Okla. Stat. tit. 59, § 59-353.20.2: Varying amounts of prescription refills - Pharmacist

discretion – Permissible dispensing without a prescription.

A. Except as provided in subsection C of this section, unless

the prescriber has specified on the prescription that dispensing a

prescription for a maintenance medication in an initial amount

followed by periodic refills is medically necessary, a pharmacist

may exercise his or her professional judgment to dispense varying

quantities of medication per fill-up to the total number of dosage

units as authorized by the prescriber on the original prescription

including any refills.

B. Subsection A of this section shall not apply to scheduled

medications or any medications for which a report is required under

the controlled substance database. Dispensing of medication based

on refills authorized by the physician on the prescription shall be

limited to no more than a ninety-day supply of the medication.

C. 1. A pharmacist may dispense without a prescription one or

more devices or medications as medically necessary to prevent the

death of or serious harm to the health of a patient if the following

conditions are met:

a. the pharmacy which the pharmacist owns or at which the

pharmacist is employed has a current record of a

prescription for the medication or device prescribed

in the name of the patient who is requesting it, but

the prescription has expired and a refill requires

authorization from the licensed practitioner who

issued the prescription and neither the patient nor

the pharmacist was able to obtain the refill after

reasonable attempts were made to obtain such refill

and the pharmacist documents such attempts on a form

prescribed by the State Board of Pharmacy,

b. the failure of the pharmacist to dispense the

medication or device reasonably could result in the

death of or serious harm to the health of the patient,

c. the device or medication is listed on the formulary

described in paragraph 4 of this subsection,

d. the patient has been on a consistent medication

therapy as demonstrated by records maintained by the

pharmacy, and

e. the amount of the medication or device dispensed is

for a reasonable amount of time; provided, if the

patient or pharmacist is unable to obtain a refill

prescription from the patient's licensed practitioner

before the amount prescribed to prevent death or

serious harm to the health of the patient is depleted,

the pharmacist may dispense an additional amount of

the medication or device not more than once in an

amount consistent with past prescriptions of the

patient.

2. The standard of care required of a pharmacist licensed in

this state who is acting in accordance with the provisions of this

subsection shall be the level and type of care, skill and diligence

that a reasonably competent and skilled pharmacist with a similar

background and in the same or similar locality would have provided

under the circumstance.

3. Any pharmacist licensed in this state who in good faith

dispenses one or more medications or devices to a patient pursuant

to the provisions of this subsection shall not be liable for any

civil damages or subject to criminal prosecution as a result of any

acts or omissions except for committing gross negligence or willful

or wanton acts committed in dispensing or failure to dispense the

medication or device.

4. The State Board of Pharmacy shall develop and update as

necessary an inclusionary formulary of potentially life-saving

prescription medications and devices, not to include controlled

dangerous substances, for the purposes of this subsection. Such

medications and devices shall include but not be limited to:

a. insulin and any devices or supplies necessary for the

administration of insulin,

b. glucometers and any devices or supplies necessary for

the operation of the glucometer, and

c. rescue inhalers.

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dangerous substances, for the purposes of this subsection. Such

medications and devices shall include but not be limited to:

a. insulin and any devices or supplies necessary for the

administration of insulin,

b. glucometers and any devices or supplies necessary for

the operation of the glucometer, and

c. rescue inhalers.

5. Dispensing in accordance with this subsection shall be

deemed dispensing under a legal prescription for purposes of the

Pharmacy Audit Integrity Act, Section 356 et seq. of this title.

D. Upon receipt of a valid Schedule II opioid prescription

issued pursuant to the provisions of Section 2-309I of Title 63 of

the Oklahoma Statutes, a pharmacist shall fill the prescription to

the specified dose, and shall not be permitted to fill a different

dosage than what is prescribed. However, the pharmacist maintains

the right not to fill the valid opioid prescription.