Comments on: Switch from OTC to prescription meds

Question: Switch from OTC to prescription meds

0xFCAF — Tue, 12 Feb 2008 09:38:28 -0800

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.

By: pocams

pocams — Tue, 12 Feb 2008 09:48:24 -0800

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.

By: pocams

pocams — Tue, 12 Feb 2008 09:49:57 -0800

Incidentally, Prilosec is not available OTC here in Canada, so there must be a pills-in-a-bottle version of it in existence too.

By: Eringatang

Eringatang — Tue, 12 Feb 2008 09:51:15 -0800

I asked this for Clartin and they said no problem. This was a few years ago.

By: grumpy

grumpy — Tue, 12 Feb 2008 09:53:10 -0800

As long as it's not dangerous or a controlled substance, most doctors will prescribe whatever you want.

By: dirtynumbangelboy

dirtynumbangelboy — Tue, 12 Feb 2008 10:10:38 -0800

pocams, not all prescription meds are sold as pills-in-a-bottle. Tamiflu, for example, comes prescription-only in blister packs.

By: JimN2TAW

JimN2TAW — Tue, 12 Feb 2008 10:16:36 -0800

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.

By: 0xFCAF

0xFCAF — Tue, 12 Feb 2008 10:19:40 -0800

I understand how pills work. This is not your standard blister pack.

By: TuxHeDoh

TuxHeDoh — Tue, 12 Feb 2008 10:32:40 -0800

I'm with OxFCAF on the darn Prilosec blisters... I end up cutting them out too. It's just easier.

By: COD

COD — Tue, 12 Feb 2008 10:33:49 -0800

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.

By: gramcracker

gramcracker — Tue, 12 Feb 2008 10:35:55 -0800

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.

By: neuron

neuron — Tue, 12 Feb 2008 11:25:58 -0800

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.

By: Taken Outtacontext

Taken Outtacontext — Tue, 12 Feb 2008 11:35:52 -0800

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.

By: JimN2TAW

JimN2TAW — Tue, 12 Feb 2008 13:09:10 -0800

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.

By: gd779

gd779 — Tue, 12 Feb 2008 15:53:30 -0800

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.

By: Octoparrot

Octoparrot — Tue, 12 Feb 2008 17:19:34 -0800

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.