If there is a shortage of a CII such as oxycodone, can the pharmacist change the drug to oxycodone/APAP after consulting the practitioner?

The legal framework governing pharmacy practice allows for modifications to prescriptions under certain circumstances, especially when addressing drug shortages. In the case of a controlled substance like oxycodone, if a pharmacist consults the practitioner and receives consent to change the prescription to another formulation, such as oxycodone combined with acetaminophen (APAP), this can be permissible.

This approach prioritizes patient care by ensuring continuity of therapy when the originally prescribed medication is unavailable. However, it is crucial that the pharmacist establishes clear communication with the practitioner to confirm that the alternative choice is appropriate for the patient’s needs. Furthermore, documenting this consultation process is essential for accountability and legal compliance.

In contrast, insisting on filling the original prescription without consideration for the patient’s immediate needs or the constraints posed by the shortage does not serve the best interests of the patient. Similarly, requiring patient consent or ruling out any modifications under all circumstances would not align with the recognized practice of adaptive patient care in pharmacy.