Why prescriptions are required for buying Rx drugs
Unlike vitamins or over-the-counter pain relievers, prescription medications require a doctor's authorization. But why is showing a prescription crucial? What are the risks if a pharmacist gives out these medications without one?
Recently, a Facebook user went viral for calling out a pharmacist who refused to dispense an Rx drug, specifically showing Irbesartan (a maintenance drug), without a prescription.
In her caption, she questioned why she was refused to be given an Rx drug without a prescription when she was always able to buy one from other pharmacies despite not presenting one.
“New policy daw sa DOH?! Palihug edukaha ko (please educate me),” she wrote.
At the beginning of the now-deleted viral video, the pharmacist was seen explaining to the social media user that if there’s an “Rx” indicated in the medicine, a customer needs to present a prescription.
Sa Pharmacy tinuruan kami pag may RX ang drug label automatic it needs a prescription from the physician before dispensing it. SOP yan, wala nang tanung-tanong. In this video from Joan DV Alcudia tama yung Pharmacist, pinahamak lang nung nag video yung staff sa other drugstore. pic.twitter.com/UxCy7haRU7
— @pauloinmanila and 99 others (@pauloMDtweets) April 22, 2024
The pharmacist explained the risks associated with dispensing an Rx drug without a valid order. He said this could result in the loss of their license.
“So you mean Rose Pharmacy, Mercury [Drug], and Watsons, they don’t have [a] license?” a man in the background replied.
The pharmacist replied, “Sa rules of the Philippines, with Rx, you need a prescription.”
Why do you need a prescription?
Nikko Lim, a public health advocate and a topnotcher in the 2019 Pharmacists Licensure Exam (PhLE), explained that there are two primary categories of medicine: over-the-counter (OTC) or non-prescription medicines and prescription medicines.
The former is typically for “symptomatic relief of minor ailments like pain, fever, coughs, colds, and diarrhea, among others.”
Meanwhile, prescription medicines, or Rx drugs, can only be bought upon presentation of a valid prescription from a licensed healthcare provider—physician, dentist, or veterinarian—accompanied by necessary pharmacist advice. These are antibiotics and medications for chronic conditions, such as hypertension, diabetes, dyslipidemia, or cancer.
“Prescription medicines are often more potent, carry higher risks of side effects, or require careful monitoring by healthcare professionals,” he told PhilSTAR L!fe.
Rendzborg Bautista, a college instructor and a topnotcher in the 2022 PhLE shared with L!fe that a prescription is required to “ensure these medications truly belong to them.”
“Prescription drugs have significant risks associated with its use that’s why taking these meds should be under the supervision of a licensed medical practitioner,” he said.
This was echoed by Lim, adding that prescription is a personalized approach that helps “minimize the risk of adverse reactions or ineffective treatment.”
He also noted that it helps ensure patient safety not only in treating their current medical condition but also from potential misuse.
“The prescription requirement acts as a safeguard against the misuse, abuse, or diversion of certain medications, particularly those with the potential for addiction or dependence,” he added.
What could happen if a pharmacist sells an Rx drug without a prescription?
Bautista warned that dispensing Rx drugs without a prescription might lead to “adverse effects.”
“It might lead to adverse effects especially when these medications will be taken by patients who were not prescribed to take it in the first place,” he said.
He also noted, “Nowadays, self-medication is rampant. Minsan kasi, porke’t narinig nila sa kapit-bahay na effective yung isang gamot, iinom na rin sila.”
Bautista also stressed that prescription is crucial because this will serve as pharmacists’ reference in giving the correct dose on maintenance medications.
“In the case of dispensing maintenance medications, we as pharmacists really need to ensure that the dose being taken by the patient is regularly updated by their physician,” he said.
“Sometimes kasi, the dose needs to be increased or decreased depending on the patient’s response to the medication. We can only verify this through a prescription written by a doctor,” he continued.
Lim also noted that prescription requirement is established under the Republic Act 10918, or The Pharmacy Law, which states, “Prescription/Ethical medicines refer to medicines which can only be dispensed by a pharmacist to a patient, upon the presentation of a valid prescription from a physician, dentist, or veterinarian and for which a pharmacist's advice is necessary.”
“Thus, such actions are not only illegal but also subject to disciplinary measures against the pharmacist. Article VI, Section 44, and Article VII, Section 46 of the same legislation outline potential penalties, including revocation or suspension of the pharmacist's Certificate of Registration (COR),” he explained.
'Knowledge is power'
The recent viral video about the pharmacist is unfortunate, to prevent situations like this from happening, Bautista believes in the adage, “Knowledge is power.”
“We really need to educate the people about the proper use of medications. Although it’s hard to be idealistic in this type of healthcare system, I do believe na kailangan maexplain nang maayos sa patients yung mga ganitong bagay,” he stressed.
Lim also said the same thing, adding that informing the public about the importance of prescription requirements can be done through “patient counseling, signage in pharmacies, and community outreach efforts.”
“It's also an opportunity to educate the public that pharmacists are not merely ‘tinderos/tinderas’ in boticas; we are healthcare professionals capable of providing patient care,” he stressed.
He added: “Pharmacists, who are bound by law to adhere to regulations, should remain vigilant and strictly adhere to professional and legal standards, refusing to dispense prescription drugs without a valid prescription.”
Lim furthered that regulatory agencies like the Department of Health, the Food and Drug Administration, and the Professional Regulation Commission, "should strictly regulate and enforce these practices."
"The Philippine Pharmacists Association, as the accredited professional organization of the pharmacy profession, should actively engage and advocate on these matters, especially to the public," he added.
On the other hand, they also underscored that the public also has a role in conforming to such requirements by reporting pharmacies that don't adhere to the law.
Bautista stressed, “The patients/consumers should be open-minded. After all, as healthcare professionals, what we are all after is the improvement of everyone’s health."