Q: When you present a pharmacist with a doctor’s prescription is the pharmacist allowed to give the generic equivalent of the medicine prescribed by the doctor? Are there any over-the-counter antibiotics or can antibiotics be provided only on presentation of a doctor’s prescription?

A: Yes, your pharmacist is allowed to substitute without a doctor’s permission (unless the doctor states that no generic may be used). This change was implemented a few years ago. In fact, your pharmacist has to inform you if a generic is available and it’s your choice to take it or not. Please note this is the case only with generic equivalents – a pharmacist may not simply replace a drug with a therapeutic equivalent (a different medicine with a similar effect). All antibiotics need prescriptions.

Q: Can St John’s wort and evening primrose capsules be used with Fortzaar blood pressure tablets?

A: Although no definite results are available for the effect of hypericum (St John’s wort) on Fortzaar I recommend you discuss it with your prescribing doctor first as there’s a risk of hypertension if St John’s wort is taken with foods (including certain cheeses and wines) that contain the natural chemical tyramine. The interaction between St John’s wort and tyramine may lead to an increase in blood pressure. Evening primrose oil has a positive effect (reduction) on blood pressure but if you take it in combination with prescription medication I recommend you let your prescriber know which natural products you’re taking.