OT: Number of tablets per card in a blister-pack

[NY]

I'm on various medications, long term. These are prescribed and dispensed as

4 weeks = 28 tablets at a time. Depending on tablet size, these are on blister-pack cards of 7, 14 or 28 tablets per card, with 4, 2 or 1 of those cards respectively in each box.

The dispensary at the doctor's must have bought its aspirin from a new supplier. And I notice that the blister pack has *25* tablets on the card, so the pharmacy has had to cut out an additional strip with 3 tablets on it.

It's not even a 5 x 5 card: the supplier has chosen to use a card shaped for the normal 7 x 4 and then decided not to use some of the spaces.

Can anyone think of the logic of dispensing tablets as 25 per card? It makes for a lot more work for the pharmacy technician, and for the pharmacist who checks the technician's work. And they will need to keep a card of an arbitrary number of tablets from which they cut three for each order of a

4-week supply. Weird.

[Jack Harry Teesdale]

I have 2 regular(monthly) prescriptions. One comes in a 2x14 pack, the other 2x15, i have to take one of each per day. This plays havoc with re-ordering as i can get out of sync easily. I have never yet had supplementary ones added to make up the deficit to 30.

The convenience/cost saving to the producer seems to take precedence over the needs of the patient.

[Theo]

It seems to come in sizes of 28, 32, 56, 100 or 1000. I'd guess the 100s probably come 4 cards in a box, with each card being 25. Pharmacists aren't allowed to sell more than 100 tablets per transaction, so that is the largest unit they can stock.

There seems to be lots of supply chain issues at the moment - perhaps they couldn't get the 28 or 56 sizes.

Theo

[Peter Johnson]

It's not a supply chain issue. It's a permanent feature of the pharmaceuticals trade. I was prescribed Finasteride and Tamsulosin for an enlarged prostate. One came in packs of 28, the other in packs of

1. Prescription was for 28 days. The pharmacist always cut two out of the 30 pack and sometimes I'd get a pack with several small bits to make up the prescriptiion. Commenting on it one time the pharmacist agreed with me that they ought to be the same as they are always prescribed together.

[Theo]

According to the BNF there are plenty of suppliers offering 28 tablets of aspirin, so it makes no sense for a pharmacist to supply them in strips of

25 - even if they save some pennies on ordering bulk packs of 100. The time overhead cancels out any saving like that. So a pharmacist is only going to use the 100s if they don't have any 28s.

But Tamsulosin is only available in packs of 30, according to the BNF:

if you are prescribed 28 then they have to cut them down - they can't buy another size.

Finasteride 5mg comes in 28, 30 and 84, with the 30 being at an exhorbitant price. (28 bought from a variety of generics manufacturers for £1.50, 30 from Organon Pharma at £14.94). So even if you're prescribed 30 they will hand out a box of 28 and 2 extras, saving the NHS £13.44

It is possible to get Tamsulosin with other drugs in compound tablets, but it seems not with Finasteride.

Theo (IANA pharmacist)

[Richard]

So you're a doctor now?

[Richard]

That's a relief.

[Brian Gaff (Sofa]

That is very unusual, but pity the poor blind person here, unless you read Braille, which a lot of blind people do not, you have no idea which is which, and as the strips themselves do not have any markings its usually a sighted persons job to cut of corners or put little nicks in each strip. You would think, also that packaging across the industry would be all standard in weeks except for courses of short term medication. It sadly is not and really when you consider the safety aspect and a lot of older people with failing sight are the most likely target for these, one might have thought it would be sorted by now. You can get dispensers of cours with fancy alarm devices to unlock compartments but then its an extra job for somebody to do to load them up every renewal time, and mistakes can be made. Perhaps these days the raw drugs could be on tap and each pharmacy could

3D print one tablet a day containing what the patient needs. Brian

[tim...]

really?

I was told it was one or the other

I was tolerant of neither of them

[Steve Walker]

You can ask the pharmacy to prepare your daily meds in blister packs or dosettes. They will put them into daily or morning/evening batches and you just open and use the next one, without having to identify what each tablet is.

[Gopalan Sampath]

There is some logic behind 28. I get my BP tabs in 28 where the strip also has the day listed under each as, SUN< MON<>>so on. It helps me a lot in the morning when some days browsing the phone or tablet after finishing coffee I wonder whether I had taken the day's dose. Especially the blister pack has already punched holes. Past 75 yrs of age as I am sure doubts do occur With a 28 "day-printed" blister pack I never miss my dose any day.

[The Natural Philosopher]

Typical Roddery.

It is completely sane.

I have a 28 day prescription, 4 weeks. So I don't run out on a Sunday

Well I transfer to a pill box. One from each compartment but one every morning, and one from the other compartment every evening

[Tim Lamb]

I have been on a daily statin and tamsulosin for several years.

Pills are ordered through Patient Access (was patient service) which links to my medical practice. They usually allow me 6 prescriptions sent directly to our local Chemist and currently delivered to our door!

Theoretically I should have an examination at 12 months but this is currently extended due to Covid.

Pill pack numbers seem to depend on price/availability, currently Statin

28 day and Tamsulosin 30 day. Nobody seems to worry about modest over- and certainly not snipping strips.

[williamwright]

I'm on four regular tablets plus various sprays, powders, and creams. The thing about getting odd numbers in each strip or pack has always been the same. Sometimes I get 28 in a little bottle! As a precaution against pandemic, nuclear attack,the total breakdown of society, or the end of free prescriptions for the elderly, I have for years reordered one/three days early each month. As a result I now have three months' supply of everything. I observe 'best before ' dates.

I also have a room full of incontinence products, paracetamol (etc), catheter bags, wheelchairs, commodes, bathing aids, specialised dressings, and more left over from the prescriptions of the now deceased.

It took a year before I could persuade the NHS to collect the oxygen machine. Their attitude to everything above (many hundreds of pounds' worth) was, "We don't want to know."

Bill

[tim...]

really!

all it does for me is tells me that I have missed a dose

:-)

[Gopalan Sampath]

what I meant was: during morning coffee I tend to lose myself into minutes of internet browsing. and get a real doubt whether I ha d taken the pill for the day. Looking at the blister pack with day printed under each tab, it is easy to know whether I have taken it, just one look at the day in the strip of the next unpunched blister. If it carried today's day then I need to punch that out and gulp it! Simple and yet clever way to help absent minded doubting Tom in me !