Can An OTC Product Be Dispensed As A Prescription?
In our latest question and answer, the pharmacist discusses why your doctor may write you an OTC drug to be dispensed as a prescription.
If a doctor calls in a prescription and a pharmacist puts a prescription label on an over-the-counter (OTC) product, is it considered a prescription or an OTC product?
Mar 22, 2023- Yes, a pharmacist can dispense an over-the-counter product as a prescription when a doctor writes one, and it must then follow all prescription labeling and record-keeping rules. Common reasons prescribers write prescriptions for OTC products include getting insurance or HSA coverage, ensuring specific dosage instructions are followed, and maintaining medication records. When an OTC product is dispensed as a prescription, it typically costs more than buying it over the counter because of added dispensing fees and other factors.
Answer
What a great question! Thanks for reaching out to us. I'm happy to answer it.
Why Would A Prescriber Write An OTC Product As A Prescription?
There are a number of reasons why a prescriber may write a prescription for an over-the-counter product, which, by law, don't require one to be written. These reasons include:
- Insurance/HSA Coverage: Some health insurance plans cover certain OTC medications only if they are prescribed by a doctor (or other prescribers). Similarly, some HSA (health savings accounts) cards only will work for prescription items.
- Dosage: Prescribers may choose to prescribe an over-the-counter (OTC) medication to their patients in order to provide specific dosage instructions. This ensures that patients take the medication in the appropriate way as recommended by the prescriber, which may differ from the general product directions.
- Record-Keeping: In some cases, prescribers may prescribe OTC medications to keep a record of the patient's medication use. This can help prevent medication interactions and ensure that the patient is taking the appropriate medications for their condition.
Overall, it is not uncommon for prescribers to write a prescription for an OTC product, and the reasons I gave above are the most common.
If A Prescriber Prescribes An OTC Product, Is It Now A Prescription?
If a pharmacy dispenses an OTC product as a prescription, it must follow all of the applicable state and federal rules and regulations required for a prescription.
This includes having a prescription label affixed to the product, which should include the prescription directions, quantity, refill information, and the name of the doctor who prescribed the medication (among other things). The federal requirements for prescription labeling can be found on the FDA website. Individual states may have additional requirements.
These rules and regulations are in place to ensure patient safety and prevent medication errors.
You asked whether a pharmacy putting a prescription label on an OTC product makes it a prescription.
If I understand your question correctly, the answer is yes, if an OTC product is dispensed as a prescription, it must follow prescription regulations.
For example, if your doctor writes you a prescription for 'Benadryl 25mg', an OTC product, and your pharmacy fills it as a prescription, it is considered a prescription.
However, nothing is stopping you from just buying the product over the counter without involving the pharmacy, and of course, the product is still an 'OTC' drug. Nothing has changed about its regulatory status.
Again, there are a number of reasons why your doctor may have written you a prescription for something that can be purchased over the counter. When I worked in a retail pharmacy, the most common reason was for that particular product to be covered by insurance or HSA cards.
In such cases, the OTC product is still an OTC product but must be dispensed as a prescription for coverage.
As a final note here, I want to mention that the price of an OTC product can vary depending on whether you purchase it as a prescription or not.
If your pharmacy fills an OTC as a prescription, it generally will be more expensive, as other things have been factored into the price, like a 'dispensing fee'. It's just something to keep in mind.
Final Words
I hope this answered your question!
Feel free to reach back out anytime if anything else comes up for you.
References & sources
- New York Education Law Article 137, Pharmacy — New York State Education Department
- CFR - Code of Federal Regulations Title 21 — AccessFDA
Glossary — Terms in This Answer
- OTC
- Over-the-counter medications that can be purchased without a doctor's prescription.
- HSA
- Health savings accounts that are special accounts used to pay for qualified medical expenses with pre-tax money.
- Prescriber
- A healthcare professional, such as a doctor, who is authorized to write prescriptions for medications.
- Prescription label
- A label that must be affixed to medication dispensed as a prescription and includes directions, quantity, refills, and prescriber information.
- Medication interactions
- Unwanted effects that can happen when two or more medications are taken together and affect how each other works.
- Dispensing fee
- A charge added by a pharmacy for the cost of processing and preparing a prescription medication for a patient.
- Regulatory status
- The legal classification of a drug that determines whether it requires a prescription or can be sold over the counter.
- FDA
- The Food and Drug Administration, the federal agency responsible for regulating medications and medical products in the United States.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
More answers from Brian →