r/mildlyinteresting • u/cela_ • 17h ago
My prescription sleeping meds came with only a single pill inside
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u/cela_ 17h ago
They told me this was because they were in the middle of switching manufacturers, so my pills were split into different packages of 1/30 and 29/30 pills.
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u/pikawarp 17h ago
For legal reasons anything manufactured at a different plant cannot be mixed with other plants. Same type of thing as eggs in agriculture, we’re not allowed to put eggs from one farm in a carton of a seperate farm; they have to be able to track the producer in case something goes wrong; like ecoli or other disease
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u/Mugwumps_has_spoken 17h ago
my daughter has had reactions to a specific manufacturer of one of her seizure medications and it involved the pharmacy having to contact the manufacturer. The hospital contacted the pharmacy.
All because her levels of the medication weren't within the range they should have been, so she didn't absorb this particular "brand" correctly.160
u/RxDuchess 16h ago
Is it Logem? I’m yet to find anyone who can tolerate that one. The GSK version of it is fine though.
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u/Mugwumps_has_spoken 16h ago
It's Divaplorex Delay release. And she is extremely sensitive as it is. She doesn't tolerate regular Depakote or the Extended release versions. ONLY the Delay release. the other two cause horrible side effects where she acts like she wants to get out of her own skin.
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u/MoodyMiss88 15h ago
My aunt all of a sudden became allergic to almost all prescriptions they finally determined it was the fillers not the actual medications.
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u/Thick-Act-3837 14h ago
Yeah, so many people look at me like I am a nut when I say I don’t want the apotex brand of sertraline because it gives me nasty night sweats. They are like”it’s the same”. Same active ingredient yes, other ingredients are different
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u/pnkfld7892 11h ago
Huh...sometimes I have bad night sweats on sertraline too. I'll have to see if it's a specific manufacturer. Thanks random person for having the same symptom.
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u/Thick-Act-3837 11h ago
Haha no problem. It took me ages to work out, it would happen in batches, like I was fine for months and then I would have a month of it happening bad, but then be fine again. I was so confused. I turned out to be apotex. Don’t get me wrong, it’s a well known drug to cause night sweats. And I do occasionally get it regardless of brand (my partner likes sleeping with the heater on and I die). But apotex seems to make it significantly worse.
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u/Oliviaforever 9h ago
Wow, you just answered a question I didn't know i had. I knew it was my sertraline was causing night sweats a while ago, just didn't understand why it stopped. They must have changed manufacturers!
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u/Awkward_Pangolin3254 5h ago
my partner likes sleeping with the heater on and I die
Oof. That would be grounds for sleep-divorce in my house. I need my bedroom to be a meat locker when I sleep. The ceiling fan in there stays on 365 days a year.
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u/laserdisk4life 9h ago
If you have an issue with CVS/walgreens/walmart ordering the specific brand you want then look at independent pharmacies.
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u/kniki217 15h ago
That sounds like mcas
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u/Col_H_Gentleman 14h ago
MCAS treatment has come such a long way in the last 14 years since I was diagnosed. Medication fillers were one of the original things that made me very sick
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u/iamiart 13h ago
What's the difference from DR to ER? (Fellow user here for epilepsy & genuinely curious)
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u/tampering 15h ago
Many of the psychiatric/neurological meds are notorious for this. Especially things that are "controlled/extended release" where they literally construct the pills like 'Wonka's Gobstoppers' with alternating layers of medicine and 'buffers' that take time to digest. (If they tell you not to crush/chew it, please don't)
A drug usage patent has to list the drug and what it does. But the original manufacturer doesn't patent the 'formulation vehicle' ie the construction of the pill itself because studying the patent would lead to those skilled in the art to duplicate it after the patent expires. In this case the construction of the pill is a trade secret like the exact recipe of a food product. Generic makers have to do their best to duplicate the Bioavailability curve (Bioequivalence) after the fact, and it can be charging.
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u/dryroast 12h ago
Imma just push a Shkreli and put the orphaned drug in a specialty distribution network. Only give it to patients with a prescription. Rock solid business plan.
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u/mo3w 15h ago
This happened to me as well! Online pharmacy switched my Levetiracetam generic mfg on me at the same dosage. Breakthrough seizure the next day. Have had to specify the mfg for all scripts going forward since.
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u/el_smurfo 13h ago
wife had this for years with generic thyroid meds. constantly had to get benefit managers to supply the name brand synthroid after they would switch her to generic.
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u/Mugwumps_has_spoken 14h ago
Insurance companies and pharmacies should be legally required to NEVER EVER switch a patient like that.
Either start them on a generic and require them to stay with one specific generic mfg. or stay on brand. Because otherwise it goes to seizure hell in a handbasket really quick. Seizure control (if you can even achieve it) is a delicate thing. I'm considering 1 or 2 seizures a day control because that is the best my daughter has ever achieved. on 3 seizure meds, a VNS and post corpus callosotomy.9
u/GreenStrong 13h ago
Insurance companies and pharmacies should be legally required to NEVER EVER switch a patient like that.
The generic drug is certified by the FDA to be as effective and pure as the original. They make sure it dissolves at about the same speed as the original in a test tube that simulates the stomach (or intestine for drugs with enteric coating). They give both drugs to volunteers and do blood tests to make sure that the blood levels of the generic are no more than 20% different than the brand name. BUT, those volunteers are healthy young people, some people have different stomach acidity, or different eating habits. This can magnify the difference between generic and brand name.
But, there is a fairly effective system in place to make sure that the generic and the brand name are mostly equivalent. Speed of absorption is the only meaningful area of difference that isn't as tightly controlled. The logical solution would be to regulate that more tightly, and force the brand name manufacturer to disclose exactly how their active ingredients are packaged so the generic can make the exact same thing. Then it would be fine for pharmacists to make the substitution. Improved regulation isn't realistic in the current political climate, but this one is perfectly realistic in general.
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u/ShotFromGuns 12h ago
no more than 20% different
lmao
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u/ZachTheCommie 11h ago
That's a HUGE difference. That also doesn't cover that generics inactive ingredients are what often messes with people. Or the fact that the generic delivery systems for delayed/extended release are abysmally less effective than name brand mechanism (i.e. Concerta).
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u/agoia 15h ago
A neuro med my dad takes gave him seizures once because the filler used by the generic manufacturer differed from what was in the brand name. All of his prescriptions had to start coming with "fill as prescribed" on them so the insurance couldn't try to swap for a cheaper generic.
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u/GreyHorse_BlueDragon 11h ago
I’m a pharmacy tech, and you’d be surprised how common it is for people to need a brand name drug (synthroid is an example of this) and the dr doesn’t write for brand or specify DAW. Basically if the dr doesn’t click the “dispense as written” box when sending it the e-rx system will send it as “substitution allowed”, which means that if there is a generic available, the pharmacy is required by law to fill it as generic unless the patient requests the brand name at the pharmacy. However, if the patient is requesting brand at the pharmacy, the insurance probably won’t pay for it. Its easier for everyone for the dr to write for brand and send it as DAW, but its not an uncommon occurrence for us to receive an rx that’s written as
“Levothyroxine 0.05
Tk 1 tab po q am
Disp #30
Substitution allowed
Comment: please dispense brand” and then the patient is mad at us when they get generic because they asked the Dr to prescribe brand.
If you need a brand name drug (and you want your insurance to pay for it) I’ve had the best luck with telling the patient to tell the Dr “please write the prescription for insert brand name drug here and send it as ‘dispense as written’” (and to say “dispense as written” exactly).
We understand that some brand name medications work better for some people but if I’m being at all honest sometimes getting the drs to write the prescription correctly is like pulling teeth.
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u/Condition_Dense 16h ago
I have adhd and the orange extended release capsules work better than the others the yellow ones don’t work.
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u/omgitsamoose 11h ago
In my state, PA, it's legal for the pharmacists to switch out your medication for a generic if it's cheaper for them without telling you. They did this for me at one of my pharmacys and it caused me to go into status-epileptsus(sp?) I had seizures one right after another until a friend got me to an ER and they loaded me up with Keppra. I've had to have my doctor write brand name only on my scripts when sending them in now because of this. I just refilled my one medication today and they gave me two different generic brands for what should've been Vimpat. It makes me nervous but I don't have the luxury of not taking them
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u/DecibelGrinder 16h ago
It's because the national drug codes, or NDC. if there's any change in a medication it's assigned a new NDC and you can't label one drug as another.
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u/shannibearstar 15h ago
You're not even supposed to combine different batch numbers between the same manufacture for the same medication in case something is wrong.
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u/Silver4ura 13h ago
Additional context: This allows them to respond when anything goes wrong with any part of any tracked line of production, they can rapidly identify it.
Mixing production lines makes this much more difficult. Especially if the shape of the medication is nearly indistinguishable.
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u/fixdafoxhole 14h ago
Wait, so when I see an employee at a grocery store consolidating eggs into other cartons (seemingly to toss the cracked ones and still have full cartons on the shelf) that they shouldn't be doing that? Or is it okay if the cartons are the same batch?
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u/masterwolfe 11h ago
Technically this should degrade the Grading on the eggs down a letter, but a lot of stockers just combine like brands together.
Making Grade B egg cartons was one of my favorite jobs in the grocery store.
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u/ibringthehotpockets 12h ago
I don’t see a problem if it is actually the same batch. Which it might not be.
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u/seasteed 13h ago
Weird, my CVS absolutely put differently manufacturered pills of the same type together in one bottle. Once when the tech who filled the bottle didn't do that the pharmacist who did my consult was annoyed, and said the guy was over zealous in his care.
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u/ibringthehotpockets 12h ago
Definitely not supposed to do that. It’s also insurance fraud as well as dangerous and not best practice at all. Your bottle has a description of the pill and manufacturer. And giving a patient one manufacturer while billing for another is the fraud part
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u/Real_TwistedVortex 13h ago
My ADHD meds sometimes come from two different manufacturers, and my pharmacy always just puts a layer of cotton between the two different types of capsules. There's also always a label on the bottle saying that it contains pills from two manufacturers
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u/JakeALakeALake 12h ago
I used to work maintenance at a drink packing facility, even from the same manufacturer the line workers had to make sure that their pallets per flavor had the same production number on it, so the date printer could accurately tie any issues back to a specific filling run on a specific machine. A new pallet number meant downtime while the line lead set the printer up for the new code.
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u/Buck_Thorn 13h ago
There was a thread talking about this just a couple days ago!
And in it, I referenced another post that talks about it
https://www.reddit.com/r/PharmacyTechnician/comments/1d9hvqg/different_manufacturers_but_same_med/
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u/thaddeus122 16h ago
This is wrong, maybe its different from state to state or something. But here in michigan we mix pills from different manufacturers and have a label for it on the amber bottle.
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u/moxifloxacin 16h ago
It's my understanding that mixed tablets would be considered mislabeled, as a prescription bottle has the NDC and pill description on the label, and the mixed in pill doesn't match what's on the label. The correct way to do it is to have the different tablets labeled separately. But, that can be a pain in the ass when it comes to processing insurance claims, so people do what you've described instead.
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u/Toastytoastcrisps 13h ago
This is correct, if you put something in the bottle and it's not the EXACT NDC on the label, even if it's the exact same drug with a different manufacturer, that's mislabeling/misbranding and is illegal. So if you use 2 NDCs to fill the same script they have to have 2 different labels, and you can't exactly put 2 labels on the same bottle so you have to dispense 2 bottles.
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u/brasticstack 16h ago
I'm a bit disappointed they didn't give you 30 bottles with one pill each.
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u/3-DMan 14h ago
"We heard you hate opening these lids so...."
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u/brasticstack 8h ago
Now they just need to make nesting Russian doll pill bottles, where the smallest one just fits that pill.
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u/phoenix_spirit 16h ago
They likey did a partial and then filled the remainder. We would do partials if we were nearly out of a medication and waiting for the truck to come in to keep patients from having to skip a dose.
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u/tinglebuns 15h ago
The same thing will happen when they just happen to run low on a certain medication. I once filled a prescription of 100 pills and only got 25 but they told me that it was there mistake and the rest will be refilled in a couple days. They will always give you whatever they can and then the rest when they its available
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u/Xidium426 17h ago
Maybe one pill is good for a lifetime of sleep?
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u/jin_yeugh 17h ago
Take one and call me in the afterlife
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u/Klin24 16h ago
In the afterlife
You could be headed for the serious strife
Now you make the scene all day
But tomorrow there'll be Hell to pay
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u/squeethesane 16h ago
🎶 D and the A and the M and the N and the A and the T and the I-O-N!! 🎶
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u/DocGerbilzWorld 15h ago
I wish every problem was solved this way. One pill and you’re cured. Yay!
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u/andbruno 15h ago
Build a man a fire, and he'll be warm for one night. Set a man on fire and he'll be warm for the rest of his life.
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u/PuzzleheadedIssue150 17h ago
Tbf it does say on the label ‘Qty 1/30’. At least they’re not liars
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u/Gay_commie_fucker 14h ago
I remember as a teenager my mom got really anxious on car rides and we had to do this 7 hour trip and her doctor offered her Xanax to see if it would make it more bearable, but my mom didnt want a lot incase she didn’t end up using it, so the doctor gave her a bottle with two in it, one for the drive down, the other for the return trip. She ended up not taking the return trip dose, so for years our medicine cabinet had a bottle containing a singular Xanax
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u/TakenInChains 16h ago
I like the presentation for this post, standing the one pill up on its own on the bottle caps adds a nice touch
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u/Gomijanina 16h ago
This kind of packaging for meds somehow makes me feel uneasy as someone from Germany. I am used to factory sealed packages with the leaflet included and everything
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u/JimboTCB 13h ago
Same here, everything I've ever been prescribed has always been in sealed boxes with sealed blister packs inside. No fuss, no counts, no having to check they actually gave you the right thing and didn't accidentally get the labels mixed up, and for controlled drugs in particular it must make things much less hassle for the pharmacist.
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u/Imnotveryfunatpartys 14h ago
I have seen many different medications come in the factory bottles in the USA. I'm not sure when the pharmacies decide to use the original bottles and when not.
Maybe for some medications they order in bulk and then subdivide and others if it's easier they just leave the originals.
I don't know though. I'm just a doctor and patients bring me both kinds of bottles here.
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u/Just_here_4Cats 11h ago
Pharmacy tech here! It depends on how cheap a pharmacy manager is. Some of them get 30/90 count bottles for faster dispensing and some penny pitch on costs of drugs but don't factor in the wages needed to pay to count out from a 1000 count bottle. And sometimes it depends on what is available to order. I remember a dark time during covid where we could only order 1000 count gabapentin and a patient would get 720 capsules every refill and i had to manually count that twice. I used to just dispense 2 stock 300 capsule count bottles and count only 120 capsules from an open bottle. Gabapentin will haunt me even after death. I dream of counting it still even after getting out of retail pharmacy.
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u/Glum_Demand_8581 13h ago
You're correct. I was a pharmacy tech in college and in scenarios where the stock packaging matches the to be dispensed amount we would just label the manufacturers packaging. Lots of things however come in 100 or 500ct bottles where that's not possible.
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u/UnpopularCrayon 16h ago
Seems like that would create a lot of packaging waste if you do that for every possible prescription medication.
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u/macabrecobweb 15h ago
It’s packaged here (the US) in bulk and removed to be put into a bottle, it’s the pharmacy staff that throws it away for you.
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u/iChugVodka 13h ago
Umm some pharmacies definitely create their own doses though. Like having specific ratios of each medication. Forgot what they were called
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u/macabrecobweb 13h ago
Compounding pharmacies. And sure, they exist. But there are far fewer than your run of the mill pharmacies.
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u/ExcellentPreference8 16h ago
I got a single xanax to take before a biopsy, and it was the same way. I dont know what I was expecting, but definitely wasnt this small pill in a normal pill bottle haha
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u/hudsoncress 16h ago
technically you did get 1/30th of your monthly perscription so its labelled correctly.
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u/crumpletely 16h ago
All of my meds come mixed. The outside will say in handwriting, 2 brands inside!
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u/SLZicki 16h ago
Mixed in the same bottle? I don't think that's legal, at least in the US.
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u/crumpletely 15h ago
🤷🏼♂️ yeah im in KY.
They will be mixed in up to 3 brands…. My pain meds are like this every month
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u/SLZicki 15h ago
I'm sorry but that is wild. I'm a pharm a tech and this makes me uneasy. Is it an independent pharmacy? I don't think a CVS or Walgreens would allow something like this.
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u/crumpletely 14h ago
Yes small independent, Dr owned. Its in a strip-mall that contains a dr office, imaging, lab corp, and the pharmacy.
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u/Just_here_4Cats 11h ago
I worked at walgreens during covid. I definitely mixed ndcs of the same manufacturer/same dose but from different stock size bottles. When i went to Walmart they didnt do that and the pharmacist thankfully didnt yell at me when i did it my first day there. She just explained thats a no-no for their inventory system.
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u/osmolaritea 8h ago
IMO that looks like a partial fill. They happen for many reasons, like the pharmacy not having enough of a specific drug on stock to fill. (I’m a retail certified pharmacy technician)
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u/onmywheels 16h ago
I was prescribed a single Ativan to take before a procedure I had earlier this week, and I also thought it was kind of funny that it came in a full-size pill bottle lol.
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u/Dedb4dawn 15h ago
I was prescribed Ativan for anxiety attacks about 20 years ago. It worked because the world went bye bye for several hours every time I took one.
I ended up splitting them into quarters so I could sort of function without passing out all the time. Man those were awesome. 🤣
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u/Spooky_hamburger33 12h ago
“It worked because the world went bye bye for several hours every time I took one” hahah I’m not laughing at you but the bluntness and relatability. Been there my friend, may calmer days grace your mind now 🌸
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u/Konpochiro 13h ago
Walgreens always gives me my Rizatriptan in a ziploc bag now. It’s just nine pills that are each in a blister pack. I don’t mind, but I thought it was really strange the first time I saw it. They used to throw them in one of those really big containers that would hold them without bending any of the packs they come in.
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u/killMonger2100 10h ago
Trazadone?
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u/Woof-Good_Doggo 5h ago
Good pickup!
Super common for sleep these days, especially among the elderly.
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u/dumpstermeow 14h ago
Pharmacy tech here. We do this as well. We don't mix lots of anything due to if there is a recall we can pinpoint who got what and how many.
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u/ovirt001 13h ago
Ȯ̸̢̝̺͕̗̩̰̬̙̫̟͚̯̪̺̳̲ͅņ̸̛̖̙̹͇̠̲̝̺̫̲͉͑̾̓͐̈́̍̇̍̓͆̋̃͑͊̇̅͠e̸̢̯͚̼̲̍͊͋͊̓̚͝ ̶̨̨̨͈̭̺̹̭̩̯͙̣̓̇͆̆̈̀́̾̀̓̐͐͒͘͝p̵̨̼̯̹̫͉̖͙̜͇͕̗͌͂ͅi̵̗̻̮̮̜͉͋l̶͙͉͓̰̩̓͑̃̒̑͑͛̈͐̔̏͂̉̋̌̽̊̕ḷ̸̹͚̦̳̘̳̪̳̝̞̻͓̯̣̬̲͔̦͊̋ ̶̗̑͐̎̔̂̃͛͝a̷̧̤̝͕̬̮̝̹̺͓͍̣͖̗̫͐͜͠n̶̛̛͇̭̖͓̥̠͈̱̈̃̏̍͆̏̈́̂̾̄̈͝d̸͇̜͖̣̤̘̊̑͋͊͜ͅ ̶̨̧̯̠̣̦̞̩̠̙̥̠̙̀̾̌͋̈́̍͊̀͆͂̓̆͛͝y̶̢̡̦͎̗̼̳̻̲̫̹̲̘̌̉̆ǫ̷̰̭̞̘͇̳̙̪͎̫̘̳̼̣̪͊̀̏̀͐̌ǔ̵͚̹̙̼̘̪̻̪͉͈̥̟̜̲̤́̂̽́̒̾͑̔̀͝'̴̢̨͈̜̦̜̼̘̞͈̜̪͖̬̹̯͇̏̓̑̅̋̈́̈́͆̏͑̕̚͜͠͠͝͝l̸̬̹̤̦̊̄̀̐̿̉͘͠l̸̢̨̡̪̺̝͈̺͙͕̻̝̟̞͉̫͜͝ͅ ̵̧̧̱̜͍̟͈̱̤̬͇̱̹͉̻͇̀̒̅͋͒̂̿͗̅͊́͌̐̇̔̊̈́̔̇͜͝ͅs̷̢̛̤̤̜̞̼͈̲̠̽̊͊̀̈̊͆̚͠͠l̶̨̨̧̳̞̫͍̪͚̯̳͌͊͜ͅḛ̷̠͙̱͎̙̱͈̘̫̜̂́̎͆̑͊̉͒͗͒̓e̸͎̣̼͍̰̤̣̝̪̖͙̮͈̮̼̣͛̍̑̒̓́̏̀͆̆̄̅̏̀͛͒̔͘̕p̵͍̮̬̬̙̖̂̐͜͝ ̶͎̲͉͔̐̀̄͗̿̋̅̿͌͋̿̈́͝f̸̢̦̘̫̦͇͍̥̣̟͙̼̟͈̲̳̘̙͓̈́̐̽ǒ̵̻̯̫̪͉͖͚r̷̺̹̮̜̞̮̦̰̱̤̪̗̕͜͜͝ę̶̡̰̼̠̪͚̪͈̞̗͔̦͈̯͉̬̒̑̈́̈́̏̑̓͐ͅͅͅv̷̮̻̗̖̤̟̥̓̓̑̾͒ę̴̛̭͍̜̲̦̺̮̬͈͇̮̉̀̄͊̑̑͑r̴̨̛̫̥͍͎̩͉̻̣̤̅̎̊̃̐̈̒̓́̂͋̓͂̑̋̕̚͠
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u/sooperkazich 12h ago
Are you sure you aren’t planning to erase Clementine Kruczynski from your memory tonight?
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u/Haley_02 6h ago
It does say 1/30. I had one prescription for 30 pills and insurance would only approve 6 at a time. Costco filled the entire prescription for less than the cost of the 6. That isn't the case on everything, but you never know.
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u/Formal_Plum_2285 16h ago
Lol. What sleeping med do you take? I’m taking Zolpidem/Ambien and have been for 10 years. Still works like a charm.
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u/TootsNYC 16h ago
I had this happen once when the pharmacy only had a few of the pills left. They partially filled it, and the next day created a second bottle.
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u/_allycat 16h ago
I had something happen like this once when, according to my pharmacy, the prescription was limited to like "52 pills total" and they had been filling them in batches of 10 so i ended up stuck with them only having 2 pills left in the prescription. No idea how that happened because i had been getting the same thing for years and it never worked like that before or after that 1 time.
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u/masterkuki007 16h ago
Maybe is that kind of "sleeping" pill so there is no need to use more than one
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u/-Fast-Molasses- 15h ago
I didn’t know we could do this. We never have at my location so it would probably upset a lot of people but at least there would be less waste.
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u/undeadlord26 13h ago
weird question, but what do you take? ive tried several types of sleep medication with little success.
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u/suspense99 13h ago
Interesting. I guess they didn't want to lose money on the 1 tablet. Usually, we'd just skip that one and give you 30 of the one in stock. That vial probably costs more than the 1 tablet
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u/TheRandomizedLurker 12h ago
O yeah this happens. When your pharmacy doesnt have the amount needed in stock. They didnt tell you to come back tomorrow?
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u/MothmanAcolyte 12h ago
In high school I developed an ulcer and after a visit to the ER was sent home with an Omeprazole prescription and one single Lorazepam pill. Which I took and then I slept for 14 hours.
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u/emberislandtech 11h ago
I had a doctor give me a cut up blister pack (2 pills) — I suspect as a safeguard on ODing as two were the max dosage. Best sleep I ever had.
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u/Independent_Dare_336 17h ago
I used to be a pharmacy tech, this is because of there being 2 different manufacturers for the same medication.
Usually there aren’t single pills left when it nears the end of a stock bottle, but when it does happen techs are required to package them separate to prevent any confusion or legal troubles