Pharmacy Guide for Buprenorphine Patients

Common brands for buprenorphine include Suboxone, Subutex, or Zubsolv, among others.

Some pharmacies have rules that limit how far you or your doctor (or other prescriber) are from the pharmacy. These are not laws but policies controlled by the pharmacist or the pharmacy. It’s okay if you don’t live close to your doctor or pharmacy because you may not be able to use a doctor or pharmacy that is closer to you. You can say: • “I understand. I’m using this pharmacy because my provider sent my prescription here (OR it’s the only one nearby that has my medication). I’m thankful you stock this important medication.” • “Many pharmacies don’t carry my medication. I’m just trying to safely get what my doctor prescribed.” If they still say no, ask: • “Can you make a one-time exception?” • If they say yes, you still may need to find a new pharmacy when you need a refill. Remember to make a plan to refill your prescription before you run out of medication. • “Can you recommend another pharmacy that can fill this prescription?” • Once you find another pharmacy that can help, you can ask the new pharmacy to request to transfer your prescription so the new pharmacy can fill it.

This may be true. Pharmaceutical distributors, the companies that sell medications to pharmacies, limit how much buprenorphine that pharmacies can order each month. Some pharmacies may also just not want to dispense buprenorphine or set their own patient limits. This can make it difficult for patients who need to fill their prescriptions. You can ask: • “When will you have more buprenorphine in stock?” • “Can I fill my prescription here when you have more available?” • “Do you know another pharmacy that might have it?” • Once you find another pharmacy that can help, you can ask the new pharmacy to request to transfer your prescription so the new pharmacy can fill it.

No law says you must use insurance. Some pharmacists check insurance to see how soon you last filled your prescription, but this doesn’t mean you need to use your insurance if you don’t want to. You can say: • “I’d prefer not to use my insurance and I can pay for it on my own. Can you please fill this without going through my insurance?” • You can also ask to use the store’s discounting program – if they have one – or a discount card like GoodRx or Singlecare. If they still say no: • Ask for a transfer to another pharmacy. • Once you find another pharmacy that can help, you can ask the new pharmacy to request to transfer your prescription so the new pharmacy can fill it.

Taking some medications together can carry risks, but stopping other medications suddenly can be dangerous. It’s important to make sure that you tell all of your doctors about all of the medications you are taking. It’s okay to let your doctor make this decision with you and your pharmacist. You can say: • “I’m taking both under my doctor’s care. I’d feel better if my doctor made this decision. You’re welcome to call them, and I’m happy to wait.” If the pharmacist still says no, we recommend that you call your doctor as soon as possible so they can help you figure this out. You can try to transfer your buprenorphine prescription, but if two medications are involved it would be best to call your doctor first.

Naloxone nasal spray is helpful and sometimes prescribed with buprenorphine. If your insurance doesn’t cover it, your pharmacist may charge you for it.Your pharmacist cannot require you to buy naloxone, or anything else, if you don’t want it. Many communities also have free naloxone available. You can say: • “I would rather not buy naloxone nasal spray today but I do need to fill my buprenorphine prescription. ” • You can also mention that you already have a naloxone kit or that you know how to get one for free. If they still say no: • Ask why, take notes, and let us know because we want to help prevent this from happening to others. • Ask for a transfer to another pharmacy. • Once you find another pharmacy that can help, you can ask the new pharmacy to request to transfer your prescription so the new pharmacy can fill it.

Federal law allows a one-time transfer of a buprenorphine prescription. It is best to do the following, in this order: • Call the new pharmacy first. Explain that your doctor gave you a prescription, but the pharmacy they sent it to won’t fill it. Ask if they have your medication in stock. • If they do have it in stock and can fill it the same day, ask them to request the transfer from the old pharmacy and be prepared to give them the following information: • The name of the pharmacy • The pharmacy’s phone number and address, if you can find it • Your name, date of birth, and the name of the medication(s) you are transferring. • Ask the new pharmacy when they think your prescription will be ready. • If you've already transferred this prescription once, the same prescription cannot be transferred again. You will need your doctor to send a new one. • If you can’t find a new pharmacy, contact your doctor first.

Things happen. Most doctors or pharmacists should help if you explain. If you need an early refill, your insurance may not pay for it. You will need to pay out of pocket. Ask your pharmacist to help find you the cheapest option. Sometimes, the pharmacist will let you buy less than the full amount of buprenorphine you were prescribed. If your doctor needs to send a new prescription, your pharmacy may also cancel your old prescription and you will lose any refills on it. Start by telling your doctor why you need an early refill. It’s important they know why: • “I lost my medicine / I’m traveling and will run out. Can you help me refill early?” • Your doctor may send a new prescription or call the pharmacy to explain. If the doctor is going to send a new prescription, you can ask them to write “May be filled on [today’s date].” Once your doctor contacts the pharmacy or sends a new prescription, you should call the pharmacy to confirm that they talked to your doctor and can fill your prescription. You can say: • “I need to refill my buprenorphine prescription today because I [lost my medication / am about to leave on a trip]. My doctor knows and may have already called. I want to avoid missing a dose. When can I pick it up?” If your medication was stolen, you may need to provide a police report. If you’re traveling, let your doctor know at a regular visit and plan ahead as much as possible.