restasis - 30 day supply only, no repeats

[poppy]

After going to a lot of trouble to get restasis (I'm in Australia), I'm really annoyed now that I have finally got my prescription - I've discovered its only a 30 day supply with no repeats!

Does anyone know if this is a rule for restasis in Australia or is it the doctor's fault for not giving repeats? It isn't the "real" restasis it is the stuff made by a compounding pharmacy if that makes any difference.

I'm just so annoyed, the doctor told me I needed to use it for 3-6 months to see if it was working, and I had previously told him I couldn't travel to see him regularly, but he didn't mention he was only giving me 30 days supply. So I have wasted my money and my hope on restasis which is basically pointless taking as 30 days isn't enough to see if it's working! Why did the doctor give me the restasis prescription given what I'd clearly explained to him!

I doubt very much the clueless idiots that I've been seeing at my local eye clinic will even know what restasis is let alone be willing to prescribe it. So 30 days is all I will get to try unless I can manage to get to Sydney again in the next month (and of course, pay the doctor another couple of hundred dollars plus the lost income from not working).

I really feel like giving up, cancelling my future eye clinic appointments and just letting my eyes go. I'm so sick of wasting my time and money and basically just getting ripped off by doctors and getting nowhere. In fact I feel like cancelling all future doctors appointments for any other medical conditions as well, as although dry eye is a particularly problematic area for useless doctors, I feel doctors are pretty useless in general and usually can't or won't do anything for any form of medical condition either physical or mental. They are hopeless and most medications can cause or worsen dry eye as a side effect so why bother with taking any other form of medications I am prescribed. Sorry for the rant have to vent right now.

[kitty]

Let me start by saying that I'm an RN. In my experience, most doctors don't write a new prescription for more than a 30-day supply. They want to see how you react to the medication, what side effects you experience and how you tolerate it. If you are having significant adverse effects they would not want to continue the medication. This is reasonable medical practice in my opinion. When you are about 3 weeks in to your prescription, give your doctor a call and let him/her know how you are tolerating it. If you are tolerating it okay, ask for another prescription with refills, enough to see you through until your next appointment. Good luck with the Restasis.

[Guest]

What Kitty said makes sense... here, pharmacies can call the doctor to request refills for prescriptions - check if they can do that where you live... if so, problem solved!

[littlemermaid]

Poppy, I know how you feel. This is the agony of finding out how to work the system. Not great when you're not feeling well in the first place.

You need some local support and advice - how's your GP? I would get round there pronto for a review and some guidance on how to deal with this repeat prescription problem for starters. I think you have a diagnosis and prescription note from Dr C? Doesn't GP do repeat prescription?

If no letter + prescription from Dr C to you/local GP/eye clinic - email his office/phone. Personally I like email unless I get on well with the receptionist/secr.

As SAAG says, I shopped around pharmacies until I found a chain that orders in what we need (some were hopeless, this one was very 'can do'). GP does monthly repeat prescription for eyedrops even with zero knowledge or interest on basis of ophth original letter.

I've just been to GP for this very same reason - to talk to someone medical about how to work the bizarre medical 'system', hosp docs, private docs, repeat prescriptions, eye monitoring, what to do if it's bad. To be honest I made an appointment for depression/anxiety but we quickly identified the root of the problem. Same as you, The Medical System. She was good.

Post up - we want to know how you get on. <hug>

[poppy]

Let me start by saying that I'm an RN. In my experience, most doctors don't write a new prescription for more than a 30-day supply. They want to see how you react to the medication, what side effects you experience and how you tolerate it. If you are having significant adverse effects they would not want to continue the medication. This is reasonable medical practice in my opinion. When you are about 3 weeks in to your prescription, give your doctor a call and let him/her know how you are tolerating it. If you are tolerating it okay, ask for another prescription with refills, enough to see you through until your next appointment. Good luck with the Restasis.

I know that sounds logical that they "want to see how you go" first but I don't buy it when I've been given steroids with multiple repeats and no follow up for almost 3 months....

[poppy]

Poppy, I know how you feel. This is the agony of finding out how to work the system. Not great when you're not feeling well in the first place.

You need some local support and advice - how's your GP? I would get round there pronto for a review and some guidance on how to deal with this repeat prescription problem for starters. I think you have a diagnosis and prescription note from Dr C? Doesn't GP do repeat prescription?

If no letter + prescription from Dr C to you/local GP/eye clinic - email his office/phone. Personally I like email unless I get on well with the receptionist/secr.

As SAAG says, I shopped around pharmacies until I found a chain that orders in what we need (some were hopeless, this one was very 'can do'). GP does monthly repeat prescription for eyedrops even with zero knowledge or interest on basis of ophth original letter.

I've just been to GP for this very same reason - to talk to someone medical about how to work the bizarre medical 'system', hosp docs, private docs, repeat prescriptions, eye monitoring, what to do if it's bad. To be honest I made an appointment for depression/anxiety but we quickly identified the root of the problem. Same as you, The Medical System. She was good.

Post up - we want to know how you get on. <hug>

Thanks for your reply LM. Does your GP give you repeats of steroids? I've found it really hard to get steroids from a GP which is why I'm a bit reluctant to ask for eye drops that the GP may assume have side effects like steroids.

Yes the medical system is making me very stressed too. And basically all psych meds cause dry eye. I googled what meds cause dry eye and almost everything does, not just psych meds. If I express concern about side effects of a medication on my eyes, I get told to just use more drops!

[littlemermaid]

Hey Poppy, Yes, whatever doc we've seen (hospital eye clinic/private) writes letter to LM's GP with diagnosis + prescription, arranges 3m or 6m followup in hosp eye clinic, assumes GP is looking after us meanwhile. Sometimes hosp doc sends us to hosp pharmacy to pick up new drops to start straight away. Assumption is if something weird's happening, we go to hosp emergency eye clinic for advice, they will stabilise, contact Dr Whoever for a rethink.

Monitoring has been a bit rubbish at hosp eye clinic. We should have intraocular pressure check (IOP) on steroids more frequently than ophth appointments. Sometimes I book monitoring check with hosp optometrist only. High street optom can also do IOP check, have a quick look. (They get irritated hosp don't do more organised monitoring since they prescribe steroid drops.)

GP issues prescription ongoing on instruction of hospital doc. You're right, GP should not be issuing eye steroids without ophth specialist training, ophth needs to do that, as Kitty says. However, since you're ongoing, GP can do repeat prescription on the basis you're in co-care monitoring with Dr C and ACT hosp (ideally). (This is how it could be UK, Oz maybe different.) GP can check formulary for steroid drops to get advice on looking after patient, eg frequency of IOP check, possible side effects to look for. As you say, you need help negotiating local medical system like we do, I'm still thinking GP. Docs struggle to negotiate this stuff too and get frustrated too. You need someone on your side to share this with - finally found a lady GP supportive enough to get appointment purely to talk about how we're feeling (as ColinP says, short-course antidepressants are an option - you could monitor side effects), but has the guts to refer to big-cheese hospital/private docs.

Pharmacist I finally found keeps computer record, will issue eg emergency supply, specialist order in advance for collection eg refrigerated preservative-free drops, unusual stuff. Took me a bit to find a pharmacist that good. One solution to building a stash has been: ophth prescription fulfilled at hosp pharmacy + GP repeat prescription fulfilled at high st pharmacy. Hey, we have to get crafty

[Trac]

My 30 day supply of Restasis last me for at least 3 months. I use one vial until it is empty. So one vial lasts about 3 days if I put the drops in twice a day. I am currently using Restasis 4 times a day and a vial last about 2 days. Your prescription should call for you to use 2 vials a day. So you have a lot of Restasis available. Also, once your get low on your Restasis you should call your pharmacy and your doctor and ask for a refil if you feel that the Restasis is helping.

By the way we all need to vent sometimes.