March 19, 2020: Important update regarding the novel coronavirus (Covid-19) pandemic
Health Canada has issued pharmacists a temporary Controlled Drugs and Substances Act (CDSA) subsection 56(1) class exemption from the provisions of Paragraphs 52 (c) and (d), subsection 54(1) of the Benzodiazepines and Other Targeted Substances Regulations.
While this exemption is in effect, a prescription for a benzodiazepine or other targeted substance may be refilled if more than one year has elapsed since the date it was issued by the prescriber.
Pharmacists should refer to the Subsection 56(1) class exemption for patients, practitioners and pharmacists prescribing and providing controlled substances in Canada during the Coronavirus Pandemic and related Frequently Asked Questions for further information.
Published: June 2014
Revised: March 2020
- Benzodiazepines and Other Targeted Substances Regulations Controlled Drugs and Substance Act (s.52)
College Contact: Pharmacy Practice
Pharmacists are, at times, required to determine whether it is appropriate to dispense a medication when an extended period of time has elapsed since it was initially prescribed. In the process of exercising his or her professional judgement, the pharmacist considers the patient’s history, the legal and ethical circumstances of the prescription and the length of time since a medical assessment has been conducted.
Benzodiazepines and Other Targeted Substances Regulations
In Ontario, all prescriptions authorized by prescribers remain valid, unless otherwise specified. The only type of prescription that has an expiry date is that of a benzodiazepine or targeted substance. Prescriptions for this class of drugs expire one year from the date the practitioner prescribed the medication, as legislated in the Benzodiazepine and Other Targeted Substances Regulations of the Controlled Drugs and Substances Act.
Benzodiazepines and Other Targeted Substances Regulations s. 52
52. A pharmacist may only refill a prescription for a targeted substance if
(c) less than one year has elapsed since the day on which the prescription was issued by the practitioner
As the expiry of a benzodiazepine or targeted substance prescription is one year from the day on which the prescription was issued by the practitioner, it is important for registrants to record both the date the drug was dispensed, as well as the date the prescription was issued; which in many instances may not be the same. Most pharmacy software programs have a distinct field to permit the recording of the date the prescription was issued. Proper use of this feature allows for easy identification of benzodiazepine or targeted substance prescriptions that have expired.
Many pharmacy computer software programs are set up so that all prescriptions expire one year from the date of entry into the computer. It is important to note that default expiry dates, with the exception of benzodiazepines and targeted substances, are often corporate or store policy and should not replace the pharmacist’s exercise of clinical judgment and decision-making authority.
Additionally, registrants should be aware that the expiry of reimbursement mechanisms (i.e. Limited Use, Exceptional Access Program) is a separate concern from the clinical necessity for medication therapy.