Sequential Prescriptions (Do Not Fill Until...)

21 CFR 1306.12

  • Sequential prescriptions up to a 90-day supply of a Schedule II controlled substance are permitted
    • Example:  Writing 3 prescriptions to be dispensed every 30 days by the pharmacist (all prescriptions have the same date of issuance)
      • Write one prescription for one-third of the total quantity of controlled substance to be prescribed
      • Write a second prescription for one-third of the total quantity of controlled substance to be prescribed
        • Write DO NOT FILL UNTIL ____/___/_____on the second prescription, with the date 30 days after the first prescription date of issue
      • Write a third prescription for one-third of the total quantity of controlled substance to be prescribed
        • Write DO NOT FILL UNTIL ____/___/_____on the third prescription, with the date 60 days after the first prescription date of issue

Interpretation of CFR 1306.12

  • Issuance of multiple prescriptions for schedule II controlled substances
    • DEA's regulations allow practitioners to provide individual patients with multiple prescriptions for a specific schedule II controlled substance, written on the same date, to be filled sequentially
    • This combined effect of such sequential multiple prescriptions is that it allows a patient to receive, over time, up to a 90-day supply of that controlled substance

21 CFR 1306.14(e)

  • A pharmacist cannot fill a prescription issued as one in a series of multiple prescriptions prior to the date written by the prescribing physician