Epilepsy Talk

Why Your Pharmacist is Your Best Friend | February 20, 2013

Your pharmacist is the least expensive and most accessible health resource you have. They fill prescriptions and provide expert information about medications — a very important role, considering the prominent use of seizure medications to treat epilepsy.

While it might seem easier to forge a personal relationship with one pharmacist at a small mom-and-pop pill dispensary, smart patients can and do establish great relationships with superstore pharmacists, too.

You can see the pharmacist anytime you want, without an appointment, and all consultations are free. In medicine, that’s extraordinary.

Plus, they have an amazing wealth of knowledge at their fingertips, which means at your fingertips. Many pharmacists also have access to new technology that can answer questions such as, “Is it safe to take this brand-new medication with this even newer medication?”

What’s more, they get a soldier’s view of patients with similar conditions, using different medications every day. They see who improves and who complains about side effects.

Plus, pharmacists can be helpful in discussing the potential adverse effects of medications, their costs, the relative risks and benefits of generic versus brand-name medications and potential interactions.

The “Four Cs” of pharmacy visits:

One way to keep your epilepsy treatment on track is to stick to the treatment plan you and your doctor agreed upon.  Check your prescription every time you pick it up at the pharmacy and think of “The Four Cs” …

1. Compare the new pill bottle label with the label on your last prescription.

2. Check that the pills look exactly the same (size, shape, color, and imprint).

3. Confirm with the pharmacist (if anything looks different) that he or she is aware of any change and has discussed it with your doctor.

4. Contact your doctor (or have your pharmacist call him or her) if your doctor did not request a change to your prescription.

And, as extra insurance, you can bring this letter from the EFA:

Dear Pharmacist:

Thank you for providing me with the valuable service of filling my needed prescriptions.

The purpose of this letter is to let you know that I have epilepsy and it is vital that I receive the same medication from the same manufacturer monthly in order to maintain the expected level of seizure control and side effects.

 Please ensure that no changes are made to my medications, including a change in manufacturer, without prior consent from my physician and myself. 

Please note this request in my file.  To assist you, I have listed below the name, manufacturer and dosage of the medications I am currently taking.

To download and print the entire form, click on: http://www.nomoreseizures.org/pdfs/pharma_letter.pdf

Manage your prescriptions

Don’t forget to write down the names of all of your medicines and supplements, along with the dosage and who makes it. (I keep a copy on file, update it when necessary and then just make copies to bring with me.) Take this list with you to any doctor’s appointments and trips to the pharmacy.

Talk to your pharmacist about each medicine you’re picking up, why it is prescribed and how you should take it.

And build a relationship with your pharmacist just as you do with your doctor. Say “Yes” the next time you are asked if you want to talk to the pharmacist.

As Kristin Weitzel, PharmD, CDE, Assistant Editor for Pharmacist’s Letter says: “The key for health professionals is to focus on the needs of the patient. Pharmacists are in an ideal position to help epilepsy patients by using their clinical judgment…”

Other articles of interest:

Fewer Errors in In-Hospital Meds if Pharmacists Are Involved http://www.medpagetoday.com/MeetingCoverage/ASHP/43368?xid=nl_mpt_DHE_2013-12-12&utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&eun=g678262d0r&userid=678262&email=pfjohnson@comcast.net&mu_id=5845719

Why The Hospital Wants The Pharmacist To Be Your Coach   http://www.npr.org/blogs/health/2013/02/20/172125025/why-the-hospital-wants-the-pharmacist-to-be-your-coach?ft=1&f=100

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  1. If you know of a reputable Compounding pharmacist, they can often be more knowledgeable than your run of the mill, supermarket pharmacy..


    Comment by Doug — March 14, 2013 @ 12:32 AM

  2. Compounding pharmacists are FABULOUS.

    Especially when you need some kind of bio-available supplement or hormone.

    It’ difficult to find one, but it’s an ever-growing field.

    You got it Doug. KING for the day! 🙂


    Comment by Phylis Feiner Johnson — March 14, 2013 @ 8:54 AM

  3. The pharmacists noted I was taking a blood pressure medicine instead of seizure medicine. The students accidently used the vask and dumped it and the pharmacist initially saw the top. Later in the week I showed her the colors and size difference and told her my heart was racing. She told me to go to the ER. No payment and the hospital ER didn’t pay for their mistake either! I was fortunate. This was 22 years ago. It happens but you can always ask the pharmacist! Even the mail order pharmacist are helpful too! They noted from a discription I was giving I was having a rash from medication.

    Thanks Phylis!



    Comment by Toni Robison — March 17, 2013 @ 2:15 PM

    • But if the pharmacist initially saw the top, couldn’t she have intervened and corrected the mistake?

      Or if she suspected a mistake, could she have identified the shapes and colors of the pills to be doubly sure — BEFORE you ended up in the ER?

      This does NOT make me feel warm and fuzzy.

      Such carelessness should be taken to task.

      Especially students. That’s kind of scary!

      I’m glad you’ve had more positive experiences since then…


      Comment by Phylis Feiner Johnson — March 17, 2013 @ 3:34 PM

  4. I recently spoke with a compounding pharmacist in the area, and he felt like I was thinking about things correctly. Didn’t really give me anything earth shattering, but he backed up my thinking about drugs, switching, and supplements..

    PS: Phyllis if you have a chance can you give me any advice on getting a new career in Creative Advertising, perhaps as a copywriter? I am looking for work and always felt this might suit me..


    Comment by Doug — March 26, 2013 @ 1:49 PM

  5. I’m with you all the way as far as compounding pharmacists go. Sometimes, they can offer you suggestions and options that didn’t occur to you.

    As for getting into advertising, it was difficult for me back in 1979 and now with agencies merging or going out of business, it’s extremely difficult.

    (Not to discourage you.)

    I would register on Linked-In and join any advertising group you can think of.

    That’s often where advertising jobs show up, but they’re usually in house.

    But who knows? Maybe you’ll get lucky! 😉


    Comment by Phylis Feiner Johnson — March 26, 2013 @ 2:11 PM

  6. Spoke to my compounding pharmacist friend again about the difficulty in getting any one doc to do all the blood work I want done. (Full Thyroid, Full Hormone, Adrenal, etc.) And he noted that the way I’ve been getting the tests done, piecemeal by different docs, is not the ideal way to do this.

    Of course, you talk to a doc and he says, “oh sure come on in I’ll help you..” and then when you get there, he changes his tune, saying he’s not ‘certified’ to run certain tests, or there could be an insurance problem, or he wouldn’t know how to interpret results, or if there was an issue he wouldn’t be the one to treat it.. yada.. yada.. yada..

    Hell, I can read the damn results myself. If nothing else, I’d just like to establish baselines for a given time period, especially before switching meds. But, that concept seems to difficult for these docs (neuros, endos, internists, and GPs) to understand. Either that, or they are just cowards.


    Comment by Doug — April 18, 2013 @ 5:11 PM

    • That’s the dumbest thing thing I’ve heard.

      If you have a decent primary care doctor he/she can order the tests and read them. (IF they want to.)

      If he’s/she’s too chicken, go to a GOOD endocrinologist!

      That’s ridiculous.

      Last train of thought. Go to a naturopath.

      They’re real big on testing hormones, thyroid and adrenals and they’ll probably give you good advice, as well. (Which may sync well with your compounding pharmacist.)

      Aside from Arthur’s primary care doctor, he has a long distance (La Jolla) naturopath who orders all the testing, has it sent to him, reads it and then offers suggestions.

      (Arthur suffers from terrible neuropathy. From his butt down through his toes.)


      Comment by Phylis Feiner Johnson — April 18, 2013 @ 6:33 PM

      • I’ll look into the naturopath. Thx. BTW, my neurologist is the one who used the line about not being certified to run those tests. I had told him what I wanted and why and that my endo had said something about it being the neuros job, since he was the prescribing physician of the AEDs that caused my overall concerns.

        The neuro said he wouldn’t know how to interpret the results or he might get asked questions by the insurance company as to why a neuro was ordering them and that if something came up weird, he wouldn’t know how to treat it.. PS – My insurance has never balked at anything.. and I’ve had LOTS of tests done over the years.

        Didn’t exactly inspire confidence that he would be on the look out for any long term effects if he takes that viewpoint upfront. The one thing he did say was that if my endo wouldn’t do them all, that I should find another endo. They keep pushing the reponsibility back onto each other, back and forth..

        My GP, who did my physical admitted he didn’t know much about this stuff, but he went ahead and did the TSH and T4 for me. I like him.


        Comment by Doug — April 18, 2013 @ 7:17 PM

  7. Doug, your neuro sounds like a total wuss.

    Or perhaps he doesn’t know how to perform any other kind of medicine other than his specialty.

    Maybe doesn’t want the responsibility, because he’s truly worried about being 100% qualified to read the results.

    So, obviously he’s not your go-to person in this case.

    But it’s good that you have a caring and cooperative internist — who is fully capable.

    Nonetheless, it IS the endocrinologist’s job to order and read these results.


    Comment by Phylis Feiner Johnson — April 18, 2013 @ 7:31 PM

  8. You mentioned a naturopath. I suppose I can find this online, but is an osteopath similar? A friend knows of a guy who is a D.O., but also speaks of “natural health” solutions using something called Maharishi Ayurveda.. ever heard of this?


    Comment by Doug — April 20, 2013 @ 12:43 AM

  9. A naturopathic doctor treats the whole person, taking into account the interaction of their physical, mental, and emotional factors in causing a condition.

    Naturopathic medicine recognizes the importance of the whole person, instead of just single organ systems or particular symptoms.

    Options include: aromatherapy, acupuncture, behavior control, biofeedback, massage, stress management, to name just a few.

    With Osteopathy, the key principles are based on all parts of the body functioning together in an integrated manner.

    If one part of the body is restricted, then the rest of the body must adapt and compensate for this, eventually leading to inflammation, pain, stiffness and other health conditions.

    When the body is free of restrictions in movement, Osteopathic treatment assists the body with pain
    minimization, reduced stress and greater mobility, providing the body with the opportunity to heal itself.

    Osteopaths use a broad range of gentle hands-on techniques, including soft tissue stretching, deep tactile pressure, and mobilization or manipulation of joints.

    Ayurvedic medicine is a system of healing that originated in ancient India. In Sanskrit, ayur means life or living, and veda means knowledge, so Ayurveda has been defined as the “knowledge of living” or the “science of longevity.”

    It’s entirely holistic and strives to create harmony between the body, mind, and spirit, maintaining that this balance prevents illness, treats acute conditions, and contributes to a long and healthy life.

    The Ayurvedic approach utilizes diet, detoxification and purification techniques, herbal and mineral remedies, yoga, breathing exercises, meditation, and massage therapy as holistic healing methods.


    Comment by Phylis Feiner Johnson — April 20, 2013 @ 10:35 AM

  10. going to a small compounding pharmacy is great because they know your name and they are always educating me on which medications that i am currently taking will interact with my seizure medication.


    Comment by Crystal Cahill — February 23, 2014 @ 4:17 PM

  11. Yes. In fact, one of my husband’s neuropathy meds
    comes from a compounding pharmacy.


    Comment by Phylis Feiner Johnson — February 23, 2014 @ 4:56 PM

    • okay time to rant:my insurance isn’t covering the keppra because of my former neurologist isn’t accepting medi-cal patience anymore, had to call my primary care doctor’s office and see if she can write me a new prescription, i am sure she is able to.


      Comment by Crystal Cahill — March 17, 2014 @ 7:46 PM

  12. Smart girl. If you can’t get in one door, try another!


    Comment by Phylis Feiner Johnson — March 17, 2014 @ 8:46 PM

    • left another message at ampla health for the referral nurse to call me back because this taking way too long to see a neurologist.


      Comment by Crystal Cahill — March 17, 2014 @ 8:50 PM

  13. Get a doc to muscle in! Can you? Or show up. Would that work?


    Comment by Phylis Feiner Johnson — March 17, 2014 @ 8:54 PM

    • already left several messages, i shall talk to my primary care doctor, as soon as i am able to.


      Comment by Crystal Cahill — March 17, 2014 @ 9:10 PM

      • had to pay for the keppra, the generic is cheaper, and been taking it for 3 years. next time we’ll have all the bugs worked out.


        Comment by Crystal Cahill — March 17, 2014 @ 9:38 PM

  14. Why didn’t you get the generic this time?


    Comment by Phylis Feiner Johnson — March 17, 2014 @ 11:05 PM

  15. I used to have the best pharmacist when I lived in NJ and it was a little old pharmacy, but there are no such things any more. Now there are only these big stores and I have only been lucky to have a pharmacist tell what to take and not to take it more than what it says and sign, goodbye. I have been in OR now for a few years and can’t find a good one let alone one that you can afford. Because unless you are on Medicare like am now unfortunaly they all charge whatever they want..


    Comment by Deb — August 10, 2017 @ 6:47 PM

    • Sigh. A pharmacist like yours was has so much value. Like a doc who’s always on call.

      Can you possibly find a recommendation for a good pharmacist from your Primary Care Provider?

      (I know, for example, in my BIG Walgreens, there’s one pharmacist who I always run things by. Sometimes, you just have to develop relationships, wherever you are.)


      Comment by Phylis Feiner Johnson — August 10, 2017 @ 7:03 PM

  16. I have 2 emergencies with Medication going genetic when it was Brand. One ER not paying attention to allergic reactions to medication ended up in Intensive Care.


    Comment by red2robi — January 6, 2018 @ 9:23 AM

  17. Thanks for sharing this, Phylis! Relationships with pharmacists are so valuable. My mom was a nurse and a pharmacy tech. Knowing the pharmacists and getting advice on something as simple on what cold medicine to take, considering my prescription meds, was so important. Life saving, in fact! Sudafed causes me to have seizures, so I have to take Benadryl at night. That is just one example.

    I recently found out when I joined my choir that I can’t take cough medicine because of my anti-seizure meds. It’s better for me to take Mucinex at night for congestion and apple cider vinegar in water before I sing. I had been doing the wrong thing until I asked the pharmacist. This has also helped the asthma recently. I wanted to change pharmacies to one closer to where I live, but I can’t give up the relationships I have developed over the past couple of decades.


    Comment by megambon2164 — January 7, 2018 @ 2:12 PM

  18. I have had pharmacists that know me by name which is very comforting. I am now dealing with insurance coverage issues for my aeds. My epi doc is dealing with those for me. I have heard that maybe mailorder meds would be better because they can be cheaper. My concern is there isn’t a real person that we can connect with. Is this truly a safe way to do our meds? Thanks

    Liked by 1 person

    Comment by Cindy Fiser — December 11, 2020 @ 10:08 AM

  19. Well, I agree with your concerns, Cindy. Yes, Canada is less expensive and timely on delivery. But personally, I don’t think the savings are worth the value of human contact.

    Better to get a 90-day supply and save money that way.


    Comment by Phylis Feiner Johnson — December 11, 2020 @ 10:13 AM

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    About the author

    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I also had epilepsy for decades. My mission is advocacy; to increase education, awareness and funding for epilepsy research. Together, we can make a huge difference. If not changing the world, at least helping each other, with wisdom, compassion and sharing.

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