Please request prescription refills directly from us
Pharmacies will tell you that they have contacted us for refills. You shouldn’t believe them. They often send their requests to the wrong fax number (ignoring the one printed on every prescription) so we’ll never see it. They send us many bogus refill requests: for patients we don’t have, for medications that were discontinued for good reason long ago, for medications the patient has never taken… sometimes, they just seem random. We get so many of those bogus requests that we just can’t keep up with them all. Finding the one or two valid requests in the avalanche of fantasy requests just isn’t practical.
You can request refills by email from your provider (me, email@example.com or Sonny, firstname.lastname@example.org) or Amy (email@example.com). Or you can call us or text us at our main number (916-282-0889).
Request refills at least three business days in advance
Processing a refill involves a lot more than just pushing a button or making a phone call. We have to open your chart, check to see that it’s medically appropriate and that the medication is actually due for a refill, document that the refill request was made, and transmit the written prescription (no dangerous phone calls!) to the pharmacy. If it’s a controlled medication, we’re required to check the state’s CURES database for controlled medications prescriptions. It has to be done by me or Sonny—we’ll never delegate that responsibility to someone who isn’t trained for it. Our days are often filled with the important part of our work—seeing patients—and there often isn’t time to process refill requests right away. It’s particularly important for C-II controlled medications (like stimulant medications for ADHD or opioid painkillers) that require that you come in and pick up a written prescription. If we’re not physically in the office, it will have to wait until we are.
Make sure you keep regular appointments
The law requires that we not write prescriptions for patients who have not had a “good faith examination” in advance. Exactly what that means is subject to interpretation, but community care standards generally require that:
- Patients receiving care from a specialist and specialty medications be seen annually. We prefer (and generally insist on) seeing patients at least twice a year.
- Patients who have received a new medication or a dose change on existing medication should have a follow up appointment within 30 days.
- Patients who are receiving schedule II controlled medications (ones that require a written prescription, see below) should be seen every 30 days. We make some exceptions for patients who have been on a stable dose for several months, who haven’t had any significant changes in their medical presentation, who are in stable social situations, and who haven’t asked for early refills. We sometimes will give two or three 30-day prescriptions without having the patient come in for a visit in the mean time.
- Even the most stable, uncomplicated patients need to be seen at a minimum of every 90 days to receive controlled medication prescriptions.
No early refills on prescription medications
Controlled medications are those which the US Drug Enforcement Administration feel have high abuse potential. The list is extensive, but I’ve put an excerpt from the DEA web site below that lists many of the more common ones.
Treat these prescriptions and the medications like money.
We won’t replace lost, missing, stolen, borrowed, flushed, abducted by aliens, confiscated by law enforcement, accidentally or deliberately swallowed, dropped in the sink, lost by the airline, or shorted by the pharmacy medications.
I cannot emphasize this enough. I explain this to patients every time I prescribe controlled medications, and often they’ll interrupt me to say they would, no, not ever ever ever request an early refill. Yet, every couple of weeks, someone calls or emails and says “but the pharmacy… but my dog… but… but… but…” and doesn’t understand why “NO EARLY REFILLS” means that they can’t get an early refill.
“But I had to take extra because…” If you “have” to take extra medication without clearing it with me first, that’s a red flag right there.
“The pharmacy must not have…” That’s between you and the pharmacy.
Please keep in mind, the DEA considers all lost and stolen medications to have been diverted to the street market, a justified assumption. Nobody at the DEA, the Medical Board of California, or the California Bureau of Narcotics Enforcement cares one whit that “it’s not my faaaaault!” Just as the bank won’t replace money that you’ve misplaced or had stolen, I’m not going to risk my career to replace your missing medications. Treat them like money.
DEA List of Controlled Medication
Medications in the Schedule II/IIn category must be written on special secure prescription forms and hand-signed by the prescriber. They cannot have refills. They cannot be called in nor faxed. You must pick up the original form at our office (preferably during a scheduled appointment) and take it to the pharmacy yourself.
From the Drug Enforcement Administration web site. Schedule II/IIN Controlled Substances (2/2N) Substances in this schedule have a high potential for abuse which may lead to severe psychological or physical dependence. Examples of Schedule II narcotics include: hydromorphone (Dilaudid®), methadone (Dolophine®), meperidine (Demerol®), oxycodone (OxyContin®, Percocet®), and fentanyl (Sublimaze®, Duragesic®). Other Schedule II narcotics include: morphine, opium, codeine, and hydrocodone. Examples of Schedule IIN stimulants include: amphetamine (Dexedrine®, Adderall®), methamphetamine (Desoxyn®), and methylphenidate (Ritalin®). Other Schedule II substances include: amobarbital, glutethimide, and pentobarbital. Schedule III/IIIN Controlled Substances (3/3N) Substances in this schedule have a potential for abuse less than substances in Schedules I or II and abuse may lead to moderate or low physical dependence or high psychological dependence. Examples of Schedule III narcotics include: products containing not more than 90 milligrams of codeine per dosage unit (Tylenol with Codeine®), and buprenorphine (Suboxone®). Examples of Schedule IIIN non-narcotics include: benzphetamine (Didrex®), phendimetrazine, ketamine, and anabolic steroids such as Depo®-Testosterone. Schedule IV Controlled Substances Substances in this schedule have a low potential for abuse relative to substances in Schedule III. Examples of Schedule IV substances include: alprazolam (Xanax®), carisoprodol (Soma®), clonazepam (Klonopin®), clorazepate (Tranxene®), diazepam (Valium®), lorazepam (Ativan®), midazolam (Versed®), temazepam (Restoril®), and triazolam (Halcion®). Schedule V Controlled Substances Substances in this schedule have a low potential for abuse relative to substances listed in Schedule IV and consist primarily of preparations containing limited quantities of certain narcotics. Examples of Schedule V substances include: cough preparations containing not more than 200 milligrams of codeine per 100 milliliters or per 100 grams (Robitussin AC®, Phenergan with Codeine®), and ezogabine.