Frequently Asked Questions (FAQs)
FAQs for Pharmacists - FAQs for Medical Practitioners
FAQs for Pharmacists
How long am I required to keep records of prescriptions that I have dispensed?
All records of prescriptions dispensed must be retained for two years from the date of dispensing and must be kept on the premises where the prescription was dispensed.
How long am I required to keep records concerning the emergency supply of Schedule 4 (S4) and Schedule 8 (S8) medicines?
All records of emergency supplies made must be retained for two years from the date of supply and must be kept on the premises where the order was supplied.
What are the labelling requirements for Webster® packs and other unit-dose packs?
Unit-dose packs, including Webster® packs, have the same labelling requirements as any dispensed medicine. These requirements are detailed in the Poisons and Therapeutic Goods Regulation.
A guide to poisons and therapeutic goods legislation for pharmacists is available online.
The Pharmaceutical Society of Australia also publishes standards for the provision of Dose Administration Aids which are available online.
Can I dispense a prescription for a Schedule 4 (S4) or Schedule 8 (S8) medicine written by a doctor (or dentist or vet or nurse practitioner) who is practising in another State or Territory?
Yes, provided the practitioner is registered on the Australian Register of Practitioners. The registration status of a practitioner can be accessed online.
All the normal restrictions on dispensing prescriptions still apply and details are available online.
There are requirements concerning Schedule 8 medicines that pharmacists should pay particular attention to when dispensing prescriptions for these medicines:
• before dispensing, the pharmacist should be familiar with the prescriber’s handwriting, know the patient, or verify the prescription with the prescriber (usually by phone)
• on any prescription for methylphenidate or dexamphetamine, the prescriber’s NSW Ministry of Health authority number must be written by the prescriber
• to prescribe methadone or buprenorphine for opioid dependence treatment, the prescriber must be accredited and authorised by the NSW Ministry of Health
If the patient lives outside NSW, inform him or her before dispensing that you will need to retain the prescription.
Further information can be obtained by contacting the Duty Pharmaceutical Officer at Pharmaceutical Services (NSW Ministry of Health) during business hours on (02) 9879-3214.
How many packs of a Schedule 2 (S2) or Schedule 3 (S3) medicine am I allowed to supply at once?
A pharmacist may supply a quantity in accordance with the recognised therapeutic standards of what is appropriate under the circumstances for the treatment of the customer or the person for whom the medicine is intended, e.g., a member of the customer’s immediate family.
Where should prescriptions for Schedule 8 (S8) medicines be stored?
Prescriptions dispensed for Schedule 8 medicines (‘drugs of addiction’) must be retained for two years from the date of dispensing and must be kept on the premises where the prescription was dispensed. The prescriptions must also be kept apart from other (S4) prescriptions, except certain ‘specified’ barbiturates (eg. amylobarbitone, methylphenobarbitone, pentobarbitone, phenobarbitone) and anabolic/androgenic steroidal agents. Further details are available online.
Who can have access to drugs of addiction in a pharmacy?
All drugs of addiction (Schedule 8 medicines) in a pharmacy must be kept locked in a safe at all times except when in immediate use. All keys to the safe which are in the pharmacy must be kept on the person of a pharmacist at all times the pharmacy is open, and must not be left on the premises (except locked in another safe) when the pharmacy is closed. The combination or code for the safe must never be disclosed to any staff member who is not a pharmacist.
I want to know if a particular medicine is listed as Schedule 3 (S3) or Schedule 4 (S4). How do I find out?
The NSW Poisons List contains information on the classification of medicines and poisons into Schedules and is published online by the NSW Ministry of Health. The NSW Poisons List adopts, with some minor variations, the national Standard for the Uniform Scheduling of Medicines and Poisons (SUSMP). The SUSMP, including amendments, is available online from the Commonwealth Therapeutic Goods Administration.
I've dispensed a prescription for a Schedule 8 (S8) medicine and the patient demands the prescription back to get the repeats dispensed elsewhere because he is moving. Can I give it to him?
No. All dispensed Schedule 8 prescriptions must be separately retained on the premises of the pharmacy which dispensed them. The patient (or agent) will need to come back to your pharmacy to get the repeats dispensed when they are due or make arrangements for the medicine to be delivered to them from your pharmacy. If these options are not convenient, the patient will need to obtain a new prescription from his or her doctor.
I want to know if a particular medicine is listed on the PBS. How do I find out?
The Pharmaceutical Benefits Scheme (PBS) is administered by the Commonwealth Government. To find a medicine listed on the Schedule of Pharmaceutical Benefits, search online or contact the PBS Information Line on 1800-020-613.
FAQs for Medical Practitioners
Where can I order a drug register?
Drug registers, as well as ward registers, can be ordered from the Government printing contractor SALMAT – telephone (02) 9311-9899 during business hours.
Subsidiary Drug registers for the dosing of methadone, Subutex and Suboxone (each one has their own) are available from the NSW Pharmacy Guild – telephone (02) 9467-7100.
Doctors can order a ‘Schedule 8 drugs – record book of administration’ (small and large) from the Royal Australian College of General Practitioners.
Do I need an authority from NSW Ministry of Health to prescribe a Schedule 8 (S8) medicine?
You may, depending on the S8 medicine (‘drug of addiction’) involved and the circumstances.
Note: An authority from the NSW Ministry of Health is distinct from, and independent of, an authority from Medicare Australia which is for the purposes of a subsidy under the Pharmaceutical Benefits Scheme (PBS).
Details of authority requirements in NSW are available online but a summary is provided below.
If a patient is drug dependent, written authority of the NSW Ministry of Health (Pharmaceutical Services) must be obtained prior to prescribing any drug of addiction.
Prior written authorisation is also required to prescribe the stimulant drugs dexamphetamine and methylphenidate to any patient. Particular requirements apply to the prescription of these drugs for the management of attention deficit hyperactivity disorder (ADHD) in Children and Adults which are available online.
There are authority requirements to prescribe or supply for persons who are not drug dependent for the following medicines:
- any injectable drug of addiction
- buprenorphine (except transdermal preparations)
- flunitrazepam
- hydromorphone
- methadone.
Specifically, to prescribe or supply any of the medicines listed above for more than two months (to a person who is not drug dependent) a written authority of the NSW Ministry of Health is required.
Further information can be obtained by contacting Pharmaceutical Services on (02) 9879-5239 during business hours.
Can I get an authority to prescribe an Schedule 8 (S8) medicine over the phone?
No. Authorisation to prescribe an S8 medicine is granted only after a written application is made to the NSW Ministry of Health (Pharmaceutical Services).
Application forms are available online.
Note: There are separate procedures for applications to prescribe methadone or buprenorphine under the NSW Opioid Treatment Program (OTP). Doctors interested in prescribing under the NSW OTP should contact the Mental Health and Drug and Alcohol Office of the NSW Ministry of Health in the first instance – telephone (02) 9391-9000.
Can a GP prescribe Schedule 8 CNS stimulant medication?
The prescribing of Schedule 8 CNS stimulant medication (e.g., methylphenidate, Ritalin®, Ritalin LA®, Concerta®, dexamphetamine) requires authorisation from the NSW Ministry of Health (Pharmaceutical Services) and is generally restricted to specialists, such as paediatricians and psychiatrists.
Patients who may require Schedule 8 CNS stimulant medication should be referred to a specialist for assessment.
It is illegal for anyone other than an authorised doctor to issue a prescription for a Schedule 8 CNS stimulant. Prescriptions may only be dispensed if they are endorsed with a NSW Ministry of Health authority number.
I am going to be away from my practice for several weeks. What happens to the patients for whom I have a NSW Ministry of Health authority to prescribe a Schedule 8 (S8) medicine?
If you wish the patient to continue on the S8 medicine you should write him (or her) a prescription that will provide enough medication for him until his next appointment after your return. If you are hiring a locum, or are in a multi-doctor practice, your locum or a practice partner may prescribe S8 medicines to the patient under the terms of your NSW Ministry of Health S8 authority if it is therapeutically necessary. Only a minimal amount should be prescribed – enough to last until the patient’s next appointment with you.
If you are going to be absent for an extended period of time, you should cancel your NSW Ministry of Health authorities to prescribe S8 medicines and advise the patients affected that they should ask another doctor to prescribe for them.
Can I write a prescription in my own name to get supplies for surgery use from a community pharmacy?
No. A doctor cannot buy wholesale quantities of scheduled medicines for general surgery use from a community pharmacy; the medicines should be purchased from a licensed wholesaler.
As a doctor, you can write an emergency drug order (not a prescription) to obtain small quantities of medicines from a community pharmacy for use in emergencies. For example, when it wouldn't be practicable to give a patient a prescription for an urgently needed medicine to get it dispensed at a pharmacy.
A patient has presented to the surgery asking for medicines that are subject to abuse – what should I do?
Anytime a patient presents requesting a medicine that is subject to abuse a doctor should be very circumspect. Before prescribing for the patient the doctor must be satisfied – based on clear and reasonable medical judgement – that the medication requested is the most appropriate for the situation. A doctor should not just take the word of the patient.
Requests for medications such as opioids and benzodiazepines might indicate that the patient is a doctor shopper or a drug dependent person.
If a doctor suspects a patient of getting medicine in excess of medical need, they can call Medicare Australia's Prescription Shopping Information Service on 1800-631-181 to obtain a summary of what medicines have been supplied to the patient on Commonwealth PBS subsidised prescriptions from community pharmacies. Doctors must first register with the service.
General advice on handling drug-seeking patients can be obtained from the Duty Pharmaceutical Officer at Pharmaceutical Services (NSW Ministry of Health) – call (02) 9879-3214 during business hours. The Duty Officer can also provide advice as to whether another doctor holds an authority to prescribe a drug of addiction (Schedule 8 medicine) for the patient.
Useful literature on drug-seeking behaviour can also be found online.
A patient has come to my surgery who is dependent on a benzodiazepine – he's been on it for years. Another doctor started him on it. Can I keep prescribing it to him so he won't get withdrawal symptoms?
It is inappropriate to prescribe a benzodiazepine simply to maintain a patient’s dependence. A withdrawal plan should be developed for the patient, which may require consultation with a doctor who has experience in drug dependence.
The NSW Ministry of Health has published practice guidelines for the treatment of withdrawal from alcohol and other drugs such as benzodiazepines. These guidelines (NSW Drug and Alcohol Withdrawal Clinical Practice Guidelines) are available online.
The Royal Australian College of General Practitioners have also formulated guidelines to assist general practitioners in relation to the appropriate prescribing of benzodiazepines which can be accessed online.
Practical information for GPs for the management of benzodiazepine dependence are also available online.