Supply of prescription medicines

​​​​Overview

Prescription medicines include Schedule 4 and Schedule 8 medicines as listed in the NSW Poisons List.

The NSW Poisons List adopts and uses the Schedules contained in the national Poisons Standard (SUSMP).

The information on this page is limited to the supply or prescribing of Schedule 4 a​nd 8 medicines.

On this page

1. Who can issue a prescription, or supply a prescription medicine
2. Legal forms of prescriptions
3. Handwritten prescriptions
4. Printed computer-generated prescriptions (hand-signed)
5. Conformant electronic prescriptions
6. Medication chart prescriptions
7. Supply of medicines on a telephone, fax or email order
8. Emergency supply and continued dispensing of prescription medicines
9. Supply of medicines for urgent use
10. What is required on a prescription
11. Illegal, inappropriate, or unprofessional supply of prescription medicines

Who can issue a prescription, or supply a prescription medicine

The following practitioners can supply a prescription medicine directly to a patient, issue a prescription for the patient to have the medicine dispensed by a pharmacist, or issue a direction (verbal or written) for the supply of the medicine:

• a medical practitioner
• a dentist
• a veterinary practitioner
• the following health practitioners with an endorsement under their relevant Board that qualifies them to carry out the prescribing or supplying of the prescription medicine:
• a nurse or midwife practitioner
• an optometrist
• a podiatrist
• a person authorised by the NSW Health Secretary (e.g., pharmacists authorised to supply some prescription medicines under their extended scope of practice).

Practitioners can only supply or prescribe a medicine when practicing under their scope of practice, limitations of their Ahpra registration and/or any endorsements of their professional board.

The medicine supplied or prescribed must be for a patient under the practitioner's care, where the practitioner has assessed the medicine to be reasonably necessary for the treatment of that patient.

It is a legal requirement to make a record of the supply, issue of a prescription, or direction for a Schedule 4 Appendix D (S4D) or Schedule 8 (S8) medicine. This record must include the date, patient details, details of the medicine, the quantity prescribed or supplied, and for S8 or Schedule 4 Appendix B medicines where repeats are issued, the interval at which the medicine is to be supplied. This record must be available on request by an inspector.

Under practitioner professional codes and guidelines, prescribers are required to keep clear and accurate medical records. See Ahpra Codes and guidelines for more information.

Prescription medicines supplied to patients must be labelled as per Appendix A of the Poisons and Therapeutic Goods Regulation 2008.

Legal forms of prescriptions

Prescriptions must comply with legal requirements and can be issued in one of the following formats:

Paper prescriptions (handwritten)

The prescriber handwrites and hand-signs a paper prescription.

Printed computer-generated prescriptions (hand-signed)

The prescriber generates the prescription using prescribing software, prints the prescription, and hand-signs it. Note, these are not e-prescriptions where a token may be issued.

The prescription must comply with the Criteria for Issuing Non-Handwritten (Computer-Generated) Prescriptions (TG 184).

Key criteria include:

• The prescribing system must prevent anyone but the prescriber from generating or printing the prescription
• The prescription must be hand-signed by the prescriber
• No alterations are permitted
• For Schedule 8 medicines, the medicine name, strength, dosage form, quantity (in words and numbers), directions for use, number of repeats, and repeat intervals must also be handwritten by the prescriber on one copy of the issued prescription.
• An exception to handwriting the medicine name, strength, dosage form, and quantity (in words and numbers) only applies when these Schedule 8 prescriptions are for treatment under the Opioid Treatment Program (OTP). These prescriptions must be sent directly to a pharmacist and not given to a patient.

Prescriptions issued using a public hospital electronic medication management system must comply with TG184. For further details, refer to the Factsheet for Community Pharmacies: Computer generated prescription formats from NSW public health facilities.

Conformant electronic prescriptions (e-prescriptions)

Conformant electronic prescription systems allow prescribers to send a prescription (e-prescription) directly to a patient's phone or email address as a digital token, or add it to the patient's Active Script List (ASL). These e-prescriptions must meet the following requirements to ensure compliance and safe dispensing:

• The prescription must be issued using a conformant electronic prescribing system with a valid Conformance ID. A list of these is available at Electronic Prescribing Conformance Register.
• The prescriber must complete all necessary fields, including the patient's date of birth. If a prescribing system does not have a designated field for a prescription requirement (such as the NSW Ministry of Health approval number for certain S8 medicine prescriptions), the prescriber must still enter this information into the system. The information must be recorded in a way that ensures it is displayed to the dispensing pharmacist.
• The prescriptions must be transmitted via a conformant prescription delivery system, also requiring a Conformance ID.
• The patient is issued with a unique electronic prescription token (QR code) to present at their chosen pharmacy, or is advised that the prescription has been added to their Active Script List (ASL). If the patient or their authorised agent requests that the token be sent to a pharmacy, then the prescriber should document this request.
• The pharmacist must use a conformant electronic dispensing system with a Conformance ID to process the prescription.
• More information is available at electronic prescribing.

Medication chart prescriptions

Public health facilities

Medication chart prescriptions may be used in public health facilities and include:

• the National Standard Medication Charts (NSMC) published by the Australian Commission of Safety and Quality in Health Care (ACSQHC)
• speciality medication charts (such as those developed by the Agency of Clinical Innovation) that are approved as a State Form.
• other paper-based medication charts as approved by the Chief Executive of the Local Health District (via the Drug and Therapeutics Committee)

More information is also available in:

• Policy Directive PD2022_032 Medication handling
• Factsheet for Community Pharmacies - Computer Generated Prescription Formats from NSW Public Health Facilities.

Image-based prescriptions in public health facilities

An image-based prescription is a photo or scan of either:

• a handwritten and signed paper prescription, or
• a printed electronic prescription that is hand-signed

which is sent by a prescriber to a pharmacist in a public health facility for dispensing.

Steps for image-based prescribing

• A medical or nurse practitioner creates and hand-signs a paper prescription. They then send a copy of the prescription (a photo or scanned image) directly to the public hospital pharmacy via fax or email. The original physical paper prescription does not need to be physically forwarded to the pharmacist.
• The image must be created and sent by the prescriber directly to the hospital pharmacy. It must not be sent to the patient or any other third party, and cannot be sent via text/SMS, mobile app, or website.
• The pharmacist must print and retain the prescription and any repeats for two years.
• Repeats can only be dispensed from the same public hospital pharmacy
• For further details, see Hospitals.

Private health facilities

• Prescriptions can be issued on the PBS Hospital Medication Chart, published by the Australian Commission on Safety and Quality in Health Care (ACSQHC), and can include non-PBS items, or be in a form that contains all the elements required of a prescription
• Pharmacists may dispense medicines using a copy of the medication chart prescription
• Other forms of prescriptions and/or medication charts must contain all the elements required for a prescription. See what is required on a prescription.

Residential care facilities (RCF)

Prescriptions for patients in RCFs can be issued in paper-based or electronic formats.

Prescriptions and/or medication charts must contain all the elements required for a prescription. See what is required on a prescription.

Paper-based medication chart prescriptions

The National Residential Medication Chart (NRMC) or a chart with equivalent prescribing data elements may be used.

Pharmacists can use a copy of the medication chart to dispense medicines except for:

• Schedule 8 medicines,
• Schedule 4 Appendix B medicines,
• Schedule 4 medicines listed in Clause 37 of the Poisons and Therapeutic Goods Regulation 2008.

The prescriber must issue a separate prescription for these medicines to be dispensed by a pharmacist. Refer to Prescribing and Dispensing on a residential medication chart prescription for more information.

Electronic medication chart prescriptions

Electronic medication chart prescriptions are currently being piloted by software vendors in designated facilities and pharmacies. These are approved under the Poisons and Therapeutic Goods Regulation 2008, see Approval for use of an Electronic National Residential Medication Chart (eNRMC).

For more information, refer to the Australian Commission of Safety and Quality in Health Care (ACSQHC) Electronic National Residential Medication Chart.

Supply of medicines on a telephone, fax, or email order

A prescriber may direct a pharmacist to dispense any medicine, including Schedule 8 and Schedule 4 Appendix D medicines, via telephone (verbally, not via text/SMS), fax, or email. This must be followed by a valid prescription sent to the pharmacist within 24 hours.

The prescription must include a notation by the prescriber stating that a direction was provided via telephone, fax, or email for dispensing. If the valid prescription is not received at the pharmacy within 7 days, the pharmacist must notify the NSW Ministry of Health via email at MoH-PharmaceuticalServices@health.nsw.gov.au

Restrictions on unregistered Schedule 8 medicines

• Schedule 8 medicines that are not registered on the Australian Register of Therapeutic Goods (ARTG), including compounded Schedule 8 preparations, require a valid prescription. These medicines cannot be supplied on a verbal, fax, or written (e.g., email) direction from a prescriber.
• For further details, refer to Unregistered and compounded Schedule 8 medicines.

Emergency supply and continued dispensing of prescription medicines

In an emergency or urgent situation where a patient presents to the pharmacy without a prescription, they must first be advised to obtain a valid prescription through one of the following options:

• Contact their usual prescriber, or another available prescriber, for assessment and issue of an electronic prescription (e-prescription).
• Arrange for a prescriber to provide a verbal (via phone), fax, or email direction to a pharmacist to dispense any medicine (excluding unregistered Schedule 8 medicines).
• Call HealthDirect on 1800 022 222 (available 24/7) for telehealth support and referral to a prescriber.

If a prescription cannot be obtained, a pharmacist may be able to supply the prescription medicine under one of the following:

Emergency 7-day supply by community pharmacists

Under the Poisons and Therapeutic Goods Regulation 2008, a pharmacist may supply up to 7 days of treatment, or the smallest standard pack for liquids, inhalers, creams, or ointments, prescription medicines (except Schedule 4 Appendix D and Schedule 8 medicines) without a prescription in urgent situations when:

• the patient has previously been prescribed the medicine, and
• there is an immediate need for continuation of treatment, and
• it is not practicable for the patient to obtain a prescription.

Continued dispensing

Continued dispensing is a Commonwealth initiative that allows the supply of certain eligible PBS and RPBS medicines when a patient cannot obtain a prescription and there is an immediate need for the medicine. Under Schedule 1 of the National Health (Continued Dispensing) Determination 2022, pharmacists can provide a single PBS quantity of a Schedule 4 medicine.

The criteria for continued dispensing are detailed in PBS Continued Dispensing Arrangements.

NSW Health issued legal instrument (authority)

In certain circumstances, such as extreme weather events, the NSW Ministry of Health may issue a legal instrument, such as an Authority, to permit the supply of prescription medicines without a prescription. Such instruments are published at Orders and Exemptions and can only be used under the conditions and the timeframe specified in that instrument.

Authorities have been issued to allow pharmacists with appropriate training to supply prescription medicines to help manage the following health conditions:

• urinary tract infections (UTI)
• common skin conditions
• resupply of oral contraceptive pills.

More information, including the authority conditions for the supply of prescription medicines in the above situations, is available at More services available at your local pharmacy.

Supply of medicines for urgent use

A pharmacist may supply scheduled medicines to an authorised practitioner for emergency or urgent use upon receipt of a signed and dated written order from the practitioner. Certain medicines are subsidised by the Pharmaceutical Benefits Scheme (PBS) when ordered by a prescriber for emergency use. Refer to Prescriber Bag for a list of these medicines. Medicines supplied by a pharmacist to a practitioner for urgent or emergency use by a prescriber should not be dispensed in the name of the requesting prescriber.

In a residential care facility, urgent-use medicines can be provided on a signed and dated written order from the Director of Nursing or from the Care Manager where no Director of Nursing is appointed. For more information, see urgent use medicines in RCFs.

For the supply of medicines for urgent use in a public health facility, see Policy Directive PD2022_032 Medication Handling.

What is required on a prescription

A prescription must include:

• The date of issue (prescriptions cannot be forward or back-dated)
• Patient details: name, date of birth, and address, or if the treatment is for an animal, the species of animal and the name and address of the animal’s owner
• Medicine details: name, strength, quantity of the medicine, and adequate directions for use. The dosage form of the medicine should be included if not apparent. Adequate directions should include the route of administration and the frequency of use. If the medicine is in Schedule 8 the following must also be included:
• the quantity to be supplied must be in words and numbers, and
• if prescribed on a computer-generated prescription (printed and hand-signed by the prescriber), the medicine details must also be handwritten by the prescriber.
• Repeats: the number of repeats if the prescription is to be dispensed more than once. If the medicine is a Schedule 8 medicine or a Schedule 4 anabolic-androgenic steroid:
• a time interval between repeats must be included, and
• if the prescription is computer-generated (printed and hand-signed by the prescriber), the repeat interval and number of repeats must be handwritten.
• Approval requirements: if the medicine is a psychostimulant (dexamfetamine, methylphenidate, lisdexamfetamine,) or a pharmacy-compounded Schedule 8 medicine, the approval number issued to a prescriber must be included. See Prescribe a psychostimulant medicine, or Unregistered and compounded Schedule 8 medicines for more information.
• Prescriber details:
• name and designation of the prescriber who issued the prescription
• address and telephone number of the prescriber’s principal place of practice, or if issued in a public health entity or private health facility, the name, address, and telephone number of that facility
• signature of the prescriber (for electronic conformant prescriptions, as per the ADHA conformance requirements and technical specifications)
• Reference number: printed computer-generated prescriptions (hand-signed) must include a unique reference number

Prescription validity

Prescriptions are valid for 12 months from the date of issue, except for Schedule 8 medicines and Schedule 4 Appendix D medicines, which are valid for 6 months.

Additional requirements for dentists, veterinary practitioners, optometrists, and podiatrists

The following must be included on prescriptions issued by the following prescribers:

• prescriptions issued by dentists must include the words "For dental treatment only”
• prescriptions issued by veterinary practitioners must include the words “For animal treatment only”
• prescriptions issued by optometrists must include the words "For optometric treatment only”
• prescriptions issued by podiatrists must include the words "For podiatric treatment only”.

Illegal, inappropriate, or unprofessional supply of prescription medicines

Illegal forms of prescriptions

• Prescriptions on forms pre-populated by someone other than the prescriber (e.g., a pharmacist, 'prescription broker', clerical assistant, nurse, patient).
• Prescriptions sent through companies, websites, or apps (electronic prescriptions using conformant systems with Conformance IDs are permitted).
• An image of a prescription provided to a patient.
  
• An image of a prescription provided to a pharmacy by anyone other than the prescriber.
• Paper prescriptions with digital signatures.
• Electronic or image-based veterinary prescriptions.

Other illegal and unprofessional scenarios

• Prescriptions requested by the patient in response to websites offering to arrange a supply of prescription medicines. This is contrary to Medical Board standards and telehealth principles. Refer to Telehealth guidance for practitioners.
• The decision whether to prescribe a Scheduled medicine for a patient and the choice of which medicine, form, strength, and quantity must be made by the prescriber, not governed by patient request or brokered by a third party such as a pharmacy, medicine sponsor, or others who receive financial benefit from the prescribing of the medicine.

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