Florida Regulations 64B15-18.003: Medicinal Drugs Which May be Ordered by Pharmacists
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A Pharmacist may order and dispense from the following formulary within the pharmacist’s professional judgment, subject to the stated conditions:
(1) Oral analgesics for mild to moderate pain. The pharmacist may order these drugs for minor pain and menstrual cramps for patients with no history of peptic ulcer disease. The prescription shall be limited to a six (6) day supply for one treatment. If appropriate, such prescriptions shall be labeled to be taken with food or milk.
(a) Magnesium salicylate/phenyltoloxamine citrate.
(b) Acetylsalicylic acid (Zero order release, long acting tablets).
(c) Choline salicylate and magnesium salicylate.
(d) Naproxen sodium.
(e) Naproxen.
(f) Ibuprofen.
(2) Urinary analgesics. Phenazopyridine, not exceeding a two (2) day supply. The prescriptions shall be labeled about the tendency to discolor urine. If appropriate, the prescription shall be labeled to be taken after meals.
(3) Otic analgesics. Antipyrine 5.4%, benzocaine 1.4%, glycerin, if clinical signs and symptoms of tympanic membrane perforation do not exist. The product shall be labeled for use in the ear only.
(4) Anti-nausea preparations.
(a) Meclizine up to 25 mg., except for a patient currently using a central nervous system (CNS) depressant. The prescription shall be labeled to advise of drowsiness and caution against concomitant use with alcohol or other depressants.
(b) Scopolamine not exceeding 1.5 mg. per dermal patch. Patient shall be warned to seek appropriate medical attention if eye pain, redness or decreased vision develops.
(5) Antihistamines and decongestants. The following, including their salts, either as a single ingredient product or in combination including nasal decongestants, may be ordered for a patient above (6) years of age:
(a) Antihistamines. The pharmacist shall warn the patient that an antihistamine should not be used by patients with bronchial asthma or other lower respiratory symptoms, glaucoma, cardiovascular disorders, hypertension, prostate conditions and urinary retention. An antihistamine shall be labeled to advise the patient of drowsiness and caution against the concomitant use with alcohol or other depressants.
1. Diphenhydramine.
2. Carbinoxamine.
3. Pyrilamine.
4. Dexchlorpheniramine.
5. Brompheniramine.
(b) Decongestants. The pharmacist shall not order an oral decongestant for use by a patient with coronary artery disease, angina, hyperthyroidism, diabetes, glaucoma, prostate conditions, hypertension, or a patient currently using a monoamine oxidase inhibitor.
1. Phenylephrine.
2. Azatadine.
(6) Topical antifungal/antibacterials.
(a) Iodochlorhydroxyquin with 0.5% Hydrocortisone (not exceeding 20 grams).
(b) Haloprogin 1%.
(c) Clotrimazole topical cream and lotion.
(d) Erythromycin topical.
(7) Topical anti-inflammatory. The pharmacist shall warn the patient that hydrocortisone should not be used on bacterial infections, viral infections, fungal infections, or by patients with impaired circulation. The prescription shall be labeled to advise the patient to avoid contact with eyes, mucous membranes or broken skin. Preparations containing hydrocortisone not exceeding 2.5%.
(8) Otic antifungal/antibacterial. Acetic acid 2% in aluminum acetate solution, which shall be labeled for use in ears only.
(9) Keratolytics. Salicylic acid 16.7% and lactic acid 16.7% in flexible collodion, to be applied to warts, except for patients under two (2) years of age, and those with diabetes or impaired circulation. Prescriptions shall be labeled to avoid contact with normal skin, eyes and mucous membranes.
(10) Vitamins with fluoride (This does not include vitamins with folic acid in excess of 0.9 mg.).
(11) Medicinal drug shampoos containing Lindane. The pharmacist shall:
(a) Limit the order to the treatment of head lice only;
(b) Order no more than four (4) ounces per person; and,
(c) Provide the patient with the appropriate instructions and precautions for use.
(12) Ophthalmics: Naphazoline 0.1% ophthalmic solution.
(13) Histamine H2 antagonists. The pharmacist shall advise the patient to seek medical attention if symptoms persist longer than 14 days while using the medication or if stools darken or contain blood.
(a) Cimetidine.
(b) Famotidine.
(c) Ranitidine HCL.
(14) Acne products. Benzoyl Peroxide. The prescription shall be labeled to advise the patient to avoid use on the eye, eyelid, or mucous membranes.
(15) Topical Antiviral.
(a) Acyclovir ointment may be ordered for the treatment of herpes simplex infections of the lips.
(b) Penciclovir.
Rulemaking Authority Florida Statutes § 465.186(2). Law Implemented Florida Statutes § 465.186. History-New 5-1-86, Formerly 21R-18.003, 61F9-18.003, 59W-18.003, Amended 10-16-01, 12-6-10.
(a) Magnesium salicylate/phenyltoloxamine citrate.
(b) Acetylsalicylic acid (Zero order release, long acting tablets).
(c) Choline salicylate and magnesium salicylate.
(d) Naproxen sodium.
(e) Naproxen.
(f) Ibuprofen.
(2) Urinary analgesics. Phenazopyridine, not exceeding a two (2) day supply. The prescriptions shall be labeled about the tendency to discolor urine. If appropriate, the prescription shall be labeled to be taken after meals.
(3) Otic analgesics. Antipyrine 5.4%, benzocaine 1.4%, glycerin, if clinical signs and symptoms of tympanic membrane perforation do not exist. The product shall be labeled for use in the ear only.
(4) Anti-nausea preparations.
(a) Meclizine up to 25 mg., except for a patient currently using a central nervous system (CNS) depressant. The prescription shall be labeled to advise of drowsiness and caution against concomitant use with alcohol or other depressants.
(b) Scopolamine not exceeding 1.5 mg. per dermal patch. Patient shall be warned to seek appropriate medical attention if eye pain, redness or decreased vision develops.
(5) Antihistamines and decongestants. The following, including their salts, either as a single ingredient product or in combination including nasal decongestants, may be ordered for a patient above (6) years of age:
(a) Antihistamines. The pharmacist shall warn the patient that an antihistamine should not be used by patients with bronchial asthma or other lower respiratory symptoms, glaucoma, cardiovascular disorders, hypertension, prostate conditions and urinary retention. An antihistamine shall be labeled to advise the patient of drowsiness and caution against the concomitant use with alcohol or other depressants.
1. Diphenhydramine.
2. Carbinoxamine.
3. Pyrilamine.
4. Dexchlorpheniramine.
5. Brompheniramine.
(b) Decongestants. The pharmacist shall not order an oral decongestant for use by a patient with coronary artery disease, angina, hyperthyroidism, diabetes, glaucoma, prostate conditions, hypertension, or a patient currently using a monoamine oxidase inhibitor.
1. Phenylephrine.
2. Azatadine.
(6) Topical antifungal/antibacterials.
(a) Iodochlorhydroxyquin with 0.5% Hydrocortisone (not exceeding 20 grams).
(b) Haloprogin 1%.
(c) Clotrimazole topical cream and lotion.
(d) Erythromycin topical.
(7) Topical anti-inflammatory. The pharmacist shall warn the patient that hydrocortisone should not be used on bacterial infections, viral infections, fungal infections, or by patients with impaired circulation. The prescription shall be labeled to advise the patient to avoid contact with eyes, mucous membranes or broken skin. Preparations containing hydrocortisone not exceeding 2.5%.
(8) Otic antifungal/antibacterial. Acetic acid 2% in aluminum acetate solution, which shall be labeled for use in ears only.
(9) Keratolytics. Salicylic acid 16.7% and lactic acid 16.7% in flexible collodion, to be applied to warts, except for patients under two (2) years of age, and those with diabetes or impaired circulation. Prescriptions shall be labeled to avoid contact with normal skin, eyes and mucous membranes.
(10) Vitamins with fluoride (This does not include vitamins with folic acid in excess of 0.9 mg.).
(11) Medicinal drug shampoos containing Lindane. The pharmacist shall:
(a) Limit the order to the treatment of head lice only;
(b) Order no more than four (4) ounces per person; and,
(c) Provide the patient with the appropriate instructions and precautions for use.
(12) Ophthalmics: Naphazoline 0.1% ophthalmic solution.
(13) Histamine H2 antagonists. The pharmacist shall advise the patient to seek medical attention if symptoms persist longer than 14 days while using the medication or if stools darken or contain blood.
(a) Cimetidine.
(b) Famotidine.
(c) Ranitidine HCL.
(14) Acne products. Benzoyl Peroxide. The prescription shall be labeled to advise the patient to avoid use on the eye, eyelid, or mucous membranes.
(15) Topical Antiviral.
(a) Acyclovir ointment may be ordered for the treatment of herpes simplex infections of the lips.
(b) Penciclovir.
Rulemaking Authority Florida Statutes § 465.186(2). Law Implemented Florida Statutes § 465.186. History-New 5-1-86, Formerly 21R-18.003, 61F9-18.003, 59W-18.003, Amended 10-16-01, 12-6-10.