Bad News

[bedith6]

Bad news this morning. My g.p. rang in response to my letter requesting Temgesic. She said she is not allowed to prescribe this but. will write to a neurologist to ask if she may prescribe the patch. I pointed out that other g.p.s had prescribed Temgesic in the u.k. but she said it must have been through a neurologist or that different rules apply in different parts of the country. I am devastated, . I asked how long this would take but of course she didn’t know. She said she would write immediately but that she was on holiday the following week so I obviously still have weeks of torture to endure before I know what may be decided. Does anyone know anything about the patch that she spoke of ?

[Hidden]

I dont know whether or not your GP is not allowed to prescribe temgesic or not.

I recently asked ny GP for something suggested to me by the hospital and she said she couldnt prescribe it. Instead she prescribed an over the counter alternative. However, they're not supposed to prescribe over the counter medicines!

So it's a mystery.

A GP can refuse to prescribe something if they wish, because they have then to take the responsibility for it.

The good news is, I believe, that buprenorphine the main constituent of temgesic, also comes in a patch and I'm presuming that's what she means.

I am sorry there will be a delay.

[bedith6 in reply to Hidden]

Than you for your reply Manerva I will let you know if there s re any developments

[Hidden in reply to bedith6]

OK please do.

[BBMBRB in reply to Hidden]

I'm a pharmacist working in the NHS. Some drugs are classed as 'red' and can only be prescribed in hospital. Others are 'Amber' when the hospital start it and can ask the GP to take over prescribing but only if they are comfortable taking clinical responsibility for the drug. All other drugs are prescribable in hospitals and by GPs. Local areas decide what the status of different drugs are so may be variations.

[Hidden in reply to BBMBRB]

Thank you. Useful information. It does seem to vary a lot.

It's not always tranparent why GPs refuse to prescribe something. Recently I was told simply, "I can't prescribe that", with no reason given.

I know members who have been refused pregabalin or gabapentin and told it was because they're controlled drugs, whereas my GP has no problem prescribing it. That may be as you say, they're not prepared to take the clinical responsibilty for it.

I believe that locally, GPs aren't supposed to prescribe something thar's available over the counter. Yet recently I was.

Also I believe the policy is not to prescribe a branded medicine when a generic verison is available.

Some years ago the local CCG drew up a black list of medicines and treatments. I did understand why some of them were on the list. However I did challenge one of them which I was taking at the time. I was informed that it was blacklisted because the "evidence" was that it was no more effective than the alternatives. The evidence turned out to be a reference in a book 10 years old that referred to a study carried out 20 years ago which made no reference to the condition I was using it to treat. It was about 10 times more expensive than the alternatives.

It would be useful for people to know there is a traffic light system.

[LotteM]

Bedith, sorry to hear about your difficulties. At least it doesn't seem a straight 'no'. Try to get get in touch with Puzzler1 on this forum. He managed to convince their gp to prescribe Temgesic for hos wife's RLS.

Of you search for buprenorphine, you may find his posts and replies on tje subject. He has written quite a few contributions, but it has been some 6 (?) months. He is in te UK and offered to help with info and letters etc.

Incidentally, buprenorphine also comes in patches for 3 or 7 days. But not everybody needs 24h coverage and the dosing is less easy to adjust with such long term patches. Therefore personally I preferred the sublingual tablets. Please keep at it, you won't know whether it will be helpful for you until you have tried. And with some help you may succeed in trying.

[bedith6 in reply to LotteM]

Thank y ou LottieM for. Your reply. Yes I have read and re read Puzzler’s posts but my g.p.was ve ry firm when she said she was not allowed to prescribe Temgesic. I got the impression that if left to her she would. However I am hoping that the neurologist that she writes to will say yes to the patches. Anything will be better than what I’m experiencing at the moment

[LotteM in reply to bedith6]

I'll keep my fingers crossed for you. 🤞🏼 To get relief from the RLS symptoms, through Temgesic or any other way.

[rkatt in reply to LotteM]

I had a similar problem. My GP was keen to prescribe Temgesic, but couldn't unless authorised by my neurologist, who was reluctant. In the end I contacted a private neurologist. The drug worked, though the dose was very low. On hearing this my NHS neurologist changed his mind, became quite excited that an effective treatment had loomed up. There was still a problem, though, as his hospital flatly refused to dispense Temgesic, as it isn't on the list of drugs NICE have heard of for RLS. In the end my brilliant GP agreed to take responsibility, and was allowed to write a prescription. I have to collect it every week – that's how dangerous they think it is when, a) it's much safer than other opioids they dispense easily, and b) it offers no kicks, highs, bliss, energy boost or psychedelic experience. It's less exciting than toothpaste. Could you try going private first, until the NHS side is sorted? It's not cheap, of course. Good luck!

[bedith6 in reply to rkatt]

Thank you for your reply rkatt. If I get refused for the patch and nothing else of use is offered I think I will have to consider going private although I haven’t a clue how to find one who knows anything about RLS

[Shir_11 in reply to bedith6]

Hi BedithI am in Australia and I have been on Temgesic for around 6 months and no trouble having it prescribed by my GP. The Buprenorphine Patch is called Norspan and it is slow release and and I alternate the patch for a week and the Temgesic for a week. The Norspan patch is brilliant and you have no RLS at all while on it. The Temgesic works well but after around 12 hours you start to feel restless. I usually take 1 sublingual a day but cut in half so I can take half every 12 hours. Hope this helps.

[pete-ginger]

I’m in the USA. I’m just writing to say how surprised I am by several comments below that rules for prescribing differ so much between our countries. Good luck! RLS is such an awful disease.