(1) Except as provided in subsection (3) of this section, a pharmacist who is acting in good faith and is using professional judgment and exercising reasonable care may make the following minor adaptions to an order if the pharmacist has the informed consent of the patient for whom the prescription was provided:
(a) A change in the prescribed dosage form or directions for use of the prescription drug if the change achieves the intent of the prescribing practitioner;
(b) A change in the prescribed quantity of the prescription drug if the prescribed quantity is not a package size commercially available from the manufacturer;
(c) An extension of the quantity of a maintenance drug for the limited quantity necessary to achieve medication refill synchronization for the patient; and
(d) Completion of missing information on the order if there is sufficient evidence to support the change.
(2) A pharmacist who adapts an order in accordance with subsection (1) of this section shall document the adaption and the justification for the change in the patient's pharmacy record with the original prescription and shall notify the prescribing practitioner of the adaption.
(3) A pharmacist shall not adapt an order if the prescribing practitioner has written do not adapt on the prescription or has otherwise communicated to the pharmacist that the prescription must not be adapted.
Source: L. 2021: Entire section added, (SB 21-094), ch. 314, p. 1934, � 15, effective September 1.
12-280-125.5. Pharmacists' authority to dispense chronic maintenance drugs - rules - liability. (1) In accordance with board rules adopted under subsection (2) of this section, on and after January 1, 2020, a pharmacist may dispense an emergency supply of a chronic maintenance drug to a patient without a current, valid prescription if:
(a) The pharmacist makes every reasonable attempt but is unable to obtain authorization to refill the prescription from the prescribing health-care provider or another health-care provider responsible for the patient's care;
(b) (I) The pharmacist has a record of a prescription at the pharmacy or has been presented proof of a recent prescription for the chronic maintenance drug in the name of the patient who is requesting the emergency supply; or
(II) In the pharmacist's professional judgment, the refusal to dispense an emergency supply of the chronic maintenance drug will endanger the patient's health or disrupt essential drug therapy for a chronic condition of the patient;
(c) The amount of the chronic maintenance drug dispensed does not exceed the amount of the most recent prescription or the standard quantity or unit of use package of the drug;
(d) The pharmacist has not dispensed an emergency supply of the chronic maintenance drug to the same patient in the previous twelve-month period; and
(e) The prescriber of the drug has not indicated that no emergency refills are authorized.
(2) The board shall adopt rules, in consultation with the Colorado medical board created in section 12-240-105 and the state board of nursing created in section 12-255-105, to establish standard procedures for pharmacists to follow in dispensing chronic maintenance drugs pursuant to this section. The rules adopted under this subsection (2) must include documentation requirements for a pharmacist to complete when dispensing a chronic maintenance drug without a current prescription.
(3) A pharmacist, the pharmacist's employer, and the original prescriber of the drug are not civilly liable for an act or omission in connection with the dispensing of a chronic maintenance drug pursuant to this section unless the act or omission constitutes negligence, recklessness, or willful or wanton misconduct.
Source: L. 2019: Entire section added, (HB 19-1077), ch. 40, p. 138, � 6, effective October 1.
Editor's note: This section is similar to � 12-42.5-122.5 as added in HB 19-1077. That section was superseded by the repeal and reenactment of this title 12, effective October 1, 2019. For the former section in effect from March 21, 2019, to October 1, 2019, see HB 19-1077, chapter 40, Session Laws of Colorado 2019.
12-280-125.7. Pharmacists' authority to prescribe and dispense HIV prevention drugs - definitions - rules. (1) As used in this section, unless the context otherwise requires:
(a) CDC means the federal centers for disease control and prevention in the United States department of health and human services, or any successor entity.
(b) CDC guidelines means the CDC guidelines for preexposure prophylaxis for the prevention of HIV infection and the Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV, and any analogous subsequent guidelines published by the CDC.
(c) HIV prevention drug means preexposure prophylaxis, post-exposure prophylaxis, or other drugs approved by the FDA for the prevention of HIV infection.
(d) Post-exposure prophylaxis means a drug or drug combination that meets the same clinical eligibility recommendations provided in CDC guidelines.
(e) Preexposure prophylaxis means a drug or drug combination that meets the same clinical eligibility recommendations provided in CDC guidelines.
(f) Prescriber means:
(I) A physician or physician assistant licensed pursuant to article 240 of this title 12; or
(II) An advanced practice registered nurse, as defined in section 12-255-104 (1), or a certified midwife, as defined in section 12-255-104 (3.2), with prescriptive authority pursuant to section 12-255-112.
(g) Standing order means a prescription order written by a prescriber that is not specific to and does not identify a particular patient.
(2) A pharmacist may prescribe and dispense HIV prevention drugs in accordance with a standing order pursuant to section 25-1-130 or a statewide drug therapy protocol developed pursuant to subsection (5) of this section.
(3) Before prescribing or dispensing HIV prevention drugs to a patient, a pharmacist must:
(a) Hold a current license to practice in Colorado;
(b) Be engaged in the practice of pharmacy;
(c) Have earned a doctorate of pharmacy degree or completed at least five years of experience as a licensed pharmacist;
(d) Carry adequate professional liability insurance as determined by the board; and
(e) Complete a training program accredited by the Accreditation Council for Pharmacy Education, or its successor entity, pursuant to the protocol developed by the board.
(4) The board shall promulgate rules necessary to implement this section, including rules that establish protocols for prescribing and dispensing preexposure prophylaxis and post-exposure prophylaxis.
(5) (a) On or before six months after July 13, 2020, the state board of pharmacy, the Colorado medical board, and the state board of nursing shall, in collaboration with the department of public health and environment, and as described in section 12-280-601 (1)(b), develop statewide drug therapy protocols for pharmacists to prescribe and dispense HIV prevention drugs.
(b) If the state board of pharmacy, the Colorado medical board, and the state board of nursing are not able to agree in the time period required by subsection (5)(a) of this section to statewide drug therapy protocols for pharmacists to prescribe and dispense HIV prevention drugs, the state board of pharmacy shall collaborate with the department of public health and environment to develop and implement statewide drug therapy protocols by January 1, 2021.
(c) In developing the statewide drug therapy protocols, the applicable boards and the department of public health and environment shall consider physician referrals; lab testing, including preexposure and post-exposure prescribing tests, and appropriate referrals pursuant to CDC guidelines; counseling pursuant to CDC guidelines; and patient follow-up care and counseling.
Source: L. 2020: Entire section added, (HB 20-1061), ch. 281, p. 1376, � 5, effective July 13. L. 2023: IP(1), (1)(c), (2), IP(3), (5)(a), and (5)(b) amended, (SB 23-189), ch. 69, p. 258, � 5, effective April 14; (1)(f)(II) amended, (SB 23-167), ch. 261, p. 1545, � 50, effective May 25.