Switch from OTC to prescription meds

February 12, 2008 9:38 AM

Will my doctor switch me from an OTC medication to prescription if I just ask nicely?

My employer's health insurance plan has a $0 co-pay for prescriptions. Currently I'm taking Prilosec OTC (paid for out-of-pocket) as recommended by my dermatologist to prevent heartburn aggravated by a different prescription. I'd like to a) not have to pay for it and b) not have to spend my time cutting the pills out of their blister packs.

Medically the Prilosec is working perfectly, so will a reasonable doctor object to switching to a prescription equivalent? I'm assuming there's some slightly different formulation that's not OTC-approved but has the same efficacy profile that I can switch to. If you happen to know the name of such a thing, that'd be good to know.

Barring all of the above, if there's a proton pump inhibitor that just comes as pills in a bottle rather than the ridiculous Prilosec packaging, I'd love to hear about it.

posted by 0xFCAF to Health & Fitness (15 answers total)

That's a perfectly reasonable request, IMO. Insurance coverage of PPIs is spotty here, and my own insurance company has suggested that I could ask my doctor for a specific PPI because of cost alone (I currently take Pariet, aka Rabeprazole.) There's a list of PPIs on Wikipedia, and I'm sure your doctor will have heard of all of them. Unless your doc is worried about drug interactions, I would expect asking nicely to be very successful.
posted by pocams at 9:48 AM on February 12, 2008

Incidentally, Prilosec is not available OTC here in Canada, so there must be a pills-in-a-bottle version of it in existence too.
posted by pocams at 9:49 AM on February 12, 2008

I asked this for Clartin and they said no problem. This was a few years ago.
posted by Eringatang at 9:51 AM on February 12, 2008

As long as it's not dangerous or a controlled substance, most doctors will prescribe whatever you want.
posted by grumpy at 9:53 AM on February 12, 2008

pocams, not all prescription meds are sold as pills-in-a-bottle. Tamiflu, for example, comes prescription-only in blister packs.
posted by dirtynumbangelboy at 10:10 AM on February 12, 2008

Um... you know you don't have to cut pills out of a blister pack, right? You push down on the pill from the front of the pack (you push on the clear cover) and the pill pops out through a slit in the back. No cutting. Sometimes you might also have to peel off the outer layer of the back of the pack. Again, no cutting required.
posted by JimN2TAW at 10:16 AM on February 12, 2008

Response by poster: I understand how pills work. This is not your standard blister pack.
posted by 0xFCAF at 10:19 AM on February 12, 2008

I'm with OxFCAF on the darn Prilosec blisters... I end up cutting them out too. It's just easier.
posted by TuxHeDoh at 10:32 AM on February 12, 2008

Check the warehouse stores if you have access to one. (Costo, etc) I have found they often sell OTC drugs in bulk containers (just pills in a bottle), and at far, far better prices than the drug stores.
posted by COD at 10:33 AM on February 12, 2008

Prilosec is your run of the mill PPI. I don't think your doc will have a problem... it's a common drug with few side effects (but does run a risk of a serious bacterial colon infection).

You might also try going to your insurer's website or contacting them directly--often for common meds like this they will mail you a big supply, cause it's cheaper for them to just send them to you directly instead of going through a private pharmacy which will take a cut.
posted by gramcracker at 10:35 AM on February 12, 2008

Omeprazole is available in the US as a generic prescription capsule. Whereas PrilosecOTC is an extended-release formulation, these capsules aren't. Thus, you will need to take it 30-60 minutes before a meal to get the best result.

I, too, find the Prilosec blisters to be needlessly difficult.
posted by neuron at 11:25 AM on February 12, 2008

It really depends on your insurance company. Various antihistamines I've taken have gone OTC and my med insurance would not pay, even if I did have a prescription. Check with your insurance company for each drug.
posted by Taken Outtacontext at 11:35 AM on February 12, 2008

I apologize for the annoyance, OP. On MeFi you have to first give the information, and only then do you find out that it wasn't really needed.
posted by JimN2TAW at 1:09 PM on February 12, 2008

Nexium (aka Esomeprazole) is prescription prilosec. In my understanding, it's very slightly more effective than prilosec, and was essentially invented because the patent protection on prilosec had lapsed, so they had to come up with a slight differentiation to fight the generics. But my understanding is that it is slightly more effective in some circumstances, so there may be a valid medical reason for your doctor to prefer it to prilosec.
posted by gd779 at 3:53 PM on February 12, 2008

I've had multiple doctors who would probably switch just to stick it to the insurance companies. I'm sure if you ask and explain why they'd probably be more than happy.

Very few doctors are concerned about the bottom lines of your insurance company and as long as it's safe will be fine with it.
posted by Octoparrot at 5:19 PM on February 12, 2008