Hydrocodone Combination Product (HCP) rescheduling C-III to C-II
Effective October 6, 2014
The DEA has finalized its rule to reschedule hydrocodone combination product (HCP) from Schedule III to Schedule II. Their rule becomes effective on October 6, 2014.
In reality, the only change this rule has is to delete any reference to HCPs from Schedule III.
Any hydrocodone that is not in combination with another drug (a single entity) has always been classified as a Schedule II controlled substance. The new non-combination hydrocodone product Zohydro is a Schedule II, and it is the only single entity hydrocodone product on the market.
In Georgia, the State Board of Pharmacy plans to pass a rule reclassifying HCPs to Schedule II as of October 6, 2014 – the same effective date as that of the DEA. This rule will ensure that pharmacies handle HCPs as Schedule II products, however this rule will not have the force of law in regards to criminal illegal possession or distribution. Georgia law will have to be changed via the 2015 annual drug update for the Legislature will include language to mimic the federal law for HCPs.
Georgia HCP Guidelines:
Any HCP prescription written before October 6, 2014 should be treated and filled as a Schedule III controlled substance, including refills as specified below.
Refills authorized on a HCP prescription, written and filled before October 6, 2014, may be dispensed up to five (5) times, as authorized, until April 8, 2015 or six months from the date the HCP was originally issued. No additional refills may be authorized, nor can refills be dispensed beyond the six month original issue date. (Example: a HCP prescription issued on August 1, 2014 with 2 authorized refills may be refilled 2 times up until February 1, 2015)
**Note: this refill policy comes directly from the DEA HCP rule comments and directives**
Any HCP prescription written on or after October 6, 2014 should be treated and filled as a Schedule II controlled substance.
ALL hard copy HCP prescriptions must be issued on security paper as of October 6, 2014.
No Refills may be authorized for any HCP prescription written on or after October 6, 2014.
No call-in HCP prescriptions are allowed except as authorized in emergencies for C-II controlled substances.
In Georgia, no previously filled HCP prescription can be transferred on or after October 6th. This includes refills for a previously filled prescription. All refills must come from the pharmacy where the prescription was originally filled. The reasoning behind this is that refills must be treated as new prescriptions by the receiving pharmacy, and on or after October 6th, with all HCPs being Schedule II. Since no schedule II prescription can be transferred, no pharmacy may create a new prescription based on an existing refill at another pharmacy.
So NO transfers are allowed as of October 6th.
Further, if prescription was written before October 6th, but not filled until October 6th or after, it must be treated as a Schedule II and it cannot be refilled even if it was written with authorized refills.
If ARPN or PA wrote a prescription for a HCP prior to October 6th, and the prescription is not presented until October 6th or after, the prescription cannot be refilled – it became a Schedule II on the 6th, and APRNs and PAs are not authorized to write for Schedule II controlled substances.
If a pharmacy has a computer system that will track refills of HCPs after October 6th, the pharmacist does not have to handwrite the refill date on the original prescription. However, if the pharmacy computer cannot track HCP refills after October 6th, then all HCP refill dates have to be hand written on the back of the original prescription, exactly as it has always been required under state law for instances when a pharmacy does not have a computer system.
After October 6, 2014 APRNs and PAs can no longer order or issue HCP prescriptions.
On October 6, 2014, all pharmacies and practitioners should inventory any HCP in their possession or stock by conducting an actual count of each HCP drug. This inventory should be signed and dated and included with the registrant’s biennial controlled substance inventory.
Other than existing requirements for Schedule II controlled substance prescriptions, there are no new limitations or restrictions on how often a HCP can be prescribed. There is no restriction on the quantity of a HCP that can be prescribed on one prescription. Nor is there any new requirement that a patient see a practitioner prior to obtaining a new HCP prescription.
There are simply no new requirements for HCPs other than they are now classified as C-II instead of C-III controlled substances. HCPs should be maintained the same as any other C-II controlled substance.