Beginners Guide to TikTok for Search - Rachel Pearson - We are Tilt __ Bright...
Practice md marketing booklet
1. POINT OF CARE DISPENSING
In-Practice
Physician Dispensing Program
Sample Proposal
PracticeMD, Inc.
PO Box 6657 ● 242 Lynbrook Boulevard
Shreveport ● Louisiana ● 71136
318.841.4320 direct ● 318.841.4319 fax
info@PracticeMDRx.com
Chicago ● Dallas ● Miami ● Oklahoma City ● Orlando ● Sacramento ● Tampa Bay
4. PROGRAM OVERVIEW
PracticeMD is a program that allows physicians to dispense pre-packaged medication at the
point of care. Through Cash Pay Deductibles and Workers’ Compensation, PracticeMD
allows practices to easily increase profitability within the practice. It allows doctors to enjoy a
new source of income while offsetting cutbacks in managed care.
PracticeMD also provides a “One Stop Shop” model for patients by implementing its program
directly into their doctor’s practice. This means that patients are able to get a diagnosis from
a physician and have their prescriptions filled on-site in one trip, preventing multiple stops at
retail pharmacies.
Improved Treatment Compliance
In a recent national study, three out of four Americans said they would have their prescription
filled in their doctor's office instead of a pharmacy if given the choice. This enhances patient
compliance by ensuring prescriptions are filled and the prescribed course of treatment is
followed. Studies suggest as many as 20% of all prescriptions go unfilled each year.
PracticeMD in-office medication dispensing ensures your patients have their medications in
hand before they leave your office.
How it works
Practices typically will need to carry a selection of their most commonly prescribed
medications. At the time of patient checkout, they provide these medications to them for a
small fee, usually equivalent to co-pays.
PracticeMD sets up a Formulary for your practice that will enhance profitability through low
cost pricing. This program also eliminates insurance filings for medications.
Declining reimbursement rates, combined with the emergence of consumer driven
healthcare, is leading doctors to explore new and innovative ways to heighten the patient
experience and find new sources of income. Improve patient satisfaction and enhance
revenue with the PracticeMD in-office medication dispensing program.
In-practice medication dispensing is the process of distributing safety sealed pre-packaged
medications to patients at the point of care.
Most medication dispensing programs utilize a cash and carry model, eliminating the hassle
of filing insurance claims. PracticeMD also offers Workers’ Compensation, Personal Injury
and PIP (auto Personal Injury Protection) programs where available.
1
5. PROGRAM BENEFITS
SAVE YOUR PATIENTS TIME AND MONEY
Patients who are ill, in pain or very busy will appreciate the convenience that comes from
receiving their medications from their physician or dentist, sparing them a separate trip and
long wait at the pharmacy.
INCREASE INCOME
Medication dispensing is a great way to generate additional income for your practice. With
typical net revenue ranging from $5 to $15 per prescription dispensed for our “cash & carry”
model and potentially much higher revenue using our Workers’ Compensation, Personal
Injury and PIP (auto Personal Injury Protection) program, an active in-office dispensing
program can significantly strengthen your practice’s bottom line.
FIRST-DOLLAR PROFITABILITY
There is no upfront cost to the practice for installation of equipment (DEA-approved
prescription storage cabinets, hand held scanners, labels & software), and there is a 30-day
contract with “no cause” opt out. Prescriptions are delivered with a 30-day net due invoice.
The traditional prescription order equates to a two week prescription trend. Prescriptions are
delivered via express courier with signed delivery receipt. The PracticeMD system of
delivering prescriptions with a 30-day net due invoice allows each Practice to cover all cost
on a cash & carry basis from day one. Most practices receive their 2nd or 3rd two-week
resupply order prior to payment of the original invoice.
PRACTICE ACTIVATION
PracticeMD provides training for physicians and staff, and establishes a work-flow for
dispensing operations. Traditional implementation of services requires a two (2) week
activation protocol. Staff training requires approximately one hour. Upon receipt of the first
prescription order, custom software is installed (web based), training is implemented, and the
dispensing path confirmed for delivery of prescriptions to patient through patient check out.
Key Practice support and training advantages:
Workers’ Compensation EDI Support
Formulary Development & Support
24 Hour Technical Support
On-Call Pharmacists
Online and Continuing Education / Training Available
Dedicated Client Service Personnel
2
6. Web Based Software
Point-of-care dispensing solution for unit-of-use medications
Delivers maximum flexibility to meet your practice’s dispensing needs
Bar-code technology verifies the prescribed medication for each bottle
dispensed. Once verified, the following steps are automated with the average
dispense completed in less than 30 seconds
Patient Specific Label (peel & stick)
DUR Compliance
Drug/Drug Interaction
Drug/Allergy Contraindications
Drug Over-Utilization
Physician Override Required
Education & instruction sheet provided
Inventory tracking
Refill Monitoring and Automated Patient Sequencing
Detailed Management, Utilization & Financial Reporting
Multi-Re packager Ordering Capability & Automated Inventory Reorder
Product Expiration Alerts
DEA Compliance & Reporting
STARK Regulation Compliant
Workflow – Dispensing Path (Physician approved)
Compliance Reporting
DEA “Controlled Substance” Compliant
Pharmacy Board Compliance & Reporting
HL-7 Data Interface and Data Exchange Capability
Electronic NCPDP 5.1 Claims Submission Capability
Electronic State Scheduled Drug Reporting (PDMP)
3
7. PracticeMD – A Common Sense Solution
“The average physician spends up to 60 minutes a day dealing with
pharmaceutical issues for no revenue. For every three physicians, there is
usually one employee dealing exclusively with pharmaceutical issues. This
employee is often a registered nurse whose salary and benefits may reach up
to $100,000 annually.”
- Noffsinger R. Chin S. Improving the delivery of care and reduction
healthcare cost with digitization of information. Healthcare Information
Mgmt, 2000
“American Medical Association (AMA) guidelines do not preclude office
dispensing as long as state and federal regulatory requirements are fulfilled, the
doctor prescribes only to his/her patients and allows them to fill prescriptions
where they want.”
- American Medical Association Counsel on Ethical & Judicial Affairs 8.06
4
8. PracticeMD Dispensing FAQ
The # 1 question asked by physicians: Is it legal?
Yes, every physician is allowed by law to dispense medications to his/her own patients within the
practice environment. Under Stark regulations, physician dispensing is considered acceptable when
the dispensing is limited to the physician’s own patients; and the medications and products dispensed
meet FDA guidelines for repackaging and labeling. There are only four states (Montana, New York,
Utah, and Texas) that have more restrictive laws concerning point of care dispensing; it is allowed,
but limited.
Is dispensing right for my office?
Dispensing is traditionally provided in offices which prescribe heavily for acute conditions requiring a
single course of therapy. Typical medications include antibiotics, anti-inflammatory, pain
management, etc. All medications are delivered to your office as safety sealed pre-packaged
medications.
Will I be a full-service pharmacy?
No. The key to a successful dispensing program is to identify and support existing physician
prescribed courses of medication. Physicians typically prescribe like medications repeatedly, and the
ideal in-practice formulary consists of the most frequently prescribed medications in their most
commonly ordered strengths and package size (“unit-of-use”). In-practice dispensing is not intended
to replace a full-service pharmacy, but rather to provide a subset of medications that make up 60% to
80% of prescriptions prescribed, depending on one’s specialty.
May I provide mail order service to my patients?
Yes. However, in compliance with Stark Regulations, mail order prescriptions are recognized as an
out-of-practice delivery and therefore not eligible for compensation. Physicians that offer mail order
services usually provide this option as a courtesy to one’s patients.
How much will point of care medication dispensing cost my practice?
There are no upfront cost for workers’ compensation, 3rd party insurance (i.e. State Farm Auto) and/or
cash & carry generic program. PracticeMD Dispensing will provide the use of the dispensing software,
medications, medication cabinet, bar code scanner, pharmacy labels, pharmacy bags, training and
support.
The insurance adjudication program requires a reasonable enrollment fee which credentials the entire
practice to electronically process their pharmacy claims through the respective payer. This means that
regardless of the number of physicians within the practice, all prescriptions written at that location will
be eligible for electronic claims submission. We have found that this small investment is quickly
recouped within the first few weeks of dispensing.
However, each practice is required to pay for the actual cost of medications dispensed. PracticeMD
delivers medications with a 30-day net due invoice. Additionally, medications are delivered using a
two (2) week trend; this allows most practices to dispense 2 to 3 deliveries prior to payment of the
first invoice. Several states may require an inventory or sales tax, and/or a dispensing license per
physician. PracticeMD will provide support for these requirements, if applicable. PracticeMD provides
a “no cause” ninety (90) day initial contract for services provided.
Page 1 of 6
9. Does point of care medication dispensing comply with state and federal drug dispensing
regulations?
The PracticeMD Dispensing system complies with all DEA and FDA requirements. Repackaging
companies are held to more stringent guidelines than pharmacies and all medications are repackaged
in sterile environments to assure compliance.
What is Stark Regulations? How does this affect me if I become a dispensing
practitioner?
Stark law pertains to physician self-referral for Medicare and Medicaid patients. There are exemptions
to this status for in-office ancillary services including physician dispensing. The in-office ancillary
services exception of Stark law permits physician owners of a medical group, and other members of
the group, to refer patients to their group for certain Designated Health Services (DHS). An
outpatient prescription drug given to a patient in the physician’s office, but taken by the patient at
home, is now covered by the in-office ancillary services exception. To qualify for protection under the
in-office ancillary services exception, the DHS must be furnished personally by the referring physician
or another physician member in the same group practice or by individuals who are "directly
supervised" by the referring physician or group practice member. The in-office ancillary services must
be furnished in the same building in which the referring physician or a group practice member
furnishes substantial physician services unrelated to the furnishing of DHS.
What is the profit potential to my practice?
If your practice is using the PracticeMD Dispensing system by promoting it to all patients and
encouraging use of the program, the profit potential can be significant. As with any program,
utilization is the key. For a single physician practice seeing 30 patients per day, the average annual
income range is between $50,000 - $125,000. Workers’ compensation costs and profit margins vary
by state and will generally produce much higher margins.
Why have I not heard of this before? Is point of care medication dispensing a new
concept?
The practice of point of care medication dispensing has been around since physicians began practicing
medicine; but a re-emergence as an industry began in the early 1980s with repackaged drugs being
introduced into the market. In 1983, a nationwide campaign lead by the retail pharmacy industry was
begun with the intent to eliminate the physician’s rights to dispense. In 1985, legislation in Congress
was passed in 46 states to secure the physician’s rights to dispense FDA approved medications to their
own patients. The 1990s dispensing systems were developing to make the process fast, easy and cost
effective for the physician and now in the 2000s with reimbursement cut backs to physicians and only
a limited amount of time to see patients which decreases the chance of a physician increasing his
patient load, physicians are turning to ancillary services such as dispensing to help increase their profit
margins.
Does the physician need a special license to dispense medications in the office?
Most states do not require anything beyond your existing DEA and State license in order to dispense
medications. There are a few states that have a designated dispensing license per physician. In most
cases it is offered at a minimal cost. PracticeMD Dispensing can help you in assuring you have all
proper licensure to participate in your states.
How will point of care medication dispensing benefit my patients?
First and foremost is the convenience factor for your patients, no longer will they have to wait in long
lines at a pharmacy to fill prescriptions. Filling prescriptions from your practice is an added service to
Page 2 of 6
10. your patients that saves them time and adds no additional cost. In many cases this can also mean a
cost savings to the patient because no extra commute is required.
What if patients ask about our pricing versus their regular pharmacy?
PracticeMD Dispensing system communicates using the same technology that any major retail
pharmacy uses in order to process a pharmaceutical insurance claim through the insurance payer. This
allows for instant electronic confirmation of eligibility, patient co-pay and reimbursement to the
practice. Therefore, a patient’s co-pay for brand or generic product is exactly the same as if they had
gone to the pharmacy. Note that this program does not offer a $4 generic program as most of these
subsidized drug programs are limited to a select group of generic medications and days’ supply.
Who can dispense the medications in our office? Will I need additional staff to dispense?
In most states, a directive from the physician allows other staff members to dispense medications
within the office. A few states do require that the physician actually do the dispensing.
What liability does the physician practice assume with point of care medication
dispensing?
The liability is the same as it would be when a physician writes a prescription which is filled by a
pharmacy. In point of care dispensing, there are stringent guidelines concerning packaging and
labeling of the re-packaged medications. The PracticeMD Dispensing system meets all DEA and FDA
requirements.
What if we have multiple physicians in our practice?
Having multiple physicians in a practice is not a problem, as each physician is assigned a specific
password and can track their dispensing history separately for bookkeeping, documentation or patient
information purposes. You can also have security access assigned at different levels to approved staff
members who will be assisting in the dispensing process.
What if we have multiple office locations in our practice?
Physicians may dispense from multiple office locations, however if a physician dispenses controlled
substances, then in accordance DEA Regulations, all locations must be listed on the physician’s DEA
license. PracticeMD will assist physicians in amending their DEA license to list all locations. Please
note that a physician can immediately dispense from their recognized location and expand to
additional locations upon amendment.
Will dispensing cause my malpractice premiums to increase?
No, whether a physician prescribes medications that are filled at a pharmacy or at their practice, the
physician responsibility is the same. Malpractice carriers do not charge higher rates for dispensing
physicians.
Do we have to file insurance for drugs dispensed in the practice? How do we handle
Medicare and Medicaid patients? Drug cards?
While PracticeMD Dispensing offers the use of the insurance adjudication program, it is not necessary
to file insurance claims for medications dispensed in your office for a either cash & carry and/or
workers’ compensation patient. The patient can always “opt out” of using their insurance ID card and
simply pay out of pocket cost “co-pay deductible” -- otherwise termed as a “cash dispense.”
Page 3 of 6
11. Is the PracticeMD Dispensing software program easy to use? Will PracticeMD Dispensing
train my staff? How long will the training take?
PracticeMD Dispensing software is a web based application which means that any computer within the
office that has an internet connection can be used as a dispensing terminal. The application requires
minimal time, is easy to navigate and insures an accurate dispense. It features a drug utilization
review for possible contraindications, allergies, conditions, etc., as well as generates bottle labeling
and pharmacy education printouts. State mandated reporting is also compiled and submitted by the
intuitive software application. PracticeMD Dispensing will provide complete training on the software
and technical support when you have questions or concerns.
Is point of care dispensing efficient? How much time will it take my staff to dispense a
medication?
The PracticeMD Dispensing program is easily integrated into your office procedures and is a
streamlined process that can be completed between 30 seconds to 2 minutes depending on the level
of information the physician requires on each patient. Trained staff can handle dispensing with
minimal interruption to other office responsibilities.
Does the PracticeMD Dispensing program have a patient database with dispensing
history?
Yes, patients are loaded in the database automatically when you dispense a medication and you can
pull reports on dispensing history by patient, medication, date, etc.
How much time will it take to enter a new patient into the database?
A new patient can be added in under 2 minutes while dispensing, depending on the amount of
information that the physician requests on each patient. Other demographic information is built into
the system and can be added at time of dispense or at a later date if desired. This will vary with each
individual office and the specific software programs in which the office participates. You do not have to
add this additional information for a dispensing order to be completed.
Does the PracticeMD Dispensing program have an inventory tracking process?
The PracticeMD Dispensing program will automatically tell you when a particular medication is below
the pre-set levels that will be determined by each individual office at the time of installation and
training. You can re-order medications at the inventory site with the click of a button.
How secure is the PracticeMD Dispensing program?
A sophisticated password protection system is built into the PracticeMD Dispensing software. Each
function performed by the software can be password protected to accommodate the needs and
parameters of the individual physician practice. A double check system will not allow you to dispense
a medication through the system that does not have a code match to the scanned bottle. In addition,
the DUR (Drug Utilization Review) feature confirms with your EMR or dispense history stored in our
software.
Will point of care dispensing upset local pharmacies?
If the local pharmacists are genuinely interested in good quality care, increased compliance on
prescriptions actually filled and low costs to patients, they should have no problems with point of care
dispensing. The pharmacy industry statistics report that only 70% - 80% of prescriptions are ever
actually filled, and with point of care dispensing, the physician knows that the patient filled the
prescription -- therefore increasing the chances that the patient will use the medication in compliance
with his physician’s orders. Most physicians who are using point of care dispensing will dispense only
Page 4 of 6
12. about 30%-40% of the total prescriptions written in the office, the rest will be filled at a pharmacy; so
the market share is equitable.
How much space is required for the PracticeMD dispensing cabinet and computer
hardware? Is the cabinet a locked system?
The PracticeMD Dispensing cabinet is a white metal cabinet measuring approximately 19½” wide x 25”
high and 7 ½ ” deep and weighs 24 lbs. The cabinet will hold up to 300 medications. It is a locking,
wall mounted cabinet and conforms to DEA regulations concerning the storage of controlled
substances. Depending on practice size we offer other cabinet/storage solutions.
Are the pre-packaged medications supplied as starter doses or full course doses?
Most dispensing physicians prefer to prescribe a full course dose of medication therapy to their
patients, but starter doses can be dispensed in some situations.
How do we determine which medications and how many to order? Can PracticeMD
Dispensing provide any medications I choose, including controlled substances?
PracticeMD Dispensing can supply any Schedule II - V controlled substance, as well as over the
counter medications, injectables, and compounded medications. We suggest that initially you stock
one week's supply of the 15-20 meds you prescribe daily. This offering can always be expanded, but
it is best to start with a conservative inventory. The system will track all dispenses which will
accurately determine which medications you are using most frequently and an accurate level of
inventory control keeps your practice from running low on a particular medication. Your practice’s
drug offering may develop over time and can change with seasonal practice activity.
How do we re-order medications?
The PracticeMD Dispensing program will automatically alert you of low inventory on specific drugs;
these inventory levels are determined at the time of installation and training by the physician. When
you receive a low inventory notice, you simply click a button to reorder that specific medication. You
can expect delivery, under normal circumstances, within 3-5 business days from order submission.
How do I set pricing for the medications?
PracticeMD Dispensing designed the program around the national average co-pay of $20.00 per
medication. PracticeMD Dispensing prescriptions are all approximately $20.00 for generics; a few may
be slightly higher depending on the average wholesale price of the medication, but usually never over
$20.00 for a generic. The patient simply pays the physician’s office a fee similar to the co-pay amount.
Which medications generate the most income for the practice?
Generally, generic medications and drug products offer the most profit potential for a physician’s
practice and the greatest savings to the patients.
What about theft?
The PracticeMD Dispensing process is managed in such a way that theft is rarely a problem. Password
protection, an automatic inventory system and dispensing records of who dispensed make it difficult to
hide theft of medications. Every container is accounted for in the inventory system and the reports
allow the staff to easily and quickly determine if there is a problem; unlike the basic supply closet
concept.
Page 5 of 6
13. Why purchase re-packaged medications?
State and Federal regulations state that dispensing is allowed through the physician’s practice only if
the medications are properly packaged and labeled. Products must comply to federally-mandated
current Good Manufacturing Practices (cGMPs) as noted in Title 21 of Code of Federal Regulations.
Noncompliance with these laws could render the medication as adulterated and or misbranded. It is a
federal crime to dispense an adulterated or misbranded medication to a patient.
Why repackaged medications are repackaged in negative airflow sterile rooms?
The FDA reports that 50% of all drug reactions in the United States are caused by penicillin and
cephalosporin contamination. It is almost impossible to get medications from a pharmacy that do not
have some contamination of dust spores from penicillin/cephalosporin-based medications, as all
medications are sorted using the same trays as the penicillin/cephalosporin-based medications and
cross contamination is a constant problem. One unit of penicillin is invisible to the naked eye, and
many patients are highly allergic to penicillin/cephalosporin, which can lead to anaphylactic shock.
Repackaging medications in sterile negative airflow environments greatly decreases the chance of
cross contamination.
What happens if there is a product recall from a drug manufacturer?
The PracticeMD Dispensing software program can help you quickly identify any patients who are
currently using a medication that has been recalled.
Will the software system track additional products in addition to prescriptions?
Yes, the software program is designed to track medication dispensed in-practice, prescriptions written
for a pharmacy, drug samples given to patients and virtually any other commodity the physician or
office manager wishes to track, such as Durable Medical Equipment and supplies. Please note that
additional items may not be recognized or readable via hand held bar code scanners.
Who do I call if I have problems with software, medication delivery, regulatory questions,
etc?
We at PracticeMD Dispensing are service oriented and have technical support available at any time to
help with questions and concerns, software problems and problems with medication orders. You will
have contact information for a technical support staff member upon installation and training.
Page 6 of 6
14. lflfllpro:mm:'^l*r*ru"
Rxloooro Dsre:s/i6/200e I ffifi$rh***tt*ffi5Hh" o"*, r,loor ri45 AM Rx:.r00016
.---------.---.--
clPRoFLox clN HcL
,**,
tou EPrrlmEREnEEilrcu
pr
ctpRoFLoxActN HcL30 x 500MG TAB
H6c'eiezs-rzziilr,r""" N6l:iirrr-orzzor
I
raKE oNE oR rwo rAB,-.o
NDC:63629-1724-02 Lot 13353
JEh ,to"Liro*tJo
HSHIEWELLJUST8EFonEUS| c
werby, Marcus MD cA sesee src: T".E oNE oR Tvrro TABLETS EVER'
Pd
8 HouRs
Ei
EE rvEDeRx Derno site gg,_ TAKE wrri
-gE
111 Main street .€ FOOD JOHN Q. sA,lPLE
Boise,lD 83333 Discard Ajter: 9/16/2010 DOB:l/l/1965 (44yEaroldl
Nledicalion lnfo: ti{l= DRII{K-P-LENIY lz: rall sr. zi '
Eq
e;
i:
sk
sArvpLE.JoHN(DoB:r/r/rs65)
83605 #f-l *g$}]f#h. irirJildijdo-s'
'-
23 MAIN ST 2A SOISE lD t
*.-.- j:]::1"-
1
cau.on:Federar raw pRoHrBirsr-ansrErorhis drus to :" ^iiirDiCi.{8. iltlPiciglt;
*{"##"=.til['"%1"+Silg l/blbv, M-arcus MD
oe aly p66on of,€, rlan abo* nameo pauem
E8-
a>
o6 7)Y COIOR. S|ZE.ORSHAPE Ay Llc:uAwvvg
APPEAB DtFFEREilr.
-a, oEA C,l,O00o0
9/16/09 7:45 Ar'' JOHN QSAI!,|PLE1/t/1965 Rx: 1000169/16/097:45At,t Rx 100016 63629- 1724-02 9/16/09 7:45 AM
llllilllilllllllllillillllilllllillllil
J LRSAVIITDF
tf+ffiil*ffi-'
BOISE ID 83605
Hfrffitr*"#aiitttt*
RECEIPT DUPLICATE
RECEIPT
Rx 1 000'l 6 9/16/09 7:45 AM Rx100016 9/16/09 7:45 AM
MEDeRx Demo SiteANelby, Marcus MD SAMPLE,JOHN MEDeRx Demo SiteANelby, Marcus MD SAMPLE,JOHN
111 Main Street 123 MAIN ST,24 't11 Main Street 123 MAIN ST,2A
Boise lD 83333 BOISE tD 83605 Boise lD 83333 BOISE lD 83605
Medication lnfo: DOB:1/1/1965 Medication lnfo: DOB:1/1/1 965
CIPROFLOXACIN HCL 30 x 500MG TAB Payment: $0.00 CIPROFLO)({CIN HCL 30 x500MG TAB Payment:$0.00
TAKE ONE OR TWO TABLETS EVERY 8 HOURS TAKE ONE OR TWO TABLETS EVERY 8 HOURS
Call tlour doctor tor medicaladvlce about slde eF6cts. You nray report side effect3 to FDA at l-800-FD41088.
Pationt lnformation for: CIPROFLOXACIN HCL30 x 500ltlc T a
yorirk d 4a66 G q., hhftd ni c) ciFdd*ih.y q6.rc6db6rd
contain any assurances that this product is safe, effective, or appropriate for you heart problems (heart failure, slow heartbeat, QT prolongataon in the EKG), family history of cortain heart problems (QT prolongation
in the EKG, sudden cardiac death). Low levels of potassium or magnesium in the blood may also increase your risk of QT
OFLOXACIN - ORAL (sip-row-FLox-ah-sin)
C I PR prolongation. This risk may increase if you use csrtain drugs (such as diuretics/"Mter pills") or it you hav6 conditions such as
COMMON BRAND NA[4E(S): Cipro severe sreating, diarrhea, or vomiting. Talk to your doctor about using ciprofloxacin safely. This medication may mrely cause
seriols changes in blood sugar levels, especially if you have diab€tes. VVatch for symptoms of high blood sugar including increased
Econc6rdd(38 ..pndcm.),dtryd hmF.chekyourd n yd dFi{ca trn*mr d @
/tendon pain or srelling honey, or candy, or drink fruit juice or hon-diet soda. Tell your doctor immediately about the reaction and the use of this product. To
help prev ent low blood sugar, eat meals on a regular schedule, and do not skip meals. This drug may make y ou dizy. Oo not driv e,
antibiotics. lt wrks by stopping the growth ot bacteria. This antibiotic treats only bact€rial infectiohs. lt will not wrk for virus beverages. This medicatioh may make you mor6 sensitiv6 to the sun. Avoid prolonged sun exposure, tanning booths, and sunlamps
infections (e.g., common cold, flu). Unn€cessary use oroveruse of any antibiotic can leadto its decreased elfectiveness- Use a sunscre6n and war prot€ctive clothing when outdoors. Caution is adv ised v"hen using this drug in children because they may
be more sensitive to its possible side sff€cts (e.9., joint/tendon problems). Discuss the risks and benefits with tho doctor. Kjdney
uid.@idbyydl'f.l'fhidqdb,6.ii6r!fdonob*du
medical condition and response to treatment. Drink plenty of fluids while taking this medication unless y our doctor tells y ou needed. Discuss the risks and benefits with your doctor. This medication pass€s into breast milk. Breastfeeding js not recommendod
otheMise. Take this medication 2 hours before or 6 hours after taking any medications or antacids containing magnesium, vvhile taking thas drug. Consult your doctor before breast-feeding.
aluminum, or calcium. Some examples include quinapril, certain forms of didanosine (cheMble/dispersible buff ered tablets or
p6diatric oral solution), vitamins/minerals, antacids, dairy products (e.9., malk, yogurt), calcium-snriched juice, and sucralfate. DRUG INTERACTIONS: See also the How to Use section. Your doctor or pharmacist may already be aMre of any possible drug
Other products include bismuth subsalicy late, iron, and zinc. These medications/products bind with ciprofloxacin and prev ent its full interactions and may be monitoring you for them. Do not start, stop, or chang€ th€ dosage ol any medicine before checking with
absorption. However, this medication may be taken with dairy products or calcium-enriched juice as part of a meal because food them lirst. This drug should not be usod with the following medications because v€ry serious interactions may occur: strontium,
helps prevent this effect. Ask your doctor or pharmacist about safely using nutritional supplements/replacements with this tianidine. lf you are currently using any of these medications listed above, tell your doctor or pharmacist before starting
medication. Antibiotics wrk best when the amount ot medicin€ in your body is kept at a constant level. lt is important not to miss ciprofloxacin. l4any drugs b€sides ciprofloxacin may affect the heart rhythm (QT prolongation), including amiodarone, dofetilide,
a dose. To help you remomb€r and to keep the drug at a constant level, take it at the sam€ times every day. Continue to tak€ this quinidine, procainamid€, sotalol, c€rtain macrolide antibiotics (e.9., orythromycin, clarithromycin), and certain antapsychotic
medication until the full prescrib€d amount is finished, even il symptoms disappear aftera fewdays. Stopping the medication too medicatiohs (e.9., pimozide, thioridazine, ziprasidone), among others. Therefore, bofore using ciprofloxacih, report all medications you
early may allow bacteria to cohtinue to grow, which may result in a return of the infection. lell your doctor if your condition are currently using to your doctor or pharmacist. Before using this medication, tell your doctor or pharmacist of all prescription and
persists or rcrsens. nonprescription/h€rbal products you may use, especially of: live bacterial vaccines (e.9., typhoid, BCG), "blood thinhers" (e.9.,
Mrfarin), corticosteroids (e.9., prednisone, hydrocortisone), cyclosporine, drugs removed trom your body by certain livor enzymes
Sl D E EF F EC TS: See also Ahrn ing sectaon. N au sea, diarrhea, dizines s, lightheadedn es s, headac he or trouble sleepi ng m ay (such as clozapine, duloxetine, phenytoin, ropinirole, tacrine), drugs for diab€tes (e.9., glyburide, insulin), methotrexate, nonsteroidal
occur. lf any of these effects persist or wrsen, toll y our doctor or pharmacist promptly. Remember that y our doctor has anti-inflammatory drugs (NSAlDs such as ibuprofen, naproxen), probenecid, sevelamer, theophylline, urinary alkaliniars (e.9.,
proscribed this medication because he or she has judged that the benefit to you is greater than the risk of side 6ffects. Many potassium/sodium citrate). Also report the us6 of drugs that might increase seizure risk when combined wth this modication such as
people using this medication do not have serious side efl€cts. lell your doctor immodiately if any of these unlik€ly but serious isoniazid (lNH), phenothiazines (e.9., chlorpromazine), or tricyclic antidepressants (s.9., amitriptyline), among others. Consult your
side effects occur: mental/mood changes (e.g., anxiety, confusion, hallucinations, depression, rare thoughts of suicide), shaking doctor or pharmacist for details. Avoid drinking large amounts of toverages containing caflejne (coffee, tea, colas), eating large
(tremors), skin that sunburhs more €asily (sun sensitivity). Ciprofloxacin may .arcly cause serious nerve problems that may be amounts of chocolate, or taking over-the{ounter products that contain caffein€ to keep you aMke and alert. This drug may
reversible if identified and treated earjy. Seek immediate medical attention if you develop any of the following symptoms: increase and/or prolong the eflects of caff€ine. This document does hot contain all possible interactions. Therefore, b€fore using this
pain/numbness/burning/tingling/reakness in any part of the body, changes jn how you sense touch/paih/temperature/body product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the llst
position/vibration. Tell your doctor immediately if any of these rare but very s€rious side effecls occur: unusual bruising/bleedlng, with y our doctor and pharmacist.
severe/p€rsistent headache, signs of a newinfsction (e.g., nevpersistent fever, persistent sore throat), unusual change in the
amount of urine, change in color of urine (redlpink urine), signs of liver problems (e.g., unusual tiredness, stomach/abdominal pain, OVERDOSE: lf overdose is suspected, contact yourlocal poison control center oremergency room immediately- US residents can
persistent nausea/vomiting. yellowing eyes/skin, dark urine), vision changes. Seek immediate medical attention if any of these call the US National Poison Hotline at 1-80G222-1222. Canada residents can call a provincial poison control center.
rare but very serious side effects o6cur severe diziness, fainting, fast/irregular heartbeat, seizures. This medication may Erely
cause a sev ere intestinal condition (pseudomem branous colitis) due to a ty pe of resistaht bacteria. This condition may occur during NOTES: Do not share this msdicatioh with others. This medication has been prescnb€d tor your current condition only. Do not use it
treatment or reeks to months after treatment has stopped. Do not use anti{iarrhea products or narcotic Pain m6dications it you later for another infection unless told to do so by your doctor. A different medication may be necessary in those cases. Laboratory
have any of the following symptoms because th€se products may make them rcrse. Tell yourdoctor immediately if you develop: ahd/or medical t6sts (e.9., kidn€y function, blood counts, cultures) should b€ p€rformed p€riodically to monitor your progress or
p6rsistent diarrhea, abdominal or stomach pain/cramping, blood/mucus in your stool. Use of this medication for prolonged or check for side effects. Consult your doctor for more details.
repeat6d periods may result in oral thrush or a new vaglnal yeast infection. Contact your doctor it you notice white patches in your
mouth. a change in vaginal discharge, or other n€w symptoms. A very serious allergic reaction to this drug is rare. However, seek MISSED DOSE: lf you miss a dose, take it as soon as you rem6mbsr. lf it is near the time of the hext dose, skip the missed dose
immediate medical attention if you notice any of the following symptoms of a sorious allergic reaction: rash, itching/swlling and resume your usual dosing schedule. Do not double the dose to catch up.
(especially ol the face/tongue/throat), severe diziness, trouble breathing. This is not a comPlete list of possibl€ side elfects. It
w^',^^ri-a^tha'effsi.h^tlierFdah^vp.^ni..tv^".d^.t^r^r^h2rm.^i<t lnihpllS-Crllv^'rrdMt^rf^rmcdi.aladvi.Frh^r't
57064 SPECIAL DUO.WEB STVLE F
15. Save Time
Get your prescribed medication
right here, right now. Ask how.
In many cases you may purchase your prescription medication here at our
office rather than making an extra trip to the pharmacy. The medication you
purchase here is in full compliance with FDA regulations for your safety and
convenience. If you would like to participate in this program, please ask your
doctor or our staff for more information.
PracticeMD
16. Heading to
the
pharmacy?
The FRONT of the line begins
RIGHT HERE.
In many cases you may purchase your
prescription medications here at our
office rather than making an extra
trip to the pharmacy. The medication you
purchase here is in full compliance with
FDA regulations for your safety and
convenience. If you would like to participate
in this program, please ask your
doctor or our staff for more information.
17. Save time,
Get your prescribed medication
right here, right now. Ask how.
In many cases you may purchase your prescription medication here at our
office rather than making an extra trip to the pharmacy. The medication you
purchase here is in full compliance with FDA regulations for your safety and
convienience. If you would like to participate in this program, please ask your
doctor or our staff for more information.
PracticeMD