Partial Fill and Transfer of a Schedule II Prescription
A 42-year-old patient presents a paper prescription for oxycodone 5 mg, #60, written today by a local surgeon. The pharmacy has 30 tablets in stock. The patient asks you to dispense 20 now and the remaining 40 in about five weeks when she returns from a work assignment. She also asks whether she can take the prescription to a pharmacy near her job to get the rest. The prescription has no refills. Your state has no additional rule on partial fills.
1. May you dispense 20 tablets now at the patient's request, and what must be documented?
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Yes, but only as a patient-requested partial fill. Under 21 CFR 1306.13(b), a Schedule II prescription may be partially filled at the request of the patient or prescriber if the total quantity dispensed does not exceed the amount prescribed and all dispensing occurs within 30 days of the date written. You must note the quantity dispensed and the date on the prescription and in your records. Because the patient wants the remainder at about five weeks, that remainder cannot be dispensed on this prescription. If instead the pharmacy could not supply the full quantity, the 72-hour rule in 1306.13(a) would apply, not the 30-day patient-request rule.
2. Can the remaining 40 tablets be transferred to another pharmacy near the patient's job?
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No. Schedule II prescriptions cannot be refilled, and a partially filled remainder is not an initial fill. Federal rules now permit a one-time transfer of an electronic Schedule II prescription between DEA-registered pharmacies for initial filling, but that does not cover a paper prescription or a previously partially filled remainder. State law may be more restrictive. The practical answer is that the patient needs a new prescription from the prescriber for the remaining quantity, and the new prescription must independently satisfy all Schedule II requirements.
3. What changes if your stock was the reason for the partial fill rather than the patient's request?
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The rule changes. Under 21 CFR 1306.13(a), if the pharmacist is unable to supply the full quantity, the remaining portion may be filled within 72 hours. If the remainder is not filled within 72 hours, you must notify the prescriber and no further quantity may be supplied beyond 72 hours without a new prescription. Document the partial quantity, the date, the reason, and the prescriber notification. Do not use the 30-day patient-request rule as a workaround for inadequate stock.