Q. I have been reading about pharmacists refusing to fill prescriptions for birth control pills on moral grounds. I find this attitude infuriating!
They would be amusing in their self-importance if there were not dire consequences for the customers in small towns who don’t have much choice in drug stores. Pharmacists should stick to dispensing pills instead of their personal criteria for eternal salvation.
A. The issue of pharmacists refusing to fill prescriptions for ethical or religious reasons has a lot of people excited. We checked with David Work, Executive Director of the North Carolina Board of Pharmacy, one of the country’s experts in pharmacy law.
He suggested that pharmacists should think carefully about refusing to fill a prescription for contraceptives: “If the woman cannot find an alternative source in a timely manner and turns out to be pregnant, she could have a cause of action against the pharmacist.
“There is precedence, of sorts, in a Michigan case where a pharmacist made an error on a prescription for oral contraceptives. He dispensed a tranquilizer by mistake and the patient became pregnant. She brought litigation and obtained substantial damages for the cost of raising the child.”
Q. I know that aspirin reduces the risk of heart attacks, strokes and cancer, but I am confused about the best dose. Some experts recommend a baby aspirin while others suggest a regular aspirin daily.
I am prone to stomach irritation from chronic NSAID use. How can I get the benefits of aspirin and minimize the risks? Is buffered aspirin better?
A. Even low-dose aspirin (81 mg) can cause digestive tract irritation for some people. That’s why no one should undertake a lifelong aspirin program without medical supervision.
There is still a lot of confusion about the ideal dose. The cardiovascular benefits of aspirin are detectable at surprisingly low levels (40 mg), but some people are resistant and may need higher amounts.
We are sending you our Guide to Key Aspirin Information and Alternatives for Arthritis, for more details on the benefits, risks and interactions of aspirin. Anyone who would like copies, please send $4 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. 3-A, P. O. Box 52027, Durham, NC 27717-2027.
Neither buffered aspirin nor enteric-coated aspirin provides complete protection against digestive tract damage. An acid-suppressing drug like Prilosec OTC might help. Doctors sometimes prescribe Cytotec (misoprostol) to prevent stomach ulcers.
Q. I’ve been taking Lanoxin and verapamil for irregular heartbeats. When I renewed my prescription, the pharmacist warned me that these drugs can interact.
I spoke to my doctor about this, but he seemed put out by the question. He said the dose was too low to be a problem. Should I worry?
A. The pharmacist was right to warn you about this potentially dangerous interaction. Verapamil may gradually increase digoxin levels and lead to toxicity.
Your doctor must monitor your digoxin level carefully. He should also review this interaction so he can reevaluate if this combination is the best way to treat your arrhythmia.
