HOW TO GET MORE REFILLS FOR MY PRESCRIPTION
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"Prescription Refills"
"I'm here to pick up my prescription"
"I'm sorry sir, your presription is all out of refills"
"What? What does that mean? I have to be on this medication the rest of my life you know. Obviously the doctor wants me to have it. What do you mean it is out of refills?"
If I had a nickle for every time this conversation, or some form of it, was carried out in a local pharmacy, I would probably be writing this article from a lounge chair settled into some golden, seashore sand while watching the waves clap and crash upon the shore of my own private island in the pacific.
Why do presriptions run out of refills? And when they do...what do you do about it? As a pharmacist I am aware that this question can be frustrating for patients. Running out of refills can ruin a weekend. Have you ever tried to get your medication refilled on a Friday night, only to be told it is out of refills and you will need to wait until Monday to get more? Running out of refills wastes your time. Now you often have to make another trip back to the pharmacy to pick up your pills.
In this article I will briefly explain the reasons for "refills" on your prescriptions, how you get more, and how to avoid running out.
WHY PRESCRIPTIONS HAVE LIMITED REFILLS
Every prescription medication in the U.S. is written with a certain number of refills allowed by your doctor. This may be a specific number (e.g. "5 refills") or a specific time frame (e.g. good for 1 year). Why? Why not just write on the prescription "FOREVER?"
1. FEDERAL LAW: Federal Law has certain restrictions on the quantities and number of refills allowed on prescription medications. See image below.
2. STATE LAW: Each individual state is responsible for developing and enforcing additional laws which also limit the number of refills that any prescription may be allowed.
3. GOOD MEDICAL PRACTICE: Although you may be taking a prescription for the rest of your life, limiting the number of refills will ensure that patients regularly return to their physician for important follow-up appointments, monitoring, and evaluation of the effectiveness of the medication.
The number of refills that any particular prescription can be given is therefore determined both by pharmacy law and medical practice. As a rule, most prescription drugs are not authorized for more than 1 year of refills without the need to obtain a new prescription from the physician.
A SECTION FROM THE FEDERAL CONTROLLED SUBSTANCE ACT
HOW TO GET MORE REFILLS
So, how do you get more refills on your prescription? Simply put, your doctor must be contacted, either...
- By you or
- By your pharmacy.
Which one depends on the state you live in and the preference of your own physician. The easiest way to get a refill on your prescription is just to call the refill in to the pharmacy you use. In MOST cases, if you are out of refills, the pharmacy will contact the prescriber for refills on your behalf. I say "most" cases, because some pharmacies may not do this, or some doctors may not allow it. But those exceptions are rare. I recommend patients allow 1-2 days for this process to occur. Then simply call the pharmacy back and see if the refill is ready.
ALWAYS call the pharmacy back before actually going to the pharmacy to pick up your prescription that was previously out of refills. Did you notice the word "Always?" It is important. Although your pharmacy may have contacted your doctor...there may be many reasons why the doctor has not called in your refill yet. Save yourself some time, and make a call.
Some (not all) possible reasons why a physician may NOT routinely authorize a refill on your prescription:
- You don't need it. Some prescriptions, like antibiotics, are intended for one-time treatment. Others are intended for short term therapy only.
- You need an appointment. As stated before, the condition you are being treated for needs monitoring. Virtually every major condition and/or disease will change over the course of a patient's life. This needs to be considered, and sometimes the prescription needs to be changed as a result.
- You are misusing it. If your doctor writes a prescription intended to last for 6 months, and it is gone in 3 months, something is wrong.
HOW TO AVOID RUNNING OUT OF REFILLS
Here are a couple hints from your friendly (well...usually) pharmacist on how to avoid the frustration of running out of refills on your prescription at the pharmacy:
Check your bottle/label for refills. The prescription label should clearly state exactly how many refills your prescription has left. Note: It should also tell you when the prescription will expire (and thus cannot be filled) EVEN if refills are left. Yes, that is right. Typically a prescription will expire in 1 year (sooner for some drugs) and after this time it CANNOT be refilled no matter how many refills are left.
If you see "NO REFILLS" then make a plan. I suggest writing something on your calendar 6 DAYS BEFORE YOU WILL BE OUT. Write something like "Call pharmacy for Lipitor refill." Allowing 5-6 days gives you some wiggle room. Two days after you call the pharmacy, call back and see if it is ready. If not, then call your doctor's office yourself. If they tell you they will take care of it, wait 1 more day, then call the pharmacy again just to be sure.
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Conversely, SOME doctors (notably county health 'free' programs and HMO's) simply have to be contacted..and will NOT 'bother' you with return visits...they will authorize the additional refills ad infinitum.
Whether or not they are supposed to seems to be beside the point. They are busy, and simply automatically authorize the refills when contacted.
I cannot tell from my end whether or not they are falsifying records of patient visits that never occurred.
I get better monitoring from the veterinarian of my cat, who needs to be on phenobarbitol to control her epilepsy. There, they are very good (strict) about an annual exam before another year of authorized refills.
Well put DzyMsLizzy! It is important for patients to try and get regular follow-up visits, even if the result is a refill of the very same medication and dosage. Diseases progress and change and proper management of them requires regular oversight by a good physician.
My son's nuerologist wrote a prescription for my son with 2 refills. Went to local pharmasit a Kmart and he didn't put the refills on the label on the bottle. The bottle reads no refills. When we questioned him, he said it was NY state law not to put refills on the bottle. He says it is noted on their computer. Does this sound right. The script is for 30 day supply of fluoxetine 20mg.
Hi Gary,
Every state has their own laws, and I personally do not practice in NY. However, my sources tell me that they DO put refills on your prescrition bottle...unless it was a transfer from out of state. So...it is possible they just made a mistake and will correct it when you return for the refill. I would make sure you call several days early to get this refill...just in case you run into any trouble. Hopefully it won't be an issue.
So if I have a prescription that says no refills, do I call the doctor first and ask for a refill, or should I call the pharmacy first and let them call him?
Hi Hnnkkk,
Call your pharmacy first. MOST pharmacies have an automated system by which they FAX or email the doctor for refills. SOME doctors will require you to call them yourself, and SOME drugs require you to contact your doctor. Your pharmacy can tell you. Ask to speak to someone there, if you have never done this before. Best wishes!
I have been taking a sleeping med for years now I can't get a refill ,I haven't slept in a month.
Cindy,
If you want, provide me with some more details and I will see if I can help. Best wishes.
I learned the hard way. Now I get the refills ASAP (ie. every 30 days) whether or not I need them at the moment. I got burnt too many times waiting until I needed them and then finding out all the rules. !@*$%^&!!!
Regards
I have chronic pain and flexeril and t3's are working for me. My doc said I can get refills my pharmacist has to fax herband she will ok them for me when I have my last one's
My insurance ran out a few months ago and I only have one refill left for my arthritis . How can I extend my prescription since I no longer have insurance?
Jenny,
See if your doctor will order you more refills to hold you over until your insurance kicks back in. Also, look into samples from your doctor or cheaper alternatives if it gets too $$$.
This seems to be a good place to ask this question.
I go to see my doc once a month for a face to face visit. I have never had a problem until this doctor was recently raided. I have all of my paperwork, mri, etc. but now the doc says he is no longer allowed to perscribe my medication that I've been taking (and I must stress taking) not abusing for the past few years. Since this has happened I've made at least thirty phone calls without any progress trying to get back on track. This has altered my entire lifestyle, work and home. I am lost. Where am I supposed to go? What options do I have? What am I supposed to do? I called all of the local pain clinics and the wait is at least three months so I set up an appt but until then what can I do and where can I go? It's a shame because I have a documented injury, pay my taxes, work hard, and have now been reduced to asking for help in an online chat room. It's sad because the people around me see the affects. Without my medication it's hard.
Movie Guy,
First, your current MD should be able to arrange for you to continue with your treatment either by:
1) Providing you with documentation so you can get your Rx written by an ER doctor or Walk-in clinic doctor until you can see a "regular" MD
or
2) Arranging to make sure you can get into see another doctor soon enough to meet your needs
or
3) Providing you with another prescription which will be sufficiently effective to help until you see another doctor
If your MD is unwilling to do any of these things, then you must attempt to see a new doctor as soon as possible, and use the ER or walk-in clinics as needed.
Also, I would file (politely) an official complaint against your doctor if he has truly resisted providing you with any of these basic options.
I am sorry for all the trouble and pain this situation has caused you. Best wishes.
Hi pharmacist - I discovered you through a comment you left for another Hubber. Glad I did. Your personal profile was very interesting and you write very well, thoughtfully, articulately, and with clarity and I really appreciate that.
Good Hub with great information. I look forward to reading more of your work. And I appreciate your willingness to teach and help others. A social conscience in this day and age is an admirable thing. Voted all kinds of UP and SHARING
phdast7,
What an encouragement! Thank you sincerely. Coming from a teacher, it is especially helpful. Best wishes!
Jason
Hi Pharmacist,
Your articles on refills are very useful for thoselike me who work on EMR products with eprescribing funtion but who don't know much about what happens between patients, pharmacy and doctors when it comes to renewal requests. Can you please write explaining about prescription Renewal process? Some questions I have are:
1. Does Renewal request always result in a new prescription to be issued by the doctor for the same medication?
2. When Pharmacy sends a renewal request to the doctor for a patient's prescription that ran out of refills, and doctor approves the request for renewal, does the pharmacy just extend the number of refills keeping the original prescription? or create a new prescription for the renewal on the Pharmacy's end?
Would appreciate if you can elaborate on this process explaining what happens to the original prescription that ran of out refills and is being renewed - at the pharmacy's end and at the prescriber's end.
Thank you!
eRxAnalyst,
1) Yes, typically. Unless the refill is denied due to the fact that the patient needs to make an appointment, or if the drug is not intended to be refilled.
2) When a renewal is requested, a whole new prescription "order" is generated, creating a new prescription number and new series of refills (if any). So, it is a "new" prescription even though it is for the "same" medication.
Hope that helps.
Hi Pharmacist,
Thanks so much for the quick response, it really helped!!
I have a couple of follow up questions if you can please answer:
1. What happens if a doctor renews a prescription that has a few refills still left and is not expired yet? perhaps because the patient has asked for more refills bcos he/she is going on vacation/travel, or because the doctor decides on the next visit that the patient would need more refills? In this case, would both the doctor and the pharmacy keep the original prescription order, and only update the number of refills? or still it would result in a new prescription order both on the Doctor's side and in the Pharmacy's system?
2. A patient got a prescription from Doctor A for 30 days plus 4 refills in January. The patient visits the clinic in March but since Doctor A is away, Doctor B sees the patient, and decides to renew this prescription with 4 more refills. Since now the prescription is by Doctor B, it will be a new prescription, isn't it? If this creates a new prescription now for the same medication, what happens to the original prescription? is it considered as discontinued? Would Pharmacy come to know that the original prescription is discontinued? and that Doctor B has renewed it with new refill count? I am stuck in this workflow when Doctor B would renew Doctor A's prescription. Hope you could clarify what typically happens in such scenarios.
Thank you.
eRxAnalyst,
You're welcome. Sounds like you need a consultant with retail pharmacy experience. Shoot me an email with some more background and maybe we can chat. Best wishes!
Jason
Can an Arizona Doctor require me by law to come in for an appt. before renewing my prescription?
GuestA,
The doctor can require you to make an appointment before he/she prescribes any medication. However, if the doctor is making unreasonable requests for visits, you have the right to take your "business" elsewhere and see another doctor. That is your choice. Best wishes.
So conversely, a doctor can not renew a prescription without a face to face visit? My question is whether this doctor is correct in saying she doesn't have a choice.
Guest,
Whether they "can" renew without a face to face may be a state law issue, if we are talking about narcotics/controlled substances. Ask the state board of pharmacy that question. She may be right.
I live in new york and due to an almost fatal hit and run incident which left me with about a hundred shattered bones etc. I have harsh chronic pain which my doctor has routinely prescribed however; now he says I need to see him every three months to get my refills. I live on my disability so I can't afford to see him so often...he used to tell me I needed to see him once a year. So what is the New York state law--he told me it's every three months.
Francis,
I am personally not aware of such a law. Massachusetts requires a 6 month visit. Of course, a prescriber can request to see you as often as he/she feels necessary to manage your condition. For more information on opioid prescribing in New York, contact:
•New York State Department of Health
Bureau of Narcotic Enforcement
433 River Street, Suite 303
Troy, NY 12180-2299
Telephone: (866) 811-7957
E-mail: narcotic@health.state.ny.us
How do you find out what individual state laws are regarding renewal of perscriptions? My schedule makes it very hard to see my doctor every three months as I can not take off from work. I have no problem with seeing the doctor for updates in my condition, but if the doctor has been seeing me for years, I would hoe this could be done via phone on occassion. Inevidently I will be going to see my doctor for something or other several times a year. If however my perscription needs renewals and my last visit has been say 3 months and 3 days and they require an appointment to see me, I have to drop everything, take a sick day from work just to get my script renewed. Thank you for your help. Your site is very useful. Linda
I am pregnant n I've had to go to the er a few times now bc I would get dehydrated and couldn't eat or drink anything and was vomiting a lot. Well I was prescribeed Zofran and it has helped a lot. Well my doctor won't prescribe me a refill till he sees me in a week and I am told that emergency rooms do not give refills and that u have to go in for another visit. But I feel bad and don't want to go in when all I need is a refill. I've left a message for the prescribing doctor to call me and I also called the pharmacy and they faxed the doctor....is there anything else I can do to speed up the process?
Hi Linda,
Such laws are typically handled by Board of Medicine in a state. Frequent appointments like this can be challenging. Until you can find an alternative, I suggest being pro-active and making the appointments well in advance so that you can plan your schedule better.
Jen,
Sounds like you have done just about everything you can. I would hope your OBGYN doctor would not make you wait for an appointment if you might get dehydrated again. If so, time to look for a new OBGYN. Use the ER again if you need to. Best wishes.
Hello I have a question. I don't not have a primary doctor of any kind and when I need medical help I always have to go to the ER. My question is this, I've recently gone to the ER for a very bad tooth ache. my tooth is pretty much broken and needs to be pulled. however I am unable to go to a dentist right now. I'm in the middle of finding a new job as well as moving into a new home and my resourses are stretched. Now I was able to get antibiotics and pain meds from the ER visit. but I'm out of pain meds and have been for sometime now. is it possible for me to call the pharmacy and inquire as to whether or not I could possibly get a refill of the 20 pain meds I received? even though I have no doctor (just ER visit) and the bottle says no refills? I dont know what else to do.
Hi Brandon,
The ER doc will not "refill" the prescription. The pharmacy would direct you to your primary care doctor. But you don't have one. Until you can get one, you are stuck using the ER or maybe a walk-in clinic. You need to get some sort of insurance, even the cheapest you can afford. In our health care system it is very important - it gets you in to care - even if you end up having to pay the full price. Check to see if you are eligible for any state insurance programs.
I am taking Lortab 2.5/500 for pain. If just one won't work, can I take 2 at one time? Thanks.
Becky,
Yes, but only if you get such approval from the MD prescribing it. With narcotics, it is critical you stay within the dosing guidelines that are prescribed.
very good
Hello Pharmacist!
I still have 2 refills for my medication, but my insurance coverage just ended last month. Now, if I get my next refill, do I need to pay the medication full in my own expense? Thanks!
Ed,
Yes, without insurance you will be fully responsible for the cost. The pharmacy can TRY to bill the insurance, but if it is truly terminated, the claim will immediately reject and they will tell you so.
Hi,
I am in a transition stage right now from leaving one job to go to another. At this moment I am working but my employment ends on May 31. I will have insurance up to that point but on June 1 I will be out of coverage for 30 days until the new employement insurance kicks in. My problem here is that I am on medication for Spondyloarthritis (embrel, hydrocodone and cymbalta). I am going to run out of insurance to pay for these meds and cannot afford to pay out of pocket. Is there any way the doctor would give me an early fill so that I don't miss out on my medication?
Missie,
Your insurance may allow an early refill for several reasons. Vacation supply is one. I would try to refill it before it cancels and see what happens. A doctor could probably not get you an early refill just because the policy is begin cancelled. The Enbrel and Cymbalta are the more expensive ones. The companies who make them may have a "patient assistance" program to help you too. Check that out. Best wishes.
KoffeeKlatch Gals Level 6 Commenter 23 months ago
Interest info, logical and straightforward. As for myself, I have prescriptions that can be filled for six months, I always thought the only reason for this is to make sure I visited him every six months.