Mr. James Johnson is a 59-year-old male who takes levothyroxine 100 mcg daily for hypothyroidism. As you are looking at his labs today, you notice that his TSH is 5.5 mIU/L. You wish to increase his dose. He has no other significant medical history or medication and normal creatinine clearance. No known allergies to medications, food, or latex
He also has asked your office staff for a prescription of Viagra for intermittent erectile dysfunction (ED). You have reviewed the chart and there is no contraindication to this medication.
Please call in the prescriptions of:
Levothyroxine: at the dose that you would like to prescribe – knowing that you are increasing the dose from the 100mcg (use your resources to determine what amount is appropriate to increase the dose by in a 59-year-old male. Dispensed amounts for most medications are usually 30 days when a dose has been changed (rather than a 90-day supply). However, levothyroxine takes a long time to be effective, so a 30- or 90-day supply will be accepted, 30-day supplies will need 3-6 refills, and a 90-day supply will be accepted with 0-1 refill. The supply is based on when the follow-up TSH will be needed (supply enough, but not too much).
Sildenafil: at the dose and amount appropriate for intermittent ED. Tip: This dispensed amount will not be 30 – it is not a daily pill. Consider the appropriate dose (you may find there is a dose for ED and a dose for pulmonary hypertension that are different). The dispensed amount should be appropriate for a 1-2 month supply only (larger amounts are often sold to friends).
You will need to research both medications prior to calling them in, and determine generic vs brand for each so that you can tell the pharmacist on the voicemail which medications you prefer.
Important: Do not prescribe a generic medication and then say “please substitute for generic” – this suggests to the pharmacist that you do not know that your prescription is a generic medication.
Audio file to Call in a Prescription
This is an audio file in which you will call in the 2 Rx into a pharmacy voicemail service.
You should record directly into the microphone in canvas in the upload area (and you may re-record until you like the end product).
***DO NOT UPLOAD audio as an mp4***
If you have problems with this method, you may pre-record your Rx in an audio file and upload it, but we have found this sometimes leads to file upload issues, so recording directly is preferred.
Remember that the real-life pharmacy voicemail is limited on time, so keep the recording under 1 minute 30 seconds total – for both prescriptions – so please practice.
Here is what is needed in your voicemail.
- Name (Full name, with an identifier, if a common name) and your role (NP)
- Name of clinic or practice
- NPI Number and DEA number, if appropriate
- Phone number where the pharmacist can check back with the prescriber if there are any questions about the prescription.
- Name, including middle initial if they have one (spell the last name if it is unusual)
- Date of birth – 03/10/1962
- Drug name
- Directions (dose & frequency of administration)
- Route of administration
- Quantity (number)
- Refills, if any
- Specify if generic substitution is permitted or brand is preferred (if appropriate)
- Special instruction – if needed – must be brief – limit to one sentence per medication
The information from your Rx PDF page will be used: USF College of Nursing Clinic
Clinic Phone number (813) 974-5555
NPI number is 7712459301
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