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Board of Pharmacy

Pharmacy Practice FAQ

​In general, no. The pharmacy can choose to require it. Also, the DEA's Expansion of Buprenorphine Treatment via Telemedicine Encounter was scheduled to be effective February 18, 2025 but has been delayed to December 31, 2025. Notably, this delayed final rule will require pharmacists filling buprenorphine telemedicine prescriptions to verify that the identity of the individual picking up the prescription matches the name of the patient or a member of the patient’s household.​​

No, a controlled substance prescription must be transferred between two pharmacists or via a real-time, online database. Title 21 CFR 1306.25​​​

No, a controlled substance prescription must be transferred between two pharmacists or via a real-time, online database. Title 21 CFR 1306.25​​​

​One time only, unless pharmacies electronically share a real-time, online database, then may transfer as many times as there are refills. Title 21 CFR 1306.25

​902 KAR 55:095 and 21 CFR 1306.13​

1. Insufficient Stock: If a pharmacist cannot supply the full quantity of a CII prescription due to insufficient stock, they may dispense the available quantity. The remaining portion must be filled within 72 hours. If not, the pharmacist must notify the prescribing practitioner, and no further quantity may be supplied without a new prescription.​

2. Patient or Practitioner Request: A CII prescription may be partially filled if requested by the patient, the patient's caregiver (if the patient is a minor), or the prescribing practitioner. The total quantity dispensed in all partial fillings must not exceed the total quantity prescribed.

3. Terminally Ill Patient: When the patient is terminally ill (for example in Hospice) and it is documented on the face of the prescription, the pharmacist has 60 days to dispense the full quantity of the prescription.

4. Long-Term Care Resident: When the patient is in a long term care facility, the pharmacist has 60 days to dispense the full quantity of the prescription. ​

5. Time Limitations: For partial fillings requested by the patient or practitioner, the remaining portions must be filled within 30 days of the prescription's issuance date.

6. Documentation Requirements: Each partial fill must be documented appropriately. This includes noting the quantity dispensed, the date of dispensing, and the identity of the dispensing pharmacist​.

There are red flags a pharmacist can look for when trying to determine the validity of a prescription.  This list is not inclusive and does not take the place of a pharmacist's professional judgment. 

  • Does the pharmacist have a relationship with the prescriber?
  • Does the pharmacist have a relationship with the patient?
  • What is the distance a patient is driving to see the prescriber?
  • What is the home address of the patient?
  • In what community is the prescriber practicing?
  • Have people unknown to the pharmacist called asking if a specific medication or a specific manufacturer of a medication is stocked by the pharmacy?
  • When prescriptions are filled for one patient, do many, many more start coming to the pharmacy?
  •  Is every patient receiving the exact same prescriptions?
  • Does the prescriber take cash only? ​

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Yes, a pharmacist has a corresponding responsibility along with the prescriber to make sure controlled substance prescriptions are written for a legitimate patient, for a legitimate medical need in the usual course of practice of the prescriber. Title 21 CFR 1306.04 KRS 218A.180(3)​​

APRN and PA controlled substance prescribing varies from state to state. Kentucky pharmacists should only dispense a controlled substance prescription for an out of state APRN  and PA up to the authority they would have if it were a Kentucky APRN or PA. ​​

​CII - PA's may not prescribe CII's.
    CIII- 30 day supply no refills, KRS 311.858(5)(c)
    CIV-V - 6 month supply, KRS 311.858(5)(d) with exceptions: Benzodiazepines C IV and Carisoprodol (Soma) C IV. All limited to 30 day supply with no refills. KRS 311.858(5)(e).

CII – 3 day supply, KRS 314.011(8) with exceptions:

Psychostimulants if APRN is certified in psychiatric-mental health 30 days, KRS 314.011(8) and hydrocodone combination products 30 days. KRS 218A.020(3)

     CIII – 30 day supply no refills. KRS 314.011(8)

     CIV – V – 6 month supply, KRS 314.011(8)

Please note that 201 KAR 20:059, limiting carisoprodol, alprazolam, diazepam, clonazepam, and lorazepam to 30 days with no refills has been repealed and these limitations no longer exist. Updated February 24, 2021.

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The Kentucky Board of Nursing has provided the following clarification on Suboxone prescriptions: "Under the language of the statute (KRS 314.011 (8)), a single prescription cannot be refillied, and the total number of doses should not exceed the statutory 30-day supply limit." If a nurse practitioner has any further questions, please direct them to the Kentucky Board of Nursing.​

Per KRS 314.011(8),the only Schedule II controlled substance used to treat pain that an APRN may prescribe for greater than a 3 day supply is any hydrocodone combination product. For all other Schedule II controlled substances used to treat pain, KRS 314.011(8) limits the quantity to a 3 day supply with no exceptions.

KRS 218A:205, limits the prescribing of a Schedule II controlled substance used to treat acute pain by all practitioners who are allowed to prescribe Schedule II controlled substances to a 3 day supply. KRS 314.011(8) limits all Schedule II controlled substances with the exception of hydrocodone combination products (and ADD/ADHD medication in specific circumstances) to a 3 day supply. The exceptions for an APRN to prescribe greater than a 3 day supply of HYDROCODONE COMBINATION PRODUCTS ONLY are: 

  1. In the professional judgment of the APRN, more than a 3 day supply is needed.  The need must be documented . For the purposes of pharmacy dispensing, the medical necessity for the hydrocodone combination product as documented by the APRN in the patient's medical record and the prescription for more than a 3 day supply for the hydrocodone combination product are presumed to be valid.
  2. Treating chronic pain.
  3. Treating cancer pain.
  4. Treating a patient at end of life or in Hospice.
  5. Treatment of pain after major surgery or significant trauma as defined by the licensing Board and the Office of Drug Control Policy.
  6. Administered directly to the patient in an inpatient setting. Administered directly to the patient in an inpatient setting.
  7. Scenarios authorized by the licensing board. 

Please note, APRNs must still follow prescribing limits set forth in KRS 314.011.​​

​From Drug Enforcement and Professional Practices (DEPP) Branch of the OIG, printed in September 2010 Newsletter:

  • After consulting with the prescribing practitioner, a pharmacist may add or modify the following items:
    1. Date of issue – may be added, but not changed
    2. Drug strength
    3. Quantity – may be modified only in conjunction with a change of strength, and the total quantity dispensed must not exceed the total dosage authorized
    4. Quantity check-off box marked
    5. Directions for use
    6. Refill instructions (Schedules III-V)
    7. Practitioner's name – printed (not a signature)
  • All consultations must be documented. 
  • The following items may be added or modified without consulting the practitioner if the information can be obtained from other reliable sources:
    1. Patient's address
    2. Dosage form
    3. Practitioner's address – printed
    4. Practitioner's telephone number
    5. Practitioner's DEA number
  • A pharmacist may never change or add the patient's name, the name of the controlled substance (except generic substitution permitted by state law), or the signature of the practitioner.

Both state and federal law still require professional judgment by the pharmacist on every prescription filled. Caution is advised whenever a change or addition is made to any prescription.


​Yes, as of January 1, 2021, Kentucky law requires the electronic prescribing of controlled substances (EPCS) for all Schedule II–V drugs. This mandate applies to all practitioners in Kentucky, regardless of the payer, and is outlined in Kentucky Revised Statute (KRS) 218A.182. The regulation is enforced through Kentucky Administrative Regulation 902 KAR 55:130.

KRS 218A.182(1) identifies certain prescriptions that are exempt from the electronic prescribing mandate, including a temporary waiver for entities that demonstrate economic hardship, technological limitations, or other exceptional circumstances.

Practitioners unable to comply with the EPCS mandate may request a temporary waiver by submitting a completed Temporary Exemption Form to the Cabinet for Health and Family Services (CHFS). Initial waiver applications were due by November 1, 2020; however, the CHFS continues to accept waiver requests. Waivers are typically granted for one year and may be renewed annually.​​​

Pharmacists can order lab tests pursuant to Collaborative Care Agreements (CCAs) and board authorized protocols under the name of the physician or other prescriber that signed the CCA or board authorized protocol so long as the criteria of the CCA or protocol have been met.

https://apps.legislature.ky.gov/law/kar/titles/201/002/220/

https://apps.legislature.ky.gov/law/kar/titles/201/002/380/

Pharmacists can perform screenings using CLIA-waived tests that are in stock and on the shelf without a prescription if the pharmacy has a CLIA certificate.  

https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=31843

https://www.cdc.gov/labquality/waived-tests.html

Pharmacists may assist patients using devices such as glucose meters under “pharmacy-related primary care."

KRS 315.010​

In order for the pharmacist to substitute a biosimilar or biologic product, Kentucky requires the biosimilar or biologic product to be interchangeable per the FDA Purple Book: Lists of Licensed Biological Products with Reference Product Exclusivity and Biosimilarity or Interchangeability Evaluations.  Please refer to KRS 217.822 (10) to review the requirements for dispensing a biologic or biosimilar product.  KRS 217.822 ​

In order for a pharmacist to substitute a generic drug for a brand name drug, Kentucky requires the generic drug to be AB rated to the brand name drug per the FDA Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations.  If the prescription is written for a brand name drug and the generic drug is not AB rated, in order for the pharmacist to dispense the generic, he must call the prescriber to obtain authorization for substitution.  An Authorized Generic Drug is not the same as an AB rated generic drug (see next question).  An example is that there is no AB rated generic for Epipen, therefore, the pharmacist must contact the prescriber prior to dispensing the generic epinephrine injection.KRS 217.822​

The National Institute for Occupational Safety and Health (NIOSH) publishes a List of Antioneoplastic and Other Hazardous Drugs in Healthcare Settings.​

Anyone who assists in the practice of pharmacy must be registered with the Board of Pharmacy as a technician. Examples of assisting in the practice of pharmacy include: offering pharmacist counseling at pickup, processing prescriptions, preparing compounds, and counting medications.  KRS 315.010​

​What an intern may do is up to the supervising pharmacist's discretion as long as the intern has successfully completed his or her first professional year coursework of a Doctor of Pharmacy degree program at an accredited school or college of pharmacy. Note: Due to federal regulations an intern cannot transfer a controlled substance prescription.   201 KAR 2:095​

Yes, the practice of pharmacy definition includes the administration of medications or biologics in the course of dispensing or maintaining a prescription drug order. Note: A pharmacist may want to check with his or her malpractice insurance provider to see if this act is covered. KRS 315.010​​

Pursuant to prescriber approved protocols a pharmacist may administer:

  • Adult immunizations
  • Immunizations to individuals five (5) to seventeen (17) years old with the consent of a parent or guardian

KRS 315.010

Immediately following the robbery or discovery of the theft, report the incident to a law enforcement agency serving the geographic area in which the pharmacy is located.  If a pharmacy has mailed or shipped a controlled substance to a location in Kentucky and learns that the mailing or shipment did not arrive, that pharmacy shall report the nonreceipt to the Kentucky State Police and, if applicable, the US Postal Inspection Service. The PIC should file reports with the following:  DEA via Form 106; the Drug Enforcement and Professional Practices Branch and the Board of Pharmacy shall receive a copy of the completed DEA Form 106.  KRS 315.335​​

A pharmacy is allowed to wholesale distribute prescription medications in a limited quantity, not to exceed 5% of the total inventory. These transactions must be documented in an invoice, similar to what the pharmacy receives from their wholesale distributer. Information to be documented includes the recipient, date, quantity, itemized description and any other information pertinent to the transaction. Please file transaction information with other invoices.  KRS 315.400​​

Permission to store records off-site must be requested and approved by the Board; requests should describe detailed storage conditions and security.​​​

Controlled substance inventory records including invoices must be kept for five years. KRS 218A.200​

Prescription records must be kept for five years. An original prescription and record of each refill, if received written or oral, should be kept as a hard copy for three years, at which point it must be kept for at least an additional two years in either hard copy form or electronically. An original prescription and record of each refill, if received via fax, may be kept in hard copy form, the original electronic image, or electronically for three years, at which point it must be kept for at least an additional two years in either hard copy form, the original electronic image, or electronically. An original prescription and record of each refill, if e-prescribed, should be kept electronically for at least five years.         

A record of the day's prescription data should be verified, dated, and signed by the pharmacist(s) who filled the prescriptions.  This record must be kept for at least 5 years and can be done electronically, manually, or in a log. The record should be readily retrievable. Controlled substance data should be identifiable apart from other items appearing in the record. Note: These are the state requirements, insurance contracts and Medicare may have more stringent requirements. ​

201 KAR 2:171​

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