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Frequently Asked Questions for Pharmacists on Health Department RN Dispensing:

 

Q: May registered nurses (RNs) dispense antivirals from health departments?

A: Board Rule .2403 provides that properly trained RNs may dispense certain types of prescription drugs from health departments.  Antivirals are not among the types listed.  Board staff, however, has no objection to properly trained RNs dispensing antivirals as needed to treat H1N1 flu.  Such dispensing is clearly a benefit to the public health and safety and well within the spirit of Rule .2403. 

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Q: May registered nurses (RNs) “compound” Tamiflu suspension if needed?

A: The Centers for Disease Control (CDC) has provided a document detailing Emergency Use Authorization (EUA) of antivirals to treat H1N1 flu.  That document is found here:  http://www.cdc.gov/h1n1flu/eua/  More specifically, the document contains detailed information about Tamiflu, which is found here:  http://www.cdc.gov/h1n1flu/eua/pdf/tamiflu-patients.pdf. The first question on the second page states:

What if my child or I cannot swallow capsules? For pediatric patients who cannot swallow capsules, TAMIFLU® Oral Suspension is preferred. If the oral suspension is not available, TAMIFLU® capsules may be opened and mixed with sweetened liquids such as regular or sugar-free chocolate syrup.

Accordingly, there is no apparent need to “compound” Tamiflu suspension from the capsules.  Dispensing professionals should simply instruct parents or other patients to open the capsule and mix the contents as described.  Dispensing professionals can also provide this service for parents or other patients who need it.

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ADDITIONAL GUIDANCE FOR PHARMACIST COMPOUNDING OF TAMIFLU ORAL SUSPENSION:  As health-care providers continue to combat seasonal and H1N1 flu, there have been some reports of shortages of commercially available Tamiflu oral suspension.  The following guidance documents – which are based on instructions provided in the Tamiflu package insert -- may be useful for pharmacists who find themselves without access to commercially available Tamiflu oral suspension or in need of preparing patient-specific doses that would be difficult to administer using commercially available Tamiflu oral suspension:

TAMIFLU COMPOUNDING INSTRUCTIONS

 

 

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