Knowing the Ins and Outs of CII Drugs

What is a CII drug?
CII drugs, also known as Schedule II substances, are those drugs that require additional care because of the potential for the patient to intentionally or unintentionally abuse the drug. Because of that added risk, CII drugs have more regulations, procedures, and laws surrounding them. As a pharmacy technician, it will be important for you to know how CII drugs are handled.

Federal Law Requirements
For Schedule II substances, you are required to have a physical address, not a post office box, in the patient profile. The pharmacist and pharmacy technician will need to carefully review the prescription for authenticity and make sure it is a valid prescription written for a valid medical condition. The drug, dose, and quantity of a prescription for a Schedule II drug can’t be altered in any way by the nurse, pharmacist or technician. The date of the original prescription should be entered into the profile, rather than the date the prescription was filled. There are no refills for Schedule II drugs. A new prescription is required each time it is dispensed.

Know Your State Laws
Some states may have regulations that control the time period for initially filling a CII prescription. In some states, a CII prescription must be filled within 7 days of issue; in other states, it must be filled within 72 hours. Most states will not allow a nurse, nurse practitioner, or a physician’s assistant to write a prescription for a CII, even if the physician signs it. Signatures on CII drugs should be handwritten and not stamped. Some states may limit the quantity of a controlled drug that may be dispensed; the limit may be 120 tablets or capsules or a 30-day supply, whichever is less.

Emergency and Special Circumstances
A CII medication is rarely dispensed without an authorized prescription except under very special circumstances. An emergency procedure is usually described as:

• A controlled substance’s administration must be immediate if the patient is to receive proper treatment.
• The pharmacist immediately converts an oral order into writing.
• The pharmacist documents the need for the emergency dispensing of the Schedule II prescription.
• If the pharmacist does not know the prescriber, then good faith efforts are made by the pharmacy to verify that the prescriber is authentic.
• Within seven days (or 72 hours in some states), the prescriber must deliver a written version of the emergency oral order to the pharmacy that includes “authorization for emergency dispensing” written on it.

These are some of the important highlights regarding CII requirements. If you are training to become a certified pharmacy technician make sure you understand the requirements for the state in which you live as well as the federal requirements of Schedule II drugs.