Prescription Dispensing, Labeling, and Patient Counseling
The valid prescription is the foundation
A prescription must be issued for a legitimate medical purpose by a prescriber acting in the usual course of professional practice, contain all required elements (patient, drug, strength, quantity, directions, date, prescriber identifiers), and be authenticated. Verify prescriber authority, including state license and, for controlled substances, DEA registration. Oral prescriptions are limited by schedule. Refills: none for CII; CIII–CV limited to five refills within six months of issue; controlled substance prescriptions generally expire one year from issue. Partial fills, interpharmacy transfers, and emergency oral CII orders each carry specific documentation rules.
Labeling: federal law requires pharmacy name and address, prescription number, date, patient name, prescriber, directions, and cautions; Alabama adds its own requirements, including substitution disclosure. Generic substitution is permitted unless the prescriber indicates dispense-as-written or the patient refuses; the patient must be informed of the substitution.
Counseling: the pharmacist must offer counseling on new and refill prescriptions - directions, storage, interactions, precautions - and document refusal. Interpreter use or written materials should be documented.
Traps: assuming a refill authorization extends expiration; transferring a CII; ignoring an expired prescriber DEA registration; skipping refusal documentation; treating an e-prescription as automatically valid without checking EPCS requirements.
Rule of thumb: no element, no fill - if a required element is missing or unverifiable, resolve it before dispensing and document the attempt.