Many prescribers’ offices are closed due to the coronavirus outbreak, leaving many pharmacies unable to obtain fill authorizations for patients.

Under California law, pharmacies may refill prescriptions without prescriber authorization if:


  • the prescriber is unavailable to authorize the refill;
  • in the pharmacist’s professional judgment, failure to refill the prescription might interrupt the patient’s ongoing care and have a significant adverse effect on the patient’s well-being.

Under Cal. Bus. & Prof. Code 4064, when dispensing under the above circumstances, the pharmacist must

  • inform the patient that the prescription was refilled pursuant to emergency-fill regulations;
  • inform the prescriber within a reasonable period of time of any refills dispensed pursuant to this section;
  • make every reasonable effort to contact the prescriber and document the attempts to contact the prescriber’s office.

In case of a follow-up audit or an inspection, documentation would be essential in showing that the pharmacy complied with California law in dispensing medications without obtaining prescriber’s authorization (especially in cases of controlled substances). Therefore, pharmacies are advised to make a note in the patient profile that the drug was dispensed per Cal. Bus. & Prof. Code 4064 and “The drug is essential to sustain the life of the patient or continue therapy for a chronic condition of the patient” or “Failure to dispense or sell the drug to the patient could result in harm to the health of the patient.”

Emergency dispensing of controlled substances (Schedule III – V) is usually limited to 72-hour supply or up to a thirty-day supply for a non-controlled dangerous drug.

California Law also provides that a “pharmacist may in good faith furnish a reasonable supply of dangerous drugs/devices to patients in emergency conditions without a prescription.” (Bus. & Prof. Code 4062 and Health & Safety Code 11167).

The Board of Pharmacy has issued a guidance on dispensing without prescription, recognizing that during emergencies or disasters, patients might not be able to produce prescription documents and it might be impossible to contact a prescriber. “To enable these patients to obtain medications needed to prevent the loss of life, intense suffering or interruption in therapy, the board advises pharmacists to exercise their professional judgment on whether to provide a reasonable quantity of medications to prevent untoward symptoms resulting from a lapse in therapy. To establish the legitimacy and accuracy of the requested medications, the pharmacist may want to consider the following:

  • Is the original prescription container(s) available?
  • Does the patient have any written prescriptions with him or her?
  • Can a prescriber with knowledge about the patient be reached?
  • Can the dispensing pharmacy be contacted? Other options to assist the patient can include a referral to an urgent care center for evaluation and new prescriptions, or to the local county emergency medical services center for a listing of available medical services in the area.”

When dispensing medications in an emergency situation, records must be maintained that include the name of the patient, the patient’s local address, the name of the prescriber, and the name, strength, dose, directions, and quantity of the medication(s) and dangerous devices dispensed and the date dispensed.

Take care and stay healthy!