Filling Prescription Drug Orders — Limitations

TITLE 54 PROFESSIONS, VOCATIONS, AND BUSINESSES CHAPTER 17 PHARMACISTS 54-1733B. FILLING PRESCRIPTION DRUG ORDERS — LIMITATIONS. (1) Drug product selection is only allowed between therapeutic equivalent drugs as published in the FDA orange book or green book. If a prescriber orders that a brand name drug shall be dispensed, then no drug product selection is permitted. (2)  Partial fillings shall be allowed as long as the total quantity dispensed does not exceed the total quantity prescribed. (3)  A prescription drug order may be refilled as authorized by the prescriber and within the limits of federal law. A pharmacist may also refill a prescription to ensure continuity of care. (4)  A pharmacist may: (a)  Change the quantity of medication prescribed if any of the following apply: the quantity or package size is not commercially available, the change is related to a change in dosage form, strength or therapeutic interchange, the change is intended to synchronize a patient’s medications, or if it is to dispense the total amount authorized by the prescriber; (b)  Change the dosage form if it is in the best interest of patient care, as long as the directions are also modified to equate to an equivalent amount of the drug dispensed as prescribed; and (c)  Complete missing information on the prescription if there is evidence to support the change. (5)  Drug product substitutions in which a pharmacist dispenses a drug product other than that prescribed are only allowed as follows: (a)  Pursuant to a formulary or drug list of a pharmacy and therapeutics committee of a hospital; (b)  At the direction of the quality assessment and assurance committee of an institutional facility; (c)  For interchangeable biosimilar products published in the FDA purple book, if the name of the drug and the manufacturer or the national drug code number is documented in the patient’s medical record; and (d)  Therapeutic interchange within the same therapeutic class is allowed if the substitution lowers the cost to the patient or occurs during a drug shortage.