Ask Your Pharmacist

November 16, 2022

Q:

Can a pharmacist refill your prescription?

A:

In some instances it is permissible for a pharmacist licensed in the province of New Brunswick to refill a prescription.  

For a prescription to be renewed by a pharmacist, a person must have a valid Medicare card, not reside in a nursing home, and also must meet certain criteria, such as not having a primary care provider (i.e. family doctor or nurse practitioner). Another situation that may apply is when the primary care provider is not available due to absence such as a leave, an illness, or a vacation.  

A pharmacist may also prescribe a renewal in an urgent situation in which the patient or the patient's pharmacist is unable to get a prescription from the primary care provider. The purpose here is to avoid an unnecessary trip to a walk-in clinic or emergency room to get a prescription refill. This is for urgent situations only, and it is not meant to replace a doctor visit.   

A patient may have a maximum of four prescription renewal services covered by the New Brunswick Medicare plan per year. The program does not cover costs associated with the dispensing of the drugs or the cost of the drugs. More information is available from the provincial government. 

At the time of renewing the prescription, it is the pharmacist's responsibility to assess the patient's other prescriptions that may be due for refill in the near future, and to determine whether it is appropriate to provide refills for these prescriptions as well.  

It is the pharmacist's clinical judgement that makes the final determination about the appropriateness of refilling a prescription should the above criteria be met. It is a tremendous privilege and responsibility for a pharmacist to prescribe a medication renewal and one that we take very seriously. You can expect the pharmacist will want to speak with you in person in most cases when making a determination about putting a refill renewal in her or his name.   

Let me use an example. A patient calls for a refill on his blood pressure medication. The patient indicates that he has been without his blood pressure medication for two days.  

He received notification in the mail that he no longer has a nurse practitioner. Although he is on the list for a new primary care provider, he is worried that he is out of pills.  

This is a situation in which it is in the interest of the health and safety of the patient for the pharmacist to add a prescription. Lack of timely access to blood pressure medication may have serious consequences for the patient.  

A pharmacist in this situation would look at the patient's health record to determine what the pattern of blood pressure medication use has been for this patient. The pharmacist would ensure that the patient has been on the same dose of medication for a consistent period of time. The pharmacist would want to know that the patient's blood pressure was and would document this on the patient's pharmacy record.  

 If there was any indication that the patient had a dangerously high blood pressure, or that medical assessment was required, the pharmacist would not refill the medication but would refer the patient for assessment. The pharmacist would also ask questions to make sure that the patient is tolerating the medication and is not experiencing side effects that would make it dangerous to renew the medication without medical assessment. 

A pharmacist would prescribe a quantity of medication based on the usual quantity of medication previously dispensed unless it was felt that the patient should be assessed by a doctor or nurse practitioner sooner.   

New Brunswick pharmacists are working hard to continue the care of your medication therapy in collaboration with your primary care prescriber. We want to keep you safe and living healthy, happy, lives. 

Dr. Kevin Duplisea (PharmD BSc. Pharm, BSc. ACPR) is a pharmacist at Shoppers Drug Mart in Quispamsis, New Brunswick. His opinions are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. Send your questions to AskYourNBPharmacist@gmail.com.