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Absolutely! Pharmacists can refuse to fill a prescription on ethical, legal or medical grounds.Some reasons include:If the pharmacist believes A) the prescription is a forgery or B) will be used for criminal activity. In this case, the most appropriate action to take is to either keep the prescription, or make a copy of it to send to a doctor to confirm (as in A) it's legitimacy, or (as in B) tell the Dr that you suspect the drug is being sold or abused. Why make a copy you ask? Because unfortunately, if a patient demands the prescription back (and it hasn't been filled) we have no legal grounds to keep it. At least that's how it is in Canada. So we copy it and bust the person asap. My personal technique is to stall the patient as long as possible while pretending to fill their prescription, and try to get a hold of the Dr. on the spot. If I am successful in contacting the Dr at that time, and (for A) they confirm a forgery, I can keep the prescription AND call the cops to bust them, or (for B) the physician cancels the Rx and I can year it up on them. It may sound bitchy, but keeping drugs off the street always makes my day :)If the pharmacist believes that the medication prescribed by the Dr will cause harm to the patient. Why or how would a Dr do this? Easy! And basically one of the main reasons I have a job. Any of the following scenarios would cause me to refuse to fill your prescription (AS IS - meaning before contacting the prescriber). A) The Dr has written a Rx for a drug you are allergic to. B) The Dr has written a Rx that interacts with another medication you're taking. C) The Dr has written a Rx for a drug that is contraindicated for your age, health conditions, sex, etc.) D) The Narcotics Monitoring System tells me that you are a methadone patient and you just brought me a Rx for an Opiate. Those are just a few examples of the many for this reason.The pharmacist, either by religious conviction or moral belief, is against dispensing a certain drug to patients. This one is a little tricky and has some stipulations attached. Primarily, that the patient they are refusing, MUST be able to access said drug from another pharmacy without it causing any real inconvenience to the patient. As, we also have to take the same Hypocratic Oath as Drs. So when might this happen? Say that a patient has been prescribed an abortion pill and they bring the prescription to their pharmacy. But the pharmacist on duty is vehemently against abortion. He/she can refuse to fill the Rx on religious or moral grounds, providing that the patient can get it at another nearby pharmacy, or at another time (when a different pharmacist is on duty) at the same pharmacy. We cannot, however, refuse to fill said prescription if doing so would prohibit the patient from getting the necessary drug they need. For example, if they live in a small town where there is only one pharmacy and one pharmacist, because telling the patient they have to drive to another town just to get the medication is an example of causing a real inconvenience, AND, by preventing the patient from getting a time sensitive drug when it is needed could cause potential harm to the patient.Anyway, I could go on, but these are the basic groups of reasons why a pharmacist can't or won't fill a prescription.Thanks for the A2A!

Best treatment would be the one closest to a cure. Three common options for treating allergy areAllergen avoidance.Drugs to control symptoms (pharmacotherapy).AIT (allergy immunotherapy).1 and 2 are palliative while only 3 comes closest to cure.HDM (House Dust Mite) Avoidance Is Not Very EffectiveSince mites and mite antigens are widely prevalent, complete avoidance isn't feasible. Avoidance has been the subject of at least three Cochrane (organisation) or other reviews that looked at available data.The one for atopic eczema concluded 'lack of clear evidence' in HDM (house dust mite) avoidance/reduction (1).The one for asthma reviewed 54 randomized controlled trials on effect of allergen avoidance (2). Here patients were diagnosed as HDM-sensitive using allergen-specific IgE responses.Quality of trials was poor to start with, many of them being non-randomized.Meta-analysis after excluding really shoddy trials showed no benefit from HDM avoidance.The one for atopic dermatitis reviewed 9 clinical trials for HDM avoidance (3). Reduction measures included impermeable bedding covers, acaricides, high-efficiency particulate air filters, plus combinations. The only borderline success was with acaricides.Studies also suggest adherence to avoidance strategies is difficult (3, 4). Obviously this'll impact benefit.Recently, some researchers suggested that Cochrane reviews set too high a bar and exclude too many otherwise worthy studies. In other words, that their reviews suffer from too many false negatives. Given this ambiguity, HDM avoidance is still a widely used approach and will continue to be, at least until better-designed studies provide conclusive evidence either for or against. It's just that complete HDM avoidance is practically impossible and it's very difficult to adhere to lifestyle habits necessary for such stringent HDM avoidance.Pharmacotherapy for HDM allergy Is A Mixed BagUnlike for allergens in general, problem with pharmacotherapy for HDM allergy is that many interventions lack sufficient scientific support, in particular few supporting evidence from meta-analysis of randomized controlled trials, i.e., the gold standard. Based on most recent available evidence (see Column 3 in Table below from 5) thenSupported by evidence from meta-analysis of randomized controlled trials (gold standard): Inhaled CorticosteroidsSupported by evidence from at least 1 randomized controlled trial: Oral Antihistamines, Anti-IgE (Omalizumab, etc.), Rapid-acting inhaled \U0001d6c32-agonists, Intranasal Decongestants, Leukotriene modifiersSupported by evidence from at least 1 other type of quasi-experimental study: Long-acting inhaled \U0001d6c32-agonists, Intranasal Corticosteroids, Nedocromil sodiumSupported by evidence from lab based studies: Long-acting inhaled \U0001d6c32-agonists, Systemic Corticosteroids, TheophyllineAIT (Allergy Immunotherapy) Is Close To Prime Time For Allergies In General And For HDM Allergy In ParticularAdvantages of AIT are many and include reducing pharmacotherapy dose, frequency, even need. As well, AIT is/can be effective even after Rx is stopped. At least one study on SLIT (Sublingual Immunotherapy) for HDM followed up 3, 4, or 5 years of Rx for 15 years and found 4 years of Rx was optimal duration for long-lasting efficacy (6). Two main AIT approaches are SCIT (subcutaneous Immunotherapy) and SLIT.SCITSlightly more effective than SLIT.Subcutaneous allergen injections done only under doctor's supervision.Best results with sustained Rx for 3 to 5 years.Patient compliance is problem since it entails considerable time commitment for several years worth of doctor's visits.Studies suggest SCIT's quite safe with low rate of systemic reactions, in the range of ~0.2% (7).SLITSublingual allergen tablets or liquid taken conveniently in privacy of one's home.Patient compliance can be problematic because often, patients stop Rx if they develop mild symptoms such as transient tongue swelling or throat itch.Best results require sustained Rx for >2 years.Studies suggest SLIT is even safer than SCIT with cases of anaphylaxis being extremely rare (6, 8).Calderon et al's summary of SCIT and SLIT for allergies in general and for HDM in particular shows (see figures from below 5)For Allergic Rhinitis (AR)SLIT is much more effective in general.However, SCIT is more effective for AR caused by HDM.For Allergic Asthma (AA)SCIT more effective in general and for AA caused by HDM.Problem is so far too few SLIT studies for AA to know its true effectiveness for this condition.As more SLIT studies for HDM are published, this picture will probably likely change.Current major drawbacks of AIT includeAmbiguity about allergen extract, batch-to-batch stability, concentration (5, 9, 10). In turn, these affect effective dose.Optimal dosing guidelines for SLIT are still insufficient (9, 11) while for SCIT, maintenance dose ranging from 5 to 20µg of major inhaled allergens are found to be effective (12).Most SCIT/SLIT products for HDM contain extracts/protein allergens from the most common dust mites Dermatophgoides pteronyssinus or D. farinae. However, such products may not be optimal in those parts of the world where the dust mite Blomia tropicalis dominates (13). In such places, until commercial products become available, patients may have to depend on made-to-order products. This may increase Rx cost.Though several commercial products available for HDM SLIT have demonstrated safety and efficacy, they also show considerable variability in allergen content (14). These include Allergovac Sublingual Plus from Bial-Aristegui; SLITone ULTRA from ALK-Abello; Staloral 300 Rapid from Stallergenes; Sublivac from Hal Allergy; TOL Forte from Laboratorios Leti. So products with consistent quality is a need of the hour.Bibliography1. Nankervis, Helen, et al. "House dust mite reduction and avoidance measures for treating eczema." Cochrane Database Syst Rev 1 (2015). http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008426.pub2/epdf/standard2. Gøtzsche, Peter C., and Helle Krogh Johansen. "House dust mite control measures for asthma: systematic review." Allergy 63.6 (2008): 646-659. http://onlinelibrary.wiley.com/doi/10.1111/j.1398-9995.2008.01690.x/epdf3. Nurmatov, U., et al. "House dust mite avoidance measures for perennial allergic rhinitis: an updated Cochrane systematic review." Allergy 67.2 (2012): 158-165. http://onlinelibrary.wiley.com/doi/10.1111/j.1398-9995.2011.02752.x/epdf4. De Blay, F., et al. "Medical Indoor Environment Counselor (MIEC): role in compliance with advice on mite allergen avoidance and on mite allergen exposure." Allergy 58.1 (2003): 27-33. http://onlinelibrary.wiley.com/doi/10.1034/j.1398-9995.2003.23674.x/epdf5. Calderón, Moisés A., et al. "House Dust Mite Respiratory Allergy: An Overview of Current Therapeutic Strategies." The Journal of Allergy and Clinical Immunology: In Practice 3.6 (2015): 843-855. Elsevier: Article Locator6. Marogna, Maurizio, et al. "Long-lasting effects of sublingual immunotherapy according to its duration: a 15-year prospective study." Journal of Allergy and Clinical Immunology 126.5 (2010): 969-975. https://www.researchgate.net/profile/Maurizio_Marogna/publication/47383405_Long-lasting_effects_of_sublingual_immunotherapy_according_to_its_duration_A_15-year_prospective_study/links/54ea1b5f0cf27a6de1136ad5.pdf7. Cox, Linda, et al. "Speaking the same language: the World Allergy Organization subcutaneous immunotherapy systemic reaction grading system." Journal of Allergy and Clinical Immunology 125.3 (2010): 569-574.8. Lin, Sandra Y., et al. "Sublingual immunotherapy for the treatment of allergic rhinoconjunctivitis and asthma: a systematic review." JAMA 309.12 (2013): 1278-1288. http://www.wolwobiotech.com/%E6%96%87%E7%8C%AE%E4%BA%A4%E6%B5%81/%E4%B8%93%E4%B8%9A%E5%AD%A6%E6%9C%AF%E6%96%87%E7%8C%AE/3-%E8%88%8C%E4%B8%8B%E8%84%B1%E6%95%8F%E7%96%97%E6%95%88%E6%80%A7/2013-JAMA-%E8%88%8C%E4%B8%8B%E8%84%B1%E6%95%8F%E6%B2%BB%E7%96%97%E9%BC%BB%E7%BB%93%E8%86%9C%E7%82%8E%E5%92%8C%E5%93%AE%E5%96%98.pdf9. Calderon, Moises A., et al. "An evidence-based analysis of house dust mite allergen immunotherapy: a call for more rigorous clinical studies." Journal of Allergy and Clinical Immunology 132.6 (2013): 1322-1336.10. Nelson, Harold S. "Update on house dust mite immunotherapy: are more studies needed?." Current opinion in allergy and clinical immunology 14.6 (2014): 542-548.11. Bronnert, M., et al. "Component‐resolved diagnosis with commercially available D. pteronyssinus Der p 1, Der p 2 and Der p 10: relevant markers for house dust mite allergy." Clinical & Experimental Allergy 42.9 (2012): 1406-1415.12. Cox, Linda, Harold Nelson, and Richard Lockey. "Allergen immunotherapy: a practice parameter third update." Journal of Allergy and Clinical Immunology 127.1 (2011): S1. http://www.kidshealthplan.org/sites/default/uploadedfiles/For_Providers/Provider_Resources/Practice_Guidelines/Allergen_Immunotherapy.pdf13. Durham, Stephen R., and Martin Penagos. "Sublingual or subcutaneous immunotherapy for allergic rhinitis?." Journal of Allergy and Clinical Immunology 137.2 (2016): 339-349.14. Moreno Benítez, F., et al. "Variation in allergen content in sublingual allergen immunotherapy with house dust mites." Allergy 70.11 (2015): 1413-1420. http://onlinelibrary.wiley.com/doi/10.1111/all.12694/epdfThanks for the A2A, Justin James Roche.

(This was originally a comment, requested to be turned into an answer)Meniere’s is usually a “diagnosis of exclusion,” made after all other conceivable causes of symptoms have been ruled out. It’s a constellation of symptoms, not all of which appear in all patients in the same way. I had a similar experience—a sudden sensorineural hearing loss that caused me to hear pitches in one ear lower than in the other, rendering instruments and vocals painfully discordant to me. (I’m a musician). Unamplified stringed instruments were particularly agonizing. A folk festival and a recording session were sheer torture for me.Several friends in online music forums & listservs reported having had the same problem after either colds or plane rides (I had recently flown while suffering with a cold). One gave me the name of the neurotologist near Seattle who successfully treated her. I called him and asked if he could refer me to anyone here in Chicago who could help me. “You’re in luck,” he replied, “I have a colleague near you who is not only an expert in the field but a musician & singer himself.”Buoyed by boundless hope, I called the colleague’s office—only to find he’d suddenly died the week before. I was turfed to his partner—a neurotologist, but neither a musician nor with any expertise dealing with musicians’ hearing disturbances (much less any enthusiasm for doing so). After a brain MRI revealed no disorders, and my hearing acuity was declared “normal” up to 8kHz (i.e., I could hear—but not necessarily accurately), this neurotologist actually said I was “too picky about pitch” (!!!!!) and told me I must therefore have atypical Meniere’s because he couldn’t find any explanation (“atypical” because I wasn’t dizzy or nauseated). He put me on a ridiculously restrictive diet (no salt, sugar, alcohol, fermented foods, caffeine or any “brown drinks”)—to no effect. At his own audiologist’s suggestion that I be custom-fitted for protective earplugs, I went to a musician-specific audiologist—who found that I could hear up to 14kHz in one ear but only 9 in the other, confirmed it was not conductive but sensorineural, and suggested I Google “sudden sensorineural hearing loss.”I did, and found first an audiologist at the Cleveland Clinic who prescribed—by phone and e-mail—an exact playlist of music (specific different styles, artists, types of instruments) to listen to while lying in various positions in order to retrain my brain to properly process pitch signals. I immediately began that protocol. I also found an article in the Lancet that described my exact situation, which was successfully treated with a combination of vitamin E, vinpocetine, manganese, alpha-lipoic acid and prednisone—with the caveat that the steroid had to be started no later than 28 days after onset of symptoms. I began taking the supplements and nagged my neurotologist (he was on vacation) until he finally called in an Rx for a prednisone dose pack…on Day 26. I immediately began taking the prednisone and continued the supplements & the brain-retraining therapy. Two days later I could finally listen to music again—and a week later I was performing.Wonder how that neurotologist is doing? And I wonder if he must be tone-deaf.