Dispensing prescriptions for psychostimulants

​​​​​​​Legislative requirements for dispensing a psychostimulant medicine in NSW

The following substances must not be supplied by a pharmacist unless the approval reference number is shown on the prescription (in accordance with clause 90 of the Poisons and Therapeutic Goods Regulation 2008):

  • dexamfetamine
  • lisdexamfetamine
  • methylphenidate

Note: An 'approval' is a reference to an authority under the Poisons and Therapeutic goods Act 1966. An approval issued to a prescriber by the NSW Ministry of Health is separate to an authority required from Services Australia for a patient to receive a PBS subsidised medicine.

Prescription requirements for psychostimulant medicines

A medical practitioner may only prescribe a psychostimulant medicine with the prior approval of the NSW Ministry of Health. 

All prescriptions written for dexamfetamine, lisdexamfetamine, or methylphenidate presented for dispensing must be endorsed with one of the following:

  • CA2023 - for use by psychiatrists, paediatricians and neurologists prescribing under the conditions of the class authority*
  • Axxxxxxx OR AU xxxxxx - unique number that may be specific for a prescriber OR specific for a patient**
  • CNSxxxxxxx  OR S28cxxxxxxx - unique prescriber approval previously issued to a prescriber by the Ministry of Health.

Note: Prescriptions endorsed with reference number “CNS" or “S28c" will remain valid for dispensing, unless expired or cancelled.​ For more information see Authority(CNS or S28c) to prescribe or supply psychostimulant medicines.

The prescriber is required to include an approval reference number on the prescription. An exemption applies when prescribing to hospital inpatients (see below).

A medical practitioner may prescribe a psychostimulant medicine on behalf of an authorised prescriber temporarily unavailable in the same practice. 

*Class authority
From 13 November 2023 the class authority number "CA2023" can be used by psychiatrists, paediatricians and neurologists when prescribing psychostimulant medicines for the treatment of ADHD to a non-drug dependent person. The class authority can be used to prescribe up to a maximum daily dose of:
  • dexamfetamine 50mg​
  • lisdexamfetamine 70mg
  • methylphenidate 108mg
To prescribe higher doses, or for non-ADHD indications, or to drug dependent patients these specialists will need to apply for an individual approval, and the prescription will show an approval number with the prefix of ‘A’. See Prescribe a psychostimulant medication for more information.
 
**Changes to approval numbers 
From 22 May 2023, the prefix to an issued approval number has changed from ‘AU’ to ‘A’. All new approval numbers will have a prefix of ‘A.’
The reason for this change is because of an upgrade of the system the NSW Health uses to process and manage authority applications

 

​Exemptions for prescribing to a hospital inpatient

In a hospital, an exemption to obtaining a NSW Health authority applies for the prescribing (either on a prescription or on a medication chart) of any registered Schedule 8 medication to an inpatient for a period of up to 14 days following admission, if the medication is being initiated in the hospital.

Following this 14 day period the prescriber must hold or obtain the necessary authority from Pharmaceutical Services​ Unit in the particular circumstance as detailed above to provide for the continuing treatment of the patient with the Schedule 8 medication and endorse the prescription as above.

In a hospital, an exemption to obtaining a NSW Health authority also applies for the prescribing of any Schedule 8 medicine for a hospital inpatient who was, immediately prior to his/her admission, being treated with that medicine under a NSW authority.

If a prescription is written under one of these exemptions, there will be no authority number shown on the prescription.  When the authority number is not shown on a prescription for a Schedule 8 psychostimulant, a pharmacist must confirm with the prescriber that the prescription has been written under this exemption, and should make and keep a note of the advice from the prescriber. If not written under this exemption, a pharmacist cannot dispense a prescription for a Schedule 8 psychostimulant unless the prescription includes the authority number.

Current as at: Friday 28 June 2024
Contact page owner: Pharmaceutical Services