How pharmacists deal with the surge in shaded ivermectin prescriptions.

Last week, a patient entered Rachael Leigh’s pharmacy in a wealthy San Diego neighborhood to ask about his ivermectin prescription. She has been poised for this moment since her pharmacy began receiving calls about drug availability.

“I was like,’Oh, awesome, here.’ This is my first one, “Lee said. He asked that her real name not be used to protect her work at national chain pharmacies.

Prescriptions do not have a diagnostic code and are used by many pharmacists to ensure that the drug is prescribed for valid medical reasons. The prescribing physician has obtained a license outside Florida. When she called the clinic for more information, employees said that ivermectin was for prophylactic COVID treatment. Lee distracted the patient.

Many pharmacists across the country are similarly uncomfortable. The demand for ivermectin, which is used to treat human parasites in the form of tablets, Increased 24 times Because of the unscientific belief that COVID-19 can be treated or prevented. Prior to the pandemic, the Centers for Disease Control and Prevention reported an average of 3,600 ivermectin prescriptions per week. The number of prescriptions began to increase rapidly in early July. Fringe doctor advocating its use.. By mid-August, the CDC reported more than 88,000 prescriptions per week.

FDA does not approve ivermectin For this indication, and National Institute of Health, World Health Organization, And even drug manufacturers MerckEveryone says that the scientific evidence for use in the treatment or prevention of COVID is inadequate.Nonetheless, some doctors write prescriptions — shaded websites There are many to offer them for a fee— And celebrities like Joe Rogan and Alex Jones advertised it. Some pharmacies meet these prescriptions, but many others should avoid frustrated patients.

“We are in a difficult situation,” Lee said. “After all, I was very strict about it just because it was my license.”

On September 1, three major national medical groups, the American Pharmacist Association, the American Medical Systems Pharmacist Association, and the American Medical Association, participated.Issued a joint statement Call for termination of ordering, prescribing, or dispensing ivermectin for the prevention or treatment of COVID-19. According to pharmacy experts, the way people try to use it is dangerous.

Anne Burns, APhA’s pharmacist and vice president of practice, says pharmacists are looking at different doses and longer-term prescriptions than are currently approved for use with ivermectin. In the form of oral tablets, ivermectin is approved as a one-time treatment, and in some cases follow-up doses are prescribed months later. “We’ve been listening to ivermectin prescriptions for days, months, and sometimes more,” Burns said. (Local versions of ivermectin are also present in certain human skin infections.) Burns also reports on a doctor who has recently asked APhA to fill out a 30-day prescription for ivermectin. I said I received it.

Overdose of ivermectin May cause symptoms From nausea and vomiting to seizures, coma and death. It can also react negatively with other medications that a person is taking.There is also a report (and meme) of the person using it Veterinary grade ivermectin, A paste used for horse, cow and pig deworming. Although the active ingredients are the same, livestock medicines are dangerous because they are intended for large animals and may also contain inactive ingredients that are not intended for human consumption.

Despite these risks, human ivermectin prescriptions are being called to pharmacies.

Some come from doctors working through suspicious online groups that provide telemedicine services such as: Frontline doctor.. Burns warns people that these online options are for buyers to pay attention to the market. “There are telemedicine sites that may not be well received,” she said, and while guidelines for prescribing through telemedicine vary from state to state, “crossing state boundaries” during COVID. There are many mitigations to work with. “

“If you’re asked to fill out an online form that requires a prescription, it’s a red flag,” she said.

Due to increasing demand, some pharmacies are short of ivermectin tablets. This is a problem for people who actually need ivermectin for approved treatment. These deficiencies are lined with strict silver for pharmacists. “I don’t want to say that a drug shortage helps,” said Michael Ganio, senior director of ASHP. “If a pharmacy doesn’t have ivermectin in stock, it’s a black-and-white decision for pharmacists not to fill it.” Told.

The pharmacist is not obliged to fill out a prescription that seems unsafe.

“Keeping the patient safe is our profession’s responsibility, and whether the patient or prescribing consents to it is not really part of the equation,” Ganio said. This means checking the correct dosage, looking for potential interactions with other drugs, and refusing to give the drug when it is not prescribed for valid medical reasons. Ganio said he had heard reports of doctors and patients struggling with pharmacists, but patients are moving to the next pharmacy to find sources rather than enter into discussions. It seems.

Some pharmacies meet those prescriptions. Helen Lim, a CVS pharmacist near Los Angeles, said it was the company’s policy to keep people with ivermectin prescriptions away at CVS. However, she said that in large chain pharmacies, staff fill out so many prescriptions that “sometimes it is not caught” when it comes to ivermectin requirements.

The pharmacist who is asked to prescribe ivermectin needs to decline and respond by educating the patient, Ganio said. “A pharmacist who knows the evidence and guidelines should be able to talk to the patient to help understand the evidence, why it is not recommended, and why it can be harmful. “

At a San Diego pharmacy, Lee explained to the patient that he was reluctant to prescribe ivermectin because the FDA had not approved the prescription for ivermectin. She told an employee of his clinic the same thing. Employees said they wouldn’t quarrel, they would just send the prescription to another pharmacy.

“After all, it’s up to the dispensing pharmacist,” Lee said.

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