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Rescheduling of Hydrocodone Combo Prescriptions: As of Today, Refills Become More Difficult

October 6, 2014 -- Today the final DEA rule on switching hydrocodone combination products like Lortab and Vicodin from schedule III to schedule II comes into effect. This rule has been put into place to help curb abuse and encourage patients and prescribers to consider alternative ways to deal with pain.

What does this mean?

Until now, hydrocodone combination products were regulated as schedule III drugs. These drugs, used as pain relievers or cough suppressants, contain both hydrocodone and some other substance, like acetaminophen or a cough/cold product. Well-known brand names include Vicodin, Lortab or Tussionex. As schedule III drugs, a prescriber could write up to 5 refills in a period of 6 months, and refills can be called in or faxed to the pharmacist.

Now, the more stringent prescription limits on schedule II hydrocodone combinations are as follows:

  • A written prescription for a schedule II drug is required; a phone order is only permitted in an emergency situation. Schedule III drugs can be called in to the pharmacist.
  • No refills – verbal or otherwise – are allowed for a schedule II drug. Refills are allowed on schedule III drugs.
  • With schedule II, patients will need to visit the doctor to get a new prescription, although certain DEA rules allow the doctor to write multiple prescriptions for up to a 90-day supply. Refills on schedule III drugs help to avoid additional doctor visits for patients in chronic pain.

Within industry, manufacturing quotas on schedule II drugs are enforced along with more strict storage rules. Pharmacists will have special forms, protocols, and pharmacy storage regulations to initiate, as well. Under Schedule II, these drugs require storage in a locked safe in the pharmacy.

Posted: October 2014