messed up prescription... really need help!!

[coldkate]

so, swim has been on adderall xr 30mg everyday. the assistance program she was on expired, and she asked her family doctor to write out a generic prescription instead to save some money, she had previously been on regular adderall 20mg twice a day. usually she gets her prescription from another center.

she got the prescription today and realized it was not generic adderall (after she left). i realize this might not be the appropriate place to ask for help but most everyone on here seems fairly knowledgeable about many pharmaceuticals besides adderall. anyway, her prescription is for: methylphenidate 20mg twice a day.

so she looked around and got confused, is it ritalin? is it concerta? she's very confused but needs to either get this prescription filled tomorrow or call back the doctor. i was hoping someone can explain and help. if it's not the combination of amphetamine, if she takes it, will she get withdrawal from not taking the adderall, is it significantly different from adderall? is it as fun as adderall? she has never tried any other stimulants. please if anyone can help tell me if she's better off with this prescription and it's good or she should go back and get adderall. thanks in advance

[Beanfondler]

Methylphenidate is Ritalin, most doctors coudln't have less of a clue what they are prescribing most of the time. It will serve the same purpose as the Adderall had previously. If you're unsatisfied ask your doctor for immediate release amphetamine salt combo AKA generic Adderal, or just tell then to check the box that indicates substitution allowed(with the old XR script) and tell the pharmacist.

[RaverHippie]

the prescription you received should satisfy your needs AFAIK.

[coldkate]

thanks for the quick responses

swim has never tried ritalin. thanks for letting me know what it was! i was confused by what wiki said about methylphenidate, it listed concerta and other drugs names, idk. thanks so much, swim will try it out.

[raven3davis]

Adderall and ritalin are completely different. For most, ritalin would not be considered as fun, although that shouldn't be why you are taking the drug in the first place. The effects of ritalin can be vastly different than those of adderall. You might feel nothing at all if you are accustomed to adderall. Only you can determine whether or not ritalin will be an acceptable substitute. Only one way to find out.

However, by the sound of things it seems as if you might be using the drug for the wrong reasons.

[coldkate]

swim legitimately has ADD but just happens to enjoy some of the effects of adderall at the same time... like seemingly a lot of the other people that post here.

[staples]

Originally Posted by Beanfondler

or just tell then to check the box that indicates substitution allowed(with the old XR script) and tell the pharmacist.

Really? would that allow the pharmacy to even substitute an IR formulation in the place of XR? Interesting, I did not know this, I thought that was only so they could substitute generics for name-brand (and for prescriptions without such a checkbox, the prescribing physician writes "DAW" where they would leave it unchecked).

Methylphenidate is Ritalin and it is the active drug in Concerta as well. Concerta is just a controlled-release mechanism for methylphenidate, whereas Ritalin is instant-release. Concerta is to Ritallin as Adderall XR is to Adderall. Adderall is to mixed amphetamine salts as Ritallin is to Methylphenidate.

In this case I would contact the doctor and tell him/her that a mistake has been made. It shouldn't be a problem to bring back the prescription for methylphenidate in exchange for a correct prescription for Adderall, and it's quite irrational for a doctor to change your medications without a consultation so that you clearly understand what s/he is doing and why.

[TheFonz]

Originally Posted by staples

Really? would that allow the pharmacy to even substitute an IR formulation in the place of XR?

It would allow them to IF there were a generic manufactured but their isn't yet, as it is still has a few more years left on its patent.... Most pharmacies will fill with a generic substitute by default, if available and state law allows them too.....


SWIM's advice, take the Methyphenidate script back to the office and tell from office clerks. They'll pull SWIYs profile, see the mistake and write a new one on the spot.....

[phillylocal]

ok, so this doctor precribes this guy i know adderall (20mg) and Ritalin (10mg) (both generic IR).

His doctor told him that ritalin is approximately 1/2 the "effect" of adderall. SO, if SWIY is used to taking 20mg's adderall, 40mgs ritalin *SHOULD* be *APPROXIMATELY* the same.

I did an experiment with my pet flamingo (he is such a good guy!!!) and he told me that it's more like 1.5x instead of 2x the value, if that makes sense (for the example above 35mgs instead of 40), HOWEVER, they are certainly DIFFERENT.

adderall half-life is approximately 10-12 hrs, while ritalin is 2-4 hrs. ...however, i digress...

[staples]

Originally Posted by TheFonz

It would allow them to IF there were a generic manufactured but their isn't yet, as it is still has a few more years left on its patent....

Right, so my question is, if someone brings in a prescription for Adderall XR (i.e, the person that the OP is talking about), which doesn't have a generic version, can the pharmacy really switch them to a generic form of IR??

Originally Posted by TheFonz

Most pharmacies will fill with a generic substitute by default, if available and state law allows them too.....

Not if the prescribing physician indicates not to do this.

Originally Posted by phillylocal

His doctor told him that ritalin is approximately 1/2 the "effect" of adderall. SO, if SWIY is used to taking 20mg's adderall, 40mgs ritalin *SHOULD* be *APPROXIMATELY* the same.

Careful. Everyone is different, so if someone decided to stick with methylphenidate rather than bring the prescription back for adderall, s/he may want to start a little lower just in case.

Originally Posted by phillylocal

I did an experiment with my pet flamingo (he is such a good guy!!!) and he told me that it's more like 1.5x instead of 2x the value, if that makes sense (for the example above 35mgs instead of 40), HOWEVER, they are certainly DIFFERENT.

I've found amphetamiene-based medication to be about 3x as potent as methylphenidate in treating ADHD...

[phillylocal]

Originally Posted by staples

Right, so my question is, if someone brings in a prescription for Adderall XR (i.e, the person that the OP is talking about), which doesn't have a generic version, can the pharmacy really switch them to a generic form of IR??

No, because it is a different medication, and it metabolizes differently. Sometimes XR is prescribed to paitents because their doctor recognizes a higher predisposition to medication abuse, and sometimes because it just works better than IR. However, you can call the doctor to phone in a change in the script if you wish. (Sometimes certain brand name medications are not covered well by health-insurance, and brand name is only applicable when the prescribing doctor determines that generics do not work...for example SWIMS (temporary) health insurance does not cover Ambien CR as well as it covers the generic Zolpidem.)

Sometimes the pharmacy will call on its own anyways, with certain medications (even when a change in medication is not necessary). For example SWIMS mother is a doctor and has prescribed Vicodin in an emergency case for a family member (someone threw out his back while lifting a heavy load) and the pharmacy called to make sure that it was a legit script. Other times SWIM has had a doctor prescribe a medication and asked the pharmacy to call the doctor to see if a generic equivilent is okay. They happily obliged.

Originally Posted by staples

Careful. Everyone is different, so if someone decided to stick with methylphenidate rather than bring the prescription back for adderall, s/he may want to start a little lower just in case.

This is true. good advice.

Originally Posted by staples

I've found amphetamiene-based medication to be about 3x as potent as methylphenidate in treating ADHD...

Like you said, everyone is different.

[staples]

Originally Posted by phillylocal

No, because it is a different medication, and it metabolizes differently. Sometimes XR is prescribed to paitents because their doctor recognizes a higher predisposition to medication abuse, and sometimes because it just works better than IR. However, you can call the doctor to phone in a change in the script if you wish. (Sometimes certain brand name medications are not covered well by health-insurance, and brand name is only applicable when the prescribing doctor determines that generics do not work...for example SWIMS (temporary) health insurance does not cover Ambien CR as well as it covers the generic Zolpidem.)

Right, I understand these differences, but Beanfondler seemed to indicate that this much of a substitution would be allowed, which is why I brought up the question. Your insurance probably likes generic zolpidem better because it's like $8 as opposed to over $200 or something for CR (I think my insurance paid like $225 for CR, but that might've been a different medication, also it was a month's worth, where usually only 14 generic zolpidem are prescribed... I bet they don't like CR because before generic zolpidem and well before CR, a lot of insurance companies wouldn't pay for more than a 2-week supply of name-brand ambien. But now I'm getting way off topic..).

Originally Posted by phillylocal

Sometimes the pharmacy will call on its own anyways, with certain medications (even when a change in medication is not necessary). For example SWIMS mother is a doctor and has prescribed Vicodin in an emergency case for a family member (someone threw out his back while lifting a heavy load) and the pharmacy called to make sure that it was a legit script. Other times SWIM has had a doctor prescribe a medication and asked the pharmacy to call the doctor to see if a generic equivilent is okay. They happily obliged.

The first case sounds like abuse prevention, the second case is normal but my doctor is usually so busy that if I miss an appointment, to schedule one spontaneously would get me one 2 weeks later, earliest. So she's usually not available to the pharmacy, but a secretary can review my record to verify a prescription has, in fact, been written if that's what the pharmacy wants.

[phillylocal]

I think that it depends on the pharmacy if you have a script for XR and the generic box is ticked....some might give IR, some will probably call the doctor to clear up the discrepancy.

I was going to write exactly what you just said about my health insurance liking generics more than brand name, but it was off topic (like you said too...haha).

I actually watched this process go down once, while waiting in my doc's office (BTW, a TOTAL HIPPA violation). So the pharmacy (I assume) called the doc's office and asked to check on a prescription, and the secretary pulled the file, and said she'd call back after she talked to the doctor. So the doc came out after his appointment, quickly checked over it, and (I guess) gave the go ahead for the change.....

The secretary literally said this (pretty loudly):

"Ok, so you want to see if it is okay to substitute for generic?..."

"what's the name again??"

"okay, i'll ask the doctor"..


ahhh, what you learn from loud-mouthed secretaries.