply to Hidden]

Not beyond its use by date I hope??!!!

[PeterWh in reply to Hidden]

PS. Somebody who actually spells superseded correctly!!!

[jeanjeannie50 in reply to Hidden]

Me too, but I never want to go back to Sotalol. Didn't agree with me at all.

[binnie01 in reply to jeanjeannie50]

hi Jean what were your side effects from sotalol I have been on it nearly 6 mths now and still having problems would really appreciate uyour feedback on this so I can take it back to gp tks Jill

[jeanjeannie50 in reply to binnie01]

Hi Jill - Shortly after I took a Sotalol pill, which was morning and evening, I would feel ill for a few hours and they did nothing to stop my spells of AF and tachycardia. I went back to taking Flecainide and for me this is a wonder pill and I feel well again!

Jean

[Hidden in reply to binnie01]

I took a huge doze of Sotalol for 2 years and then it stopped working. I had the most awful nightmares with it but it did stop the AF. However when I had a test at the cardiologist he said it had 'lengthened my Q T time and must be stopped anyway' Am now on Bisoprolol and that seems to suit fine for the moment. Keep well

[jeanjeannie50]

Interesting link. Thank you Jo.

[cali111]

Took this one up with my MP, and although he consulted with the Minister the consensus was that maybe the tablets were not stored in the right temperature and would be unsafe to reissue. I did suggest that maybe people should be issued with a free sample for a week to see if they suited as I have changed medications so often it is criminal to have to destroy these as they usually issue two months supply if they are to become repeats, but I never heard anything again..

[jeanjeannie50 in reply to cali111]

Good on you for talking to your MP re this and that's a good idea to try a weeks worth of tablets to see if they suit you. I can understand tablets that have to be stored at a certain temperature being no good for re-use, but there are lots that don't need to be. Perhaps a better system needs to be set up to send unwanted medication to poorer countries.

[cali111 in reply to jeanjeannie50]

I thought that and the surgery I was with who had their own pharmacy (It was rural) and they did send the medication to poorer countries but I asked at my local pharmacy and they said they were destroyed. I am reluctant now to have new medications as I have bad reactions (I suppose they are termed side effects) which I won`t put up with and so at present the only things I take are two diuretics to control my BP and Warfarin. I abandoned everything else as I told my GP that quality of life was more than just breathing and I preferred to take the chance. But the EP is still going to ablate me so I think I am lucky.