Can You Fill Oxycodone Early After The Directions Change?

Hi Bombshellqueen, thank you for your question.

You've hit upon a bit of a grey area, but I can give you some insight into the laws behind this situation, and what I think most pharmacists would do. However, only your local pharmacy can provide an absolute answer as the early fill will have to be up to them.

Policies Vary By State And Pharmacies

First off, every state has its own laws and regulations on how early a controlled substance can be filled.

Usually, every pharmacy has its own individual policy on early refills for medication changes as well, which can complicate things. You mentioned you are in New York, and fortunately, I am licensed in New York, so I am very familiar with their pharmacy laws.

How early you can fill a controlled substance is fairly explicitly stated in 'Part 80: Rules and Regulations on Controlled Substances in NYS'. It states:

No additional prescriptions for a controlled substance may be issued by a practitioner to an ultimate user within 30 days of the date of any prescription previously issued unless and until the ultimate user has exhausted all but a seven days' supply of that controlled substance provided by any previously issued prescription.

This is sometimes referred to as the 'seven-day rule'.

This rule basically states that, legally, the pharmacy can fill a controlled substance, like oxycodone, up to seven days early over the life of the prescriptions for that particular drug (at a particular dose). Remember though, that some pharmacy chains, or individual pharmacists, may be more strict. Many even hold patients until the actual due date.

Dose Changes

Now, the grey area I mentioned is the fact that your dose changed (i.e. your doctor changed the directions on your prescription), and you are now prescribed to take more per day than you were before. Therefore, you are going to run out of your prior prescription earlier than previously anticipated.

New York allows pharmacists to fill prescriptions early due to a dose change, so legally you should be ok.

This certainly makes intuitive sense. The patient should have a prescription vial with directions on it that accurately indicate the dosage regimen your doctor has prescribed.

However, pharmacy policy, and legal interpretation, come into play here when you still have a supply of the old prescription on hand.

If you have leftover tablets from a previous oxycodone prescription, your pharmacist may be taking that into account when determining your fill date. After all, oxycodone is a schedule II controlled substance, and the pharmacist is, in some sense, legally responsible for taking into account the risk of abuse and diversion of this drug.

Example

So, for example, let's say that you filled Oxycodone tablets, a quantity of 90 that you are directed to take every 8 hours as needed on December 1st. This is a 30-day supply (90 tablets / 3 maximum tablets per day = a 30-day supply).

Now, let’s say that you bring me a new prescription later in the month, on December 11th for the same strength of Oxycodone, but now every 6 hours as needed and a quantity of 120 tablets for 30 days. Most pharmacists, in my experience, wouldn't fill the new prescription yet, as you still should have 60 tablets left from your old prescription. However, they will take the new directions into account.

Instead of those 60 tablets lasting you 20 days, they would expect them to last at least 15 days (60 tablets / 4 maximum tablets per day = a 15-day supply), and they would be willing to fill your new prescription around December 26th. Again, this may vary based on who you are dealing with, but I think that most pharmacists think this or a similar way.

Final Words

If you are running into any sort of snag getting a new prescription that reflects the new directions your doctor gave you, please reach out to them. Having your doctor communicate with the pharmacy can be very helpful to get things moving for you.

Thanks for writing and I hope that you are able to get a bit better relief from your newer dose.