The Pharmaceutical Journal
Vol 278 No 7449 p488
28 April 2007

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Letters to the Editor

Controlled drugs

Overage and “underage”

From Miss A. M. Garton, MRPharmS

I write regarding my recent experiences with liquid controlled-drug running balances (ie, methadone). Although guidance is available with respect to how we should deal with manufacturer’s overage within the pharmacy, I find this somewhat impractical. Measuring each 500ml bottle of methadone obtained is rather arduous, inaccurate (the meniscus depth on a 500ml measure must have a degree of error), and rather risky.

It does not feel particularly safe pouring out a whole 500ml bottle into a measure — it is almost like a sitting duck waiting to be knocked off my checking bench by a flying basket. If it survives this, it risks being spilled when poured back into the manufacturer’s bottle. That aside, I welcome the Royal Pharmaceutical Society’s fact sheet on “Maintaining running balances of CD stock”, and now diligently record my 1–10ml overages on each 500ml bottle received as per my local Society inspector’s instruction.

However, I would like some guidance on the issue of manufacturers’ “underage”. My two most recently purchased bottles of methadone contained 490ml and 488ml. The possibility of underage occurring has not previously been discussed in any CD guidance or article that I have read, and yet is seemingly prevalent. Even my primary care trust and the Society can offer little help.

I have three further curiosities:

• What is the point of an overage, if not to prevent underage?

• How do I claim my 22ml back from my wholesaler (why should I pay for a full 500ml)?

• If I am subject to such stringent checks and record-keeping down to the nearest millilitre, why are manufacturers not?

Ann Garton
Nottingham

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