In our latest question and answer, the pharmacist discusses whether or not two prescriptions of Klonopin can be filled at the same time.
I recently started seeing a new psychiatrist and was put on 1mg of Klonopin, once daily with one refill. After a follow-up appointment, he increased the dosage to 1mg of Klonopin twice daily. My question is, can I get my old prescription for the 1mg Klonopin, that I take once daily, refilled as well? I only ask because my doctor and I already discussed an increase on my next appointment.
There is always some ambiguity with questions like these as state laws don't specifically give rules about filling two different strengths or sets of directions for the same controlled substance (Klonopin in this case). Additionally, laws vary by state, so what may be allowable in one state isn't always applicable to others.
To highlight some of this ambiguity, here is an excerpt from the South Carolina controlled substances regulations (S.C. Code of Regulations Chapter 61 Section 4. Controlled Substances):
"If authorized for refill, no [Schedule III, IV, V controlled substance] prescription shall be refilled sooner than 48 hours prior to the time that the prescription should be consumed if the prescribed daily dosage is divided into the total prescribed amount. (Example: 4 daily divided into 100 dosage units = 25 days.) Carry over time shall not accrue between refills."
Nowhere does the law mention multiple prescriptions for the same controlled substance medication if they vary in regard to their directions or strength.
Not only do laws vary, but the rules put in place by certain pharmacies can also be more stringent.
It is very important in situations like these to discuss everything with your pharmacist so they understand what you are trying to do. Expect that they will likely call your prescriber to ensure they are filling the prescriptions as intended.
Although there may be variations on a case-to-case basis, in general:
I discuss these situations more below.
In most cases, your pharmacy won't fill more than one Klonopin (clonazepam) prescription that is the same strength, even if they have different directions. This is especially true if your new Klonopin prescription is intended to be your new dose...it wouldn't make sense to fill a old prescription that isn't pertinent to your prescribed therapy anymore.
Additionally, it would be very unlikely that your insurance company would pay for the same strength of any prescription more than once in a specified period (e.g. 30 days).
If your doctor wanted you to fill two Klonopin prescriptions that are the same strength, but with a different set of directions, it would be preferred to combine them into a single prescription.
For example, let's say you have the following two prescriptions given to you by the doctor:
The preferred thing to do here is to combine the two prescriptions into one:
Not only would this be preferred by your pharmacist, but it would also be preferred by your insurance company.
Changing the situation slightly, if you have two prescriptions for Klonopin that are the same strength and your doctor only intends for you to have one (for example the new prescription is a new dose), then the answer is simple. The pharmacy would only fill one, the new dose.
Although your pharmacy will probably call your doctor to confirm they intend for you to have two prescriptions of Klonopin that are different strengths, this situation happens from time to time and often, they can be filled together.
This generally occurs when you need to take a dose that isn't easily divisible with commercially available strengths. For example, if your doctor wanted to you take 2.5 mg of Klonopin per dose, they may write you one prescription of Klonopin 0.5 mg to take with Klonopin 2 mg.
It is important to realize though, that anytime you get two prescriptions, you likely will be charged two co-pays by your insurance company.
Be sure to discuss situations like this with your pharmacist as they will be your best resource for what can be filled and what can't be. Remember that laws differ by state and pharmacy chains have specific rules about how they dispense controlled substances.