Monday, November 18, 2013

Texas Board of Pharmacy Inventory Rules--including rules for tramadol


At its November 2012 meeting, the Texas State Board of Pharmacy
(TSBP) amended the requirements for inventories taken by
pharmacies. The Board has been receiving numerous questions
about the changes to the inventory requirements. This column will
address those questions and answers.
Q: What inventories must now include Tramadol (Ultram)?
A: Tramadol must be included in all inventories taken after
January 1, 2013. These inventories are any:
  initial (opening) inventory
  annual inventory
  change of ownersihp inventory
  closing inventory
  change of PIC inventory
Q: Is tramadol now a controlled substance?
A: No, currently, tramadol is a dangerous drug. However, TSBP
is seeing abuse and thefts of tramadol from pharmacies.
Q: How often may a prescription issued for tramadol be refilled?
A: Refills for tramadol may be dispensed only in accordance
with the prescriber’s authorization as indicated on the original
prescription drug order. If there are no refill instructions on the
original prescription drug order (which shall be interpreted as
no refills authorized) or if all refills authorized on the original
prescription drug order have been dispensed, authorization
from the prescribing practitioner shall be obtained prior to
dispensing any additional tramadol. Prescription drug orders
for dangerous drugs (including tramadol) or nonprescription
drugs may not be refilled after one year from the date of
issuance of the original prescription drug order. If one year has
expired from the date of issuance of the original prescription
drug order, authorization must be obtained from the prescribing
practitioner prior to dispensing any additional quantities.
Q: Are invoices for tramadol required to be filed with other invoices
for controlled substance?
A: No. Invoices for tramadol should be filed with the invoices for
dangerous drugs.
Q: What drugs are required to be inventoried for a change of PIC
inventory?
A: A change of PIC inventory taken prior to June 1, 2013, must
include the following:
 all Schedule II controlled substances;
all dosage forms containing pentazocine;
all dosage forms containing phentermine;
all dosage forms containing diazepam;
all dosage forms containing phendimetrazine;
all dosage forms containing codeine;
all dosage forms containing hydrocodone;
all dosage forms containing alprazolam;
all dosage forms containing triazolam;
all dosage forms containing butorphanol;
all dosage forms containing nalbuphine;
all dosage forms containing carisoprodol; and
all dosage forms containing tramadol.
 On or after June 1, 2013, a change of pharmacist-in-charge
inventory must include ALL controlled substances; all dosage
forms containing nalbuphine (e.g., Nubain); and all dosage
forms containing tramadol (e.g., Ultram). 

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