DEA advises that “pharmacists are instructed to adhere to state regulations or policy regarding those changes that a pharmacist may make to a schedule II prescription after oral consultation with the prescriber.hen information is missing from or needs to be changed on a schedule II controlled substance prescription, DEA expects pharmacists to use their professional judgment and knowledge of state and federal laws and policies to decide whether it is appropriate to make changes to that prescription. Doesn’t the Drug Enforcement Administration (DEA) prohibit the kind of clarifications described above?Ī. The pharmacist must document the clarification after consultation with the prescriber. The pharmacist may change the brand name to match the correct combination product intended. (b) A prescriber writes for “Vicodin 5/325,” but the prescriber intended to write for Norco (hydrocodone 5 mg /acetaminophen 325 mg). The pharmacist must document on the prescription the changes made after consultation with the prescriber. Reducing the dosage slowly and carefully is key. The pharmacist may call the prescriber to clarify which product was intended – e.g., Vicodin 5/300 or another hydrocodone 5 mg/acetaminophen product containing 325 mg of acetaminophen per dosage unit (see (b) below). Withdrawal symptoms, such as nausea and anxiety, can occur if you stop taking an opioid medicine suddenly. (a) A prescriber writes for “Vicodin 5/325.” As pharmacists know, Vicodin is now formulated as hydrocodone 5mg /acetaminophen 300 mg. visit the FDA website for more information on acetaminophen dosing. The total daily dosage should not exceed 8 tablets. If a pharmacist receives a prescription for a combination product containing a schedule II drug and acetaminophen that appears to have a missing, incorrect, or unavailable acetaminophen dosage, the pharmacist may add or change the amount of acetaminophen written on the prescription after speaking directly with the prescriber and documenting the clarification on the prescription. Changes to AbbVies VicodinR (hydrocodone bitartrate and acetaminophen tablets. The usual adult dosage is one or two tablets every four to six hours as needed for pain. Benadryl 25 mg IV × 1 dose with first dose of Morphine for any pain level. Acetaminophen: Not to exceed 1 g/dose or 4 g/24 hr. Pain Level 4-6: Norco (5/325) 2 tab PO q6 h PRN (Do not give with Tylenol). Q: Can a pharmacist change or add the correct amount of acetaminophen to a prescription for a combination product containing a schedule II drug and acetaminophen?Ī: Yes. 1-2 tablets (2.5-10 mg hydrocodone 300-325 mg acetaminophen) PO q4-6hr PRN. Frequently Asked Questions for Pharmacists on Combination Products Containing a Schedule II Drug and Acetaminophen
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