§ 40:978 — Prescriptions

Louisiana § 40:978

• Jurisdiction: Louisiana
• Title 40: Public Health and Safety

Text

§978. Prescriptions
A. Except when dispensed or administered directly by a medical practitioner or
administered by a person authorized to administer by such practitioner, other than a
pharmacist, to an ultimate user, no controlled dangerous substance included in Schedule II,
which is a prescription drug as determined under the Louisiana Revised Statutes of 1950,
may be dispensed or administered without either the written prescription of a practitioner,
or an electronic prescription order as provided by federal law or regulation, except that in
emergency situations, as prescribed by the board by regulation, such drug may be dispensed
or administered upon oral prescription reduced promptly to writing and filed by the
pharmacist. Prescriptions shall be retained in conformity with the requirements of R.S.
40:976. No prescription for a Schedule II substance may be refilled nor may such
prescription be filled more than ninety days after the date of the prescription. The pharmacist
filling a prescription for a Schedule II substance may, upon request of the patient, dispense
the prescribed substance in an amount less than the full quantity prescribed in accordance
with 21 U.S.C. 829.
B. Except when dispensed or administered directly by a practitioner or administered
by a person authorized to administer by such practitioner, other than a pharmacist, to an
ultimate user, no controlled dangerous substance included in Schedule III and IV which is
a prescription drug as determined under the Louisiana Revised Statutes may be dispensed or
administered without either a written prescription, an oral prescription, or an electronic
prescription order as provided by federal law or regulation. Such prescription may not be
filled or refilled more than six months after the date thereof or refilled more than five times
after the date of the prescription, unless renewed by the practitioner.
C. No controlled dangerous substance included in Schedule V may be distributed,
administered or dispensed other than for a medical purpose by prescription of a licensed
practitioner or as otherwise permitted by the provisions of this Part. However, nothing
contained in this Subsection shall prohibit a practitioner from delegating the authority to
administer controlled dangerous substances in Schedule V to a person authorized by such
practitioner.
D. Notwithstanding the requirements of this Section, a prescription for a controlled
substance listed in Schedule II, III, IV, or V may be generated, signed, transmitted, and
received in electronic form, but only in conformance with the federal rules established by the
United States Drug Enforcement Administration at 21 CFR 1311.
E.(1) The pharmacist shall not dispense more than a ten-day supply at a dosage not
to exceed the United States Food and Drug Administration's approved labeling for the
medication if the prescriber for such medication is not licensed by the state of Louisiana, and
the medication is an opioid derivative Schedule II or an opioid derivative Schedule III
controlled dangerous substance. The dispensing pharmacist shall notify the prescriber of the
supply dispensed and the cancellation of the remainder of the prescription.
(2) Within sixty days of the dispensing of a medication pursuant to Paragraph (1) of
this Subsection, such a medication shall not be dispensed again for the individual by a
prescriber not licensed by the state of Louisiana.
(3) The provisions of this Subsection shall not apply if either of the following apply:
(a) The prescription monitoring information from the state of the prescriber may be
viewed by the dispensing pharmacist.
(b) The prescriber includes on the prescription a diagnosis of cancer or terminal
illness.
F.(1) A prescriber or his delegate shall access and review the patient's record in the
prescription monitoring program established in R.S. 40:1001 et seq. prior to initially
prescribing any opioid to a patient, and shall access the prescription monitoring program and
review the patient's record at least every ninety days if the patient's course of treatment
continues for more than ninety days. The requirement established in this Subsection shall
not apply in the following instances:
(a) The drug is prescribed or administered to a hospice patient or to any other patient
who has been diagnosed as terminally ill.
(b) The drug is prescribed or administered for the treatment of cancer-related chronic
or intractable pain.
(c) The drug is ordered or administered to a patient being treated in a hospital.
(d) The prescription monitoring program is inaccessible or not functioning properly
due to an internal or external electronic issue. However, the prescriber or his delegate shall
check the prescription monitoring program once electronic accessibility has been restored
and note the cause for the delay in the patient's chart.
(e) No more than a single seven-day supply of the drug is prescribed or administered
to a patient.
(2) The provisions of this Subsection shall be enforced by the health profession
licensing board that regulates the prescriber. Each health profession licensing board that
regulates prescribers shall promulgate rules and regulations in accordance with the
Administrative Procedure Act to comply with the mandate in this Subsection. If a health
profession licensing board becomes aware of a prescriber's first failure to comply with this
Subsection, as verified by the data of the prescription monitoring program, the board shall
notify the prescriber of the relevant statutory requirements and inform the prescriber of the
need to correct or amend his prescribing practices to comply with the provisions of this
Subsection. If a health profession licensing board becomes aware of a second or subsequent
failure to comply with this Subsection, as verified by the data of the prescription monitoring
program, the board shall treat the notification as a complaint against the licensee, but shall
not consider such notice as evidence of deviation from standard of care.
(3) The provisions of this Subsection shall not apply to individuals licensed by the
Louisiana Board of Veterinary Medicine.
G.(1)(a) Except as provided in Paragraph (2) of this Subsection, when issuing a first-time opioid prescription for outpatient use to an adult patient with an acute condition, a
medical practitioner shall not issue a prescription for more than a seven-day supply.
(b) Except as provided in Paragraph (2) of this Subsection, a medical practitioner
shall not issue a prescription for an opioid to a minor for more than a seven-day supply at any
time and shall discuss with a parent, tutor, or guardian of the minor the risks associated with
opioid use and the reasons why the prescription is necessary.
(2) If, in the professional medical judgment of a medical practitioner, more than a
seven-day supply of an opioid is required to treat the adult or minor patient's acute medical
condition or is necessary for the treatment of chronic pain management, pain associated with
a cancer diagnosis, or for palliative care, the practitioner may issue a prescription for the
quantity needed to treat the patient's acute medical condition or pain. The condition
triggering the prescription of an opioid for more than a seven-day supply shall be
documented in the patient's medical record and the practitioner shall indicate that a
nonopioid alternative was not appropriate to address the medical condition. The medical
practitioner shall indicate on the prescription that more than a seven-day supply of the opioid
is medically necessary.
(3) This Subsection shall not apply to medications designed for the treatment of
substance abuse or opioid dependence.
H.(1) Prior to issuing a prescription for an opioid, a medical practitioner shall do
both of the following:
(a) Consult with the patient regarding the quantity of the opioid and the patient's
option to fill the prescription in a lesser quantity.
(b) Inform the patient of the risks associated with the opioid prescribed.
(2)(a) A pharmacist filling a prescription for an opioid may dispense the prescribed
substance in an amount less than the recommended full quantity indicated on the prescription
if requested by the patient and the prescription complies with the provisions of this Section.
The patient may request that the pharmacist fill an additional amount not to exceed the
remaining prescribed quantity in accordance with 21 U.S.C. 829.
(b) If the dispensed amount is less than the recommended full quantity, the
pharmacist or a designee shall ensure that the actual dispensed amount is accurately recorded
in the prescription monitoring program. The pharmacist or a designee shall also, within
seven days, make a notation in the interoperable electronic health record of the patient if the
pharmacist has access to the record.
(c) Nothing in this Subsection shall be interpreted to conflict with or supersede any
other requirement established in this Section for a prescription of a controlled dangerous
substance or any requirements or conditions for drug substitutions established by law.
I. The transfer between pharmacies of a prescription or prescription information for
controlled substances is permissible in conformance with 21 CFR Part 1306.

Legislative History

Added by Acts 1972, No. 634, §1. Amended by Acts 1975, No. 667, §1; Acts 1978, No. 786, §5, eff. July 17, 1978; Acts 2011, No. 155, §1; Acts 2014, No. 865, §1; Acts 2015, No. 189, §1, eff. June 23, 2015; Acts 2016, No. 192, §1, eff. May 26, 2016; Acts 2017, No. 76, §1, eff. June 12, 2017; Acts 2017, No. 82, §1; Acts 2018, No. 32, §1; Acts 2018, No. 206, §4; Acts 2018, No. 219, §2; Acts 2018, No. 405, §1; Acts 2019, No. 426, §1; Acts 2024, No. 205, §1.