Warning about mail order medictions

[LuvOrlando]

I just had a scary experience that I think other people need to be aware of for their safety.

My son is on Pulmicort Respules (ampules) for a Nebulizer to treat his Asthma. I prefer to get their medicines from a brick and mortar pharmacy but Medco has been penalizing us for doing this so lately I've been tolerating their in-the-mail system. That is until last week when they sent me my son's Pulmicort without ice packs, even though I asked them to do so. The medicines are not sent 'signature necessary' so they just get delivered whenever and stay outside until picked up. Well, the day Pulmicort was delivered was a very hot day and they sat out in the direct sun for hours. The medicine actually felt hot to the touch, but there are no temperature reading tabs in the box to tell me how hot it actually got so I had to guess. Good thing I read the insert. So I called and complained and they gave me a song and a dance about how the temps on the insert are just 'guidelines' that the medicine doesn't REALLY need to stay at those temperatures (66-77 degrees F). They didn't say it was a mistake, they told me I was misunderstanding the instructions. I kept complaining and they got me a Pharmacist who I had to back into a corner to get a top threshold temp of 104F. I had to demand this medicine be replaced, this time packed in ice, and they did... but they acted like they were doing me a huge favor.

So just now I pulled it out of the sun and the ice is all melted and the stuff feels warm to me. So this time I called Astera-Zeneca because I wanted firm answers on what is and isn't ok for this medicine. I get a nurse reading from the same insert i have who tells me no other info is available to consumers about the upper limits of temperature tolerance, that 77 was the max and it should never ever be frozen. I asked what the temp is that this stuff freezes and she couldn't say. That I need to rely on the Pharmacy to comply with the shipping requirements they had to sign in the contract. However, the guidelines in this contract are not available to me. I could ask my Dr to call for me, as if my Dr is going to waste 1/2 hour on this. I am really upset as a consumer and parent that I am not able to make a knowledgeable decision on my child's treatment because the full info isn't available to me, it's all behind the scenes.

My head is totally swimming. I just spent $78 co-pay on a very expensive box of medicine where I have zero confidence in whether or not it's spoiled, and have the older 4 boxes waiting to be picked up by the garbage man. My kid needs this stuff to keep him breathing. How am I supposed to trust this medication, more importantly, I can't help but wonder how many other people out there are getting spoiled medications this way? I can't be the only one, this is unreal. What good does it do for the FDA to have all these specifications if they all go out the window in the final step before the medicine reaches me? What a mess.

I just thought I'd post to recommend anyone else out there getting mail order medications check the temperature limits on your meds and make sure the mail order company is keeping within the drugs requirements on the inserts. I know mine isn't, I guess I'll be paying the penalties and go back to my regular Pharmacy, this is just way too important.

 

[TinklednPants]

So I called and complained and they gave me a song and a dance about how the temps on the insert are just 'guidelines' that the medicine doesn't REALLY need to stay at those temperatures (66-77 degrees F). QUOTE]

So now you have it coming packed in ice???

 

[gator75]

so sorry this happened to you . i guess its true what they say is true what important to one person isn't important to another. for some reason i have never trusted mail order pharmacies. the same thing actually happened to my father inlaw with some diabites medication. it got to be so often that they where delevering it without ice pack that my mother inlaw had to have it delevierd to her place of work. it may cost you more but in the end i think that you you would have more peace of mind just going to the local pharmacy.

 

[BCV513]

Won't it get too cold packed in ice?

 

[ols386]

so sorry this happened to you . i guess its true what they say is true what important to one person isn't important to another. for some reason i have never trusted mail order pharmacies. the same thing actually happened to my father inlaw with some diabites medication. it got to be so often that they where delevering it without ice pack that my mother inlaw had to have it delevierd to her place of work. it may cost you more but in the end i think that you you would have more peace of mind just going to the local pharmacy.

The insurance that we used to have (we don't have it anymore), we were REQUIRED to get prescriptions filled by mail, thru Medco, for on-going medications (meds that we take all the time, not just short-term meds). We didn't have a choice about getting the prescriptions filled by mail vs. going to the local drug store. I prefer to get meds filled at the drug store, but I think doing mail-order thru Medco was supposedly less costly.

 

[Acklander]

It's probably shipped to the brick and mortar pharmacy the same way it's shipped to you.

 

[robinb]

I would contact the manufacturer of the medication to ask about the maximum temperature. It should be on the packaging and fining the customer service number should be pretty easy.

FWIW, I just looked at the insert for that medication and it also says "Do no refrigerate or freeze" so I don't see how icing the medication would work either.

Another thing to consider is that it is very difficult to keep shipped items at a controlled temperature. I found that out last December when half of my items shipped from Harry and David arrived frozen the recipient's doorsteps. When I called UPS & FedEx (both were used and both had problems) they said that even if H&D had a signature requirement the warehouses were not heated either.

 

[ols386]

It's probably shipped to the brick and mortar pharmacy the same way it's shipped to you.

That's probably true, but I bet when it's delivered to the drug store, it's not left sitting out in the hot weather/sun for long periods of time. They probably are required to deliver it to the pharmacy, inside the store, with a signature for delivery receipt.

 

[ols386]

I would contact the manufacturer of the medication to ask about the maximum temperature. It should be on the packaging and fining the customer service number should be pretty easy.

That's good advice.

 

[npmommie]

OP I would be upset too.

Is there anyway you can leave a cooler outside when you know the med is being delivered, so the UPS man can put it in there instead of leaving outside in the sun?

 

[disfan07]

That's very interesting that you were getting penalized for getting these in store.


I am on xoponex nebs and pulmicort and that is the only medication we do not get penalized for getting it at our pharmacy. We get 100 vials per perscription so it lasts more than 3 months which means our insurance doesnt consider it a "monthly" prescription so no mail order encessary.

But I do have a serious question related to what happened. Why are they packing it in ice? Wouldnt that make it drop below the recommended temperature?

I've never been told about keeping it below 77 degrees. Heck, my house is warmer than that right now (summer in Socal). My pulmonologist has always told me that it is okay to use as long as it is not outside for a prolonged period of time (he said no more than like a few hours). I left mine in the car the other day (104 degrees) and they were in there for about 2 hours and he told me they were still good to use. And I can atest to the fact that they really do work because I used one yesterday and it worked liek a charm. I would double check with his doctor before you deem that they are not good to use.

 

[fabmic]

I just had a scary experience that I think other people need to be aware of for their safety.

My son is on Pulmicort Respules (ampules) for a Nebulizer to treat his Asthma. I prefer to get their medicines from a brick and mortar pharmacy but Medco has been penalizing us for doing this so lately I've been tolerating their in-the-mail system. That is until last week when they sent me my son's Pulmicort without ice packs, even though I asked them to do so. The medicines are not sent 'signature necessary' so they just get delivered whenever and stay outside until picked up. Well, the day Pulmicort was delivered was a very hot day and they sat out in the direct sun for hours. The medicine actually felt hot to the touch, but there are no temperature reading tabs in the box to tell me how hot it actually got so I had to guess. Good thing I read the insert. So I called and complained and they gave me a song and a dance about how the temps on the insert are just 'guidelines' that the medicine doesn't REALLY need to stay at those temperatures (66-77 degrees F). They didn't say it was a mistake, they told me I was misunderstanding the instructions. I kept complaining and they got me a Pharmacist who I had to back into a corner to get a top threshold temp of 104F. I had to demand this medicine be replaced, this time packed in ice, and they did... but they acted like they were doing me a huge favor.

So just now I pulled it out of the sun and the ice is all melted and the stuff feels warm to me. So this time I called Astera-Zeneca because I wanted firm answers on what is and isn't ok for this medicine. I get a nurse reading from the same insert i have who tells me no other info is available to consumers about the upper limits of temperature tolerance, that 77 was the max and it should never ever be frozen. I asked what the temp is that this stuff freezes and she couldn't say. That I need to rely on the Pharmacy to comply with the shipping requirements they had to sign in the contract. However, the guidelines in this contract are not available to me. I could ask my Dr to call for me, as if my Dr is going to waste 1/2 hour on this. I am really upset as a consumer and parent that I am not able to make a knowledgeable decision on my child's treatment because the full info isn't available to me, it's all behind the scenes.

My head is totally swimming. I just spent $78 co-pay on a very expensive box of medicine where I have zero confidence in whether or not it's spoiled, and have the older 4 boxes waiting to be picked up by the garbage man. My kid needs this stuff to keep him breathing. How am I supposed to trust this medication, more importantly, I can't help but wonder how many other people out there are getting spoiled medications this way? I can't be the only one, this is unreal. What good does it do for the FDA to have all these specifications if they all go out the window in the final step before the medicine reaches me? What a mess.

I just thought I'd post to recommend anyone else out there getting mail order medications check the temperature limits on your meds and make sure the mail order company is keeping within the drugs requirements on the inserts. I know mine isn't, I guess I'll be paying the penalties and go back to my regular Pharmacy, this is just way too important.

How do you know that the med stayed below 77 when you get it from a brick and mortar pharmacy? It came on a truck that I am sure was not climate controlled. They can get hot in the summer. Do you live in Orlando? If so, do you rush right home with the medication to keep it below 77? Do you store this in the fridge?

It would seem to be almost impossible to guarantee it never was warmer than 77.

 

[polkadotsuitcase]

OP I would be upset too.

Is there anyway you can leave a cooler outside when you know the med is being delivered, so the UPS man can put it in there instead of leaving outside in the sun?

That's a good idea!

When we delivered Meals on Wheels, some residents would prefer to just have us leave the meal. They'd put out a cooler like this.

 

[Mkrop]

It's probably shipped to the brick and mortar pharmacy the same way it's shipped to you.

Not at all, there is usually an intermediary(sp) that handles shipping medicine. The manufactors all ship it to another company who has all the different meds from all the places on the shelf. Then a pharmacy like CVS, or a smaller chain liked I worked for will order from them, receive the delivery, they could not deliver if we were not open. We would then sign for the delivery and immediately one of us would put certain meds away. Those were usually in their own bin. Other meds would wait until we could get some downtime to put them away. Meds would not be sitting in the hot sun all day.

I hate mail order but we were recently forced to start getting stuff from them.

My DH who works in this industry says that Medco is the worst, and was quite surprised that his company would contract with them but here we are.

Many years ago, Medco mailed my dad the wrong type of Potassuim pills. He took these for his heart. On the label it said the correct ones. I just happned to be over and popped open the bottle. I noticed they were the wrong color (they were solid orange and should have been orange and white). I called the pharmacy I worked for and they verified that it was the wrong stuff. I called the doctor who verified he did not change the strength. Medco was not happy about getting called out. Taking too much potassium is pretty serious stuff.

 

[Mkrop]

OP I would be upset too.

Is there anyway you can leave a cooler outside when you know the med is being delivered, so the UPS man can put it in there instead of leaving outside in the sun?

For us, Medco delivers by mail not UPS. They are not labeled that they are even from Medco, It sits in my mailbox all day.

I do not receive any items that require tempature control but I do receive contolled substances for my DS7, his ADD meds, that should have to be signed for but Medco does not require that. I find this very dangerous. I was shocked that they were allowed to fill 3months worth because the brick and mortar pharmacies can not.

 

[PrincessBree]

At work I have to give out Pulmicort on a daily basis. We also accept it from an outside pharmacy and have never rec'd it in ice nor do we keep it in ice. It stays in a med cart. The people that deliver these medications to use also deliver to many other facilities so medications are left in a hot car during other deliveries.

 

[Tinkermommy]

My MIL is diabetic. She was also told she had to order her insulin mail-order. Well, one batch must have gotten too hot and therefore ineffective. She went to a severe reaction and had to be put in the hospital for a day or two to get it regulated.

She now refuses to get her insulin in the mail and pays a lot extra to get it at the pharmacy.

My company supplies ingredients to pharmaceutical manufacturers. When we ship out product that has to be kept at a certain temperature range, we have to conduct Validated Packing and Shipping Studies or the manufacturer will not buy from us.

I would hesitate to do this, but you could call the FDA and see if the pharmacy is following correct procedures.

 

[Christine]

For us, Medco delivers by mail not UPS. They are not labeled that they are even from Medco, It sits in my mailbox all day.

I do not receive any items that require tempature control but I do receive contolled substances for my DS7, his ADD meds, that should have to be signed for but Medco does not require that. I find this very dangerous. I was shocked that they were allowed to fill 3months worth because the brick and mortar pharmacies can not.

I use another mail order pharmacy and can vouch that 90 day prescriptions on ADD meds are allowed. I've been doing it for years with two different mail order phamacies.

I have thyroid medication that is very temp. sensitive. I *try* my best to work around it that I don't order in the summertime. If I need meds in the meantime, I will have my doctor write me out a 30-day script and I will just pay the extra money to ensure that I don't get a batch that's been subjected to a lot of heat. So far, I haven't been forced to do mail order but I certainly get financial penalized if I don't.

It all really irritates me--this mail order business. It sounds great and works great; however, I think most medications are really sensitive to high temps and I don't like mine sitting in my mailbox for 4 hours until I get home.

 

[Mkrop]

I use another mail order pharmacy and can vouch that 90 day prescriptions on ADD meds are allowed. I've been doing it for years with two different mail order phamacies.I have thyroid medication that is very temp. sensitive. I *try* my best to work around it that I don't order in the summertime. If I need meds in the meantime, I will have my doctor write me out a 30-day script and I will just pay the extra money to ensure that I don't get a batch that's been subjected to a lot of heat. So far, I haven't been forced to do mail order but I certainly get financial penalized if I don't.

It all really irritates me--this mail order business. It sounds great and works great; however, I think most medications are really sensitive to high temps and I don't like mine sitting in my mailbox for 4 hours until I get home.

Yes I was just shocked given all the restrictions on this when I was a pharmacy tech, and the fact that CVS cant do it but they can.

 

[msjprincess]

I'm confused. You're worried about the medication getting above the recommended temperature but not below it?

Almost all medication lists a temperature on the insert. I really think it's just a general guideline. My daughter's epi-pen says to store it at 77 degrees and not to let it get below 59 or above 86. Obviously my purse isn't temperature controlled so sometimes it's way over and sometimes it's way below.