A question for a pharmacist re Centyl tablets (not seeking medical advice)

_Whimsical_

I'm not seeking medical advice here firstly just am hoping a pharmacist might be able to answer this for me.

We picked up a prescription for an elderly neighbour today as she can't get out to get it herself. Part of it was Centyl tablets which my neighbour says have always been a small white tablet. Today's batch however are larger green tablets in a pill bottle marked Centyl with no dosage indicated and have no leaflet or info attached. Her prescribed dosage are the same as always.

She rang the pharmacy to ask about this and the pharmacist told her that all Centyl tabs are now larger and green.

I just wondered if this was correct?

Ive tried ringing the pharmacy several times myself but can't get through. As she's quite old I'm not positive she'd have understood the information given to her over the phone and I'm nervous that she may have been given the incorrect tablets. If someone could tell me that they are now green I'd be very relieved.

bleg

The Makers of Centyl (Leo) have stopped producing them. The alternative is Centyl K which is made by the same company but has added potassium. Some pharmacists are switching patients to these.

Activas, another company, have started to produce normal bendroflumethiazide without added potassium.

_Whimsical_

Thank you so much Bleg that is a relief!

I googled Centyl K and it does say that they're a green oval tablet.

As I picked it up I felt responsible for making sure everything was ok for her .I'd hate to have been instrumental in her taking anything that would not be appropriate for her.

bleg

No problem, fair play for taking care of your neighbour.

ZYX

bleg wrote: »

The Makers of Centyl (Leo) have stopped producing them. The alternative is Centyl K which is made by the same company but has added potassium. Some pharmacists are switching patients to these.

Activas, another company, have started to produce normal bendroflumethiazide without added potassium.

But they must have discussed it with patient and Dr first surely. Centyl and Centyl K are not the same product. The addition of potassium can be a huge deal and not something to be simply done because you have no centyl.

bleg

That would be the standard modus operandi alright.

anotherlostie

Seriously? The pharmacist would just decide to give the Potassium along with the bendro? I find that hard to believe, given that pharmacists cannot aren't supposed to substitute Pinamox if the script says Clonamox! I did get a letter from IMB about using a generic that didn't have a PA on an interim basis - that makes far more sense.

bleg

anotherlostie wrote: »

Seriously? The pharmacist would just decide to give the Potassium along with the bendro? I find that hard to believe, given that pharmacists cannot aren't supposed to substitute Pinamox if the script says Clonamox!

No no, I meant that the pharmacist would ring the doctor if such a change was necessary. That would be standard practice.

angeldelight

To be honest I didn't like the way the whole thing was done - for months and months doctors and pharmacists have known that Centyl was being discontinued. We have been actively telling patients each month to remind their doctors they need to switch. Then right bang just before it is discontinued this generic arrives. Now I know it is an 'emergency' interim measure that this can be given now and it couldn't previously but surely this could have been thought of months ago when they first heard that Centyl was being discontinued?

Apart from anything else for anyone on Centyl 5mg tablets it would have meant 2 Centyl K to get the same level of bendroflumethiazide so it would be double the potassium. Given that these patients often have other cardiac issues I don't think it's quite as trifling an issue as Leo seemed to think in their letters

_Whimsical_

angeldelight wrote: »

Apart from anything else for anyone on Centyl 5mg tablets it would have meant 2 Centyl K to get the same level of bendroflumethiazide so it would be double the potassium. Given that these patients often have other cardiac issues I don't think it's quite as trifling an issue as Leo seemed to think in their letters

That's all a little bit worrying really.

This lady definitely did not speak to her doctor about any change in her medication and the pharmacist didn't provide any leaflet or information about the change. The new pill bottle she has does not indicate how many to take or what dose the tablets are.It only has her name and the name "centyl" not "centyl K" written on it.
I think I'll tell her she should ring her doctor and make sure it's all ok on Tuesday.
Thanks you all for the enlightenment!

Nonoperational

It sounds like centyl K but it should be labelled as such. The standard practice would be the pharmacist would ring the doctor (or have an agrement in place with the doctor) and then the patient would be told of the change. Pretty poor stuff from the pharmacist there.

Graces7

Thank you for this thread.

The same happened to us with piriton; they put a different antihistamine in my prescription pack without either telling me or asking the dr; zirtene? zirtek?They said because piriton is no longer on a list?

The side effects were bad.

When I mentioned it to the surgery, they simply sent me a new 3 month scrip for.. piriton.

I wondered if this was standard procedure.

locum-motion

Piriton used to be, but is no longer, on the list of what will be paid for by the Govt.
If a GMS ("Medical Card") prescription for Piriton is presented in the pharmacy, usual procedure would be to call the surgery and agree an alternative with the prescriber. Either that, or just sell the patient Piriton over the counter. That being said, it wouldn't be unusual to have a conversation along the lines of "is it OK with you if I give Zirtek every time you write Piriton?" to which the Doc will usually say "No prob". I would usually explain that to the patient, though.
You said they didn't tell the Dr they were making that change: it is possible that the pharmacy had had the above conversation previously with the doctor or with another doctor in the practice. It wouldn't be standard practice to make an alteration without mentioning it, but nobody expects there to be a phone call made on each and every separate occasion. If there was, the Dr and the Pharmacist might as well have a permanently open phone line between them, cos neither of them would have any time for anything else.
By the way, if you had bad side effects from Zirtek or Zirtene, consider yourself lucky you didn't get Piriton; the side effects are much worse!
As regards the Centyl/Centyl K issue: big green egg-shaped tablets are Centyl K, small white round ones are Centyl. Same as above applies, ie the change should have been discussed with the Dr, but not necessarily on every separate occasion. It sounds to me, though, that if the label said Centyl and not Centyl K, yet the vial contained Centyl K, then it's not outside the bounds of possibility that an error was made. If that's the case, then the pharmacy SHOULD put their hands up, admit and apologise for the mistake, and correct it. Trying to cover it up helps nobody.
As pointed out by another poster, there's good news in that, although Centyl is being discontinued, a generic version of it is coming out, so as it happens there's no need for any patient to be changed to a different medication after all.

Graces7 wrote: »

Thank you for this thread.

The same happened to us with piriton; they put a different antihistamine in my prescription pack without either telling me or asking the dr; zirtene? zirtek?They said because piriton is no longer on a list?

The side effects were bad.

When I mentioned it to the surgery, they simply sent me a new 3 month scrip for.. piriton.

I wondered if this was standard procedure.

Graces7

Interesting; thank you.

I am fairly new to the Irish health system.

And no there was no communication between dr and pharmacist. I take your point of course.

Side effects are very idiosyncratic. I have a medical condition well known for throwing up atypical reactions.

I have used piriton for years and it suits. I googled zirtek after being awake and very agitated all night twice and found that this is not unusual with that drug.

Tried clarytyn once; they said it caused no drowsiness; slept almost 24 hours.

The worst side effect with piriton is drowsiness.

locum-motion wrote: »

Piriton used to be, but is no longer, on the list of what will be paid for by the Govt.
If a GMS ("Medical Card") prescription for Piriton is presented in the pharmacy, usual procedure would be to call the surgery and agree an alternative with the prescriber. Either that, or just sell the patient Piriton over the counter. That being said, it wouldn't be unusual to have a conversation along the lines of "is it OK with you if I give Zirtek every time you write Piriton?" to which the Doc will usually say "No prob". I would usually explain that to the patient, though.
You said they didn't tell the Dr they were making that change: it is possible that the pharmacy had had the above conversation previously with the doctor or with another doctor in the practice. It wouldn't be standard practice to make an alteration without mentioning it, but nobody expects there to be a phone call made on each and every separate occasion. If there was, the Dr and the Pharmacist might as well have a permanently open phone line between them, cos neither of them would have any time for anything else.
By the way, if you had bad side effects from Zirtek or Zirtene, consider yourself lucky you didn't get Piriton; the side effects are much worse!
As regards the Centyl/Centyl K issue: big green egg-shaped tablets are Centyl K, small white round ones are Centyl. Same as above applies, ie the change should have been discussed with the Dr, but not necessarily on every separate occasion. It sounds to me, though, that if the label said Centyl and not Centyl K, yet the vial contained Centyl K, then it's not outside the bounds of possibility that an error was made. If that's the case, then the pharmacy SHOULD put their hands up, admit and apologise for the mistake, and correct it. Trying to cover it up helps nobody.
As pointed out by another poster, there's good news in that, although Centyl is being discontinued, a generic version of it is coming out, so as it happens there's no need for any patient to be changed to a different medication after all.

locum-motion

Graces7 wrote: »

Side effects are very idiosyncratic. I have a medical condition well known for throwing up atypical reactions.

Sorry, I should have said that the side effects are usually worse with Piriton.