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Pharmskills Online - Counseling Topic Verification - View Detail

ELECTRONIC PRESCRIPTION
Date: 10/13/2025 at 01:16 AM
Patient: Hilda R. Morgan
Address: 1824 New York Street
Drug: Jardiance 10 mg Tablet
Dispense: 30
SIG: i po QD for diabetes
Refills: 5
DAW: do not substitute
Prescriber: Samuel Bernstein
Address: 3-C Medical Arts Building
DEA#: AB1294824
Rx#
4970720
Written Date
10/13/2025

Name
Hilda R. Morgan
DOB
8/14/1967
Age
58
Address
1824 New York Street
Phone
(785) 555-7474
Allergies

Prescriber
Samuel Bernstein
Practice
Internal Medicine Associates
Address
3-C Medical Arts Building
Fax
(785) 555-8679
DEA
AB1294824
NPI
7759028783
Phone
(785) 555-8678

Dispensed
Jardiance 10 mg Tablet
NDC #
00597-0152-07
Mfg
BI
Pres Qty
30
Dis Qty
30
Day Supply
30
Refills
5
DAW
1
Origin Code
3

Instructions
Take 1 tablet by mouth once daily for diabetes.

Dispensing Notes

 
New Rx - Mandatory Counseling
Document Patient Counseling Topics To Be Given Verbally
Used For: It is used to help control blood sugar in people with type 2 diabetes.
Need to Know: A rare but very bad infection has happened with drugs like this one. Get medical help right away if your genitals or the area between your genitals and rectum becomes tender, red, or swollen, and you have a fever or do not feel well.
Need to Know: This drug may make you sunburn more easily. Use care if you will be in the sun.
Side Effects: Signs of a urinary tract infection (UTI) like blood in the urine, burning or pain when passing urine, feeling the need to pass urine often or right away, fever, lower stomach pain, or pelvic pain.
Side Effects: Low blood cell counts have happened with this drug. If blood cell counts get very low, this can lead to bleeding problems, infections, or anemia.
Best Taken: Take in the morning.
Best Taken: Take with or without food.
Med Guide: I am also providing you with a required medication guide that can help patients avoid serious adverse events.