CII Prescriptions Changes - Adderall vs. Adderall XR

[CocaNapple13]

Question: I understand that there are 4 things that cannot be changed on a CII prescription in Texas: name of patient, name of doctor, name of drug and date. The law does allow the "dosage form" to be changed. --> Does that mean that we could change Adderall to Adderall XR and vice versa because it would be a dosage form change? Or would it have to be written for the generic in order to consider it a dosage form change?
Thanks!

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[Charcoales]

Question: I understand that there are 4 things that cannot be changed on a CII prescription in Texas: name of patient, name of doctor, name of drug and date. The law does allow the "dosage form" to be changed. --> Does that mean that we could change Adderall to Adderall XR and vice versa because it would be a dosage form change? Or would it have to be written for the generic in order to consider it a dosage form change?
Thanks!

I would not change it. Only capsule to tablet like with oxycodone sometimes.

 

[CetiAlphaFive]

Question: I understand that there are 4 things that cannot be changed on a CII prescription in Texas: name of patient, name of doctor, name of drug and date. The law does allow the "dosage form" to be changed. --> Does that mean that we could change Adderall to Adderall XR and vice versa because it would be a dosage form change? Or would it have to be written for the generic in order to consider it a dosage form change?
Thanks!

That is a hard no.

You can always call the board and hit option 3 when in doubt

 

[accordman83]

Question: I understand that there are 4 things that cannot be changed on a CII prescription in Texas: name of patient, name of doctor, name of drug and date. The law does allow the "dosage form" to be changed. --> Does that mean that we could change Adderall to Adderall XR and vice versa because it would be a dosage form change? Or would it have to be written for the generic in order to consider it a dosage form change?
Thanks!

I had a member of Ohio's board say this was a legal change in my state cause you're not changing the actual drug.

 

[Rouelle]

I had a member of Ohio's board say this was a legal change in my state cause you're not changing the actual drug.

That seems like a dangerous viewpoint from the board member. Consider Metadate CD 20, Ritalin SR 20, and Ritalin LA 20. True, they all contain methylphenidate, but I would argue they are not the same "drug." You definitely couldn't change the names in this case.

 

[Sine Cura]

I might do it one time if it's something they get "all the time" and the medical assistant screwed up the script without the prescriber noticing. But if it's happening all the time this is one of those things where you should just have the patient complain to the prescriber's office so that they don't keep perpetuating the same mistake.

 

[Niosh]

Given immediate release and extended release are dosage forms, I think this is a perfectly legal thing to change on a C II script after consultation with the prescriber.

 

[BidingMyTime]

Given immediate release and extended release are dosage forms, I think this is a perfectly legal thing to change on a C II script after consultation with the prescriber.

Logically this would make sense, but laws often aren't logical, my understanding is no they can't legally be changed.

 

[npage148]

So can you change duragesic to atiq (or whatever abused form you wish). Same drug, different dosage forms

 

[accordman83]

That seems like a dangerous viewpoint from the board member. Consider Metadate CD 20, Ritalin SR 20, and Ritalin LA 20. True, they all contain methylphenidate, but I would argue they are not the same "drug." You definitely couldn't change the names in this case.

Yes I definitely see your point, I definitely do not change dosage formulation over the phone, oxycodone capsules to tabs of course but that's it.

 

[MatCauthon]

I've never worked at a pharmacy that had a problem with changing the dosage form on a CII. The pharmacists I've worked with always get permission from the provider, of course. We've read the DEA law many times and haven't anything that precludes this practice. If the DEA does not prohibit this practice, then in reality, it is no different than changing a non-CII dosage form (Venlafaxine IR to Venlafaxine ER). Some examples I've seen include changing oxycodone tablets to liquid, changing between various methylphenidate formultions (when the provider puts the wrong dosage form on e-rx), changing from morphine tablets to liquid (in patients that are on feeding tubes), etc.

 

[MatCauthon]

That seems like a dangerous viewpoint from the board member. Consider Metadate CD 20, Ritalin SR 20, and Ritalin LA 20. True, they all contain methylphenidate, but I would argue they are not the same "drug." You definitely couldn't change the names in this case.

Nothing dangerous about it, especially if the provider put in the wrong dosage form to begin with. By using the patient's history and discussing with the provider you are working to correct a potential dangerous error.

 

[Rouelle]

Nothing dangerous about it, especially if the provider put in the wrong dosage form to begin with. By using the patient's history and discussing with the provider you are working to correct a potential dangerous error.

While this is quite true, the topic at hand (and the topic I was addressing) is whether a pharmacist can change the drug name on a CII hard copy. My argument is that it would be dangerous (for my license) for me to strike out "Ritalin LA 20" on a hard copy and write in "Metadate CD 20."