Hydrocodone combinations become Schedule II drugs on Oct. 6

posted 9.12.14, updated 10.2.14

Pharmaceuticals containing hydrocodone will be reclassified from Schedule III to Schedule II as of Oct. 6, 2014. The Drug Enforcement Administration published the final rule making the change in the Federal Register in August. The change is intended to curb abuse of hydrocodone, but it will require some changes in the way physicians and pharmacists handle these prescriptions. After the reclassification:

• Prescriptions for hydrocodone combinations cannot be faxed or called in to a pharmacy; instead they must be written on the official Schedule II prescription form issued by the Department of Public Safety, or they may be submitted electronically directly to the pharmacy;
• Hydrocodone prescriptions cannot be refilled; they will require a new prescription for each order; and
• Physicians will not be able to delegate authority to prescribe hydrocodone combinations to nurse practitioners and physician assistants outside of hospital or hospice settings.

Physicians and pharmacists are well aware of the requirements for filling Schedule II prescriptions, but the sheer volume of scripts for hydrocodone combinations is likely to make this a significant change in the daily practice of many doctors. Some physicians have been stocking up on the official Schedule II prescription forms in preparation for the change, but since October 2013, physicians have had the option to submit Schedule II prescriptions to pharmacists electronically. To do so, physicians must use an e-prescribing vendor that is certified to handle “e-prescribing of controlled substances,” or EPCS.

You can see which e-prescribing vendors are certified for EPCS and which pharmacies are able to receive EPCS on the SureScripts website. To find out more about e-prescribing for Schedule II drugs, check out Kara Nuzback’s feature in the July 2014 edition of Texas Medicine, “A necessary pain: E-prescribing controlled substances is worth it.”

Should you need help explaining the change to your patients, Prescriber’s Letter has published a patient handout available for download.

Check out this FAQ from the Texas Medical Association for more on what the change means for physicians.

The Regulatory Services Division of the Texas Department of Public Safety collected a set of questions received as a result of the reclassification of hydrocodone complete with answers and some helpful links. You can review the questions and answers here.

To order official controlled substance prescription pads from DPS, complete this form.

For more information on prescribing Schedule II medications, review the Texas Medical Board FAQs for Prescriptive Delegation.