Question

Why do patients need to avoid eating certain foods within two hours of taking Adcal or Adcal-D3?

Answer

Adcal and Adcal-D3 formulations should not be taken with two hours of eating food that is rich in:

• Oxalic acid, eg, cocoa, rhubarb and spinach
• Phosphate, eg, bananas, cheese spreads, ham and sausages
• Phytic/phytanic acid, eg, chocolate, pulses and wholegrain cereals.

This is because oxalic acid, phosphate and phytic/phytanic acid can reduce the absorption of calcium if taken at about the same time.

Question

Can I post patients’ medicines through their letterbox?

Answer

This is not recommended as it is associated with a number of risks:

• The medicines could be delivered to an incorrect address and patient confidentiality could be breached
• Pets or young children could potentially obtain the medicines
• It does not allow patient counselling to occur (the pharmacist could overcome this by following up the delivery with a phone call)
• A clear audit trail would not exist as a patient signature would not be obtained – this could be an issue if the patient claimed they had not received their medicines
• The pharmacist is responsible for the medicines until they have physically reached the patient.

If the pharmacist did decide to post medicines through a letterbox the following should be considered:

• A standard operating procedure should be in place for the delivery of medicines, which includes the process for posting medicines through a letterbox
• The indemnity insurer of the pharmacy should be contacted to ensure the process would be covered from an insurance point of view
• Obtain a letter of authority from the patient confirming that they have authorised for their medicines to be posted through their letterbox and that there are no pets or young children present in the property.