Leyla Hannbeck, head of pharmacy at the National Pharmacy Association, answers three of the 700 questions fielded every day by the NPA’s Pharmacy Services team

Question

Can a repeat veterinary prescription for a Schedule 4 controlled drug be dispensed after 28 days if the first dispensing was made within 28 days of the appropriate date?

Answer

No. Repeat prescriptions for Schedule 4 CDs must be dispensed within the 28-day validity period of the prescription. Veterinary prescriptions for Schedule 5 CDs are valid for six months and any repeats on the prescription must also be dispensed within this six-month period. Repeats for Schedule 1, 2 and 3 CDs are not allowed on veterinary prescriptions.

Question

Can Anbesol liquid be used by a patient who is taking erythromycin tablets 250mg?

Answer

The Summary of Product Characteristics for Anbesol liquid states: “In patients taking erythromycin the toxicity of oral lidocaine may be markedly increased”. Stockley’s Drug Interactions online advises that there is limited information about an interaction between oral lidocaine and erythromycin, and since lidocaine is not given orally this is of minor importance. However, Anbesol is an oromucosal solution and there have been reports of accidental ingestion, so the toxicity of lidocaine might be increased.

If a patient is going to use Anbesol liquid they should be counselled on the correct method of administration to ensure they don’t take the liquid like an oral medicine (Anbesol liquid should be applied undiluted to the affected area with the fingertip) or use it too frequently (it should not be used more frequently than every three hours). The patient should also be made aware of the symptoms of lidocaine toxicity, for example, bradycardia, hypotension, pins and needles, and to seek medical attention if they experience any of these.

Question

Are the isotretinoin prescribing and dispensing restrictions applicable to male patients?

Answer

No. The requirement to prescribe no more than 30 days treatment and to dispense isotretinoin within a maximum of seven days of the prescription being issued (ideally the prescription should be issued and dispensed on the same day) is not applicable to male patients.