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Pharmskills Online - Counseling Topic Verification - View Detail

ELECTRONIC PRESCRIPTION
Date: 07/01/2026 at 08:04 PM
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#
4824737
Written Date
07/01/2026

Name
Hilda R. Morgan
DOB
8/14/1968
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 1 diabetes.
Need to Know: If diarrhea happens or you are throwing up, call your doctor. You will need to drink more fluids to keep from losing too much fluid.
Need to Know: Too much acid in the blood or urine (ketoacidosis) has happened with this drug. This may need to be treated in the hospital and can be deadly.
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: Vaginal yeast infection. Report itching, bad odor, or discharge.
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.