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Pharmacist FAQs

Frequently Asked Questions for Pharmacists on Nurse Practitioners and Physician Assistants

Q: Can a nurse practitioner prescribe refills for Schedule III and IIIN controlled substances?

A: Yes. Due to a recent NP rule change (21 NCAC 36. 0809 and 21 NCAC 32M .0109) effective April 1, 2011 which removed the prohibition on refills for this class of drugs, NPs may now prescribe up to 5 refills for Schedule III and IIIN controlled substances.  Dosage units continue to be limited to a 30 day supply for each refill.

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Q: What can Physician Assistants and Nurse Practitioners prescribe?

A: At one time these individuals could only prescribe drugs from a fairly limited formulary. Over the years the restrictions have relaxed to the point that physician assistants, nurse practitioners (and certified nurse midwives) can prescribe any drugs in a protocol agreed to between the supervising physician and the midlevel practitioner.

Pharmacists have no way of knowing what is or is not on these protocols and should treat prescription orders from these individuals in the same way as they would from any other prescriber. These individuals can get DEA numbers and they can prescribe controlled substances. They are limited by Medical Board regulations to prescribing a 30 day supply of Schedules II and III drugs, but they have the same rights as any other registrant in prescribing Schedule IV drugs, including refills.

Nurse practitioners and physician assistants can dispense drugs under specific rules of the Board; see section .1703.

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Q: Are Physician Assistants and Nurse Practitioners who only dispense sample medications required to register with the Board under Rule .1703?

A: The Board has received numerous inquiries from physician assistants and nurse practitioners about Board of Pharmacy Rule .1703.  PAs and NPs have asked whether that rule’s registration, permitting, and oversight requirements apply when a PA or NP is simply handing out prescription drug samples to patients.  The Board does not interpret Rule .1703’s requirements to apply to a PA or NP who is engaged in traditional sampling – i.e., handing out, free of any charge (whether direct or indirect), starter doses or packets of prescription drug samples received from a prescription drug manufacturer in compliance with the Prescription Drug Marketing Act. 

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Q: What refill authority exists for Physician Assistants, Nurse Practitioners and Clinical Pharmacist Practitioners?

A: Summary of Rules on Prescribing by Nurse Practitioners, Physician Assistants and Clinical Pharmacist Practitioners (click here to view PDF.)

 

 

 

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