- They may notably change the form, dose, dosage regimen, route, length or quantity.
- They then write a new prescription in their own name.
- For a designated substance, the total quantity originally prescribed cannot be exceeded.
What can they change?
The guide cites the dosage form, dosage regimen, concentration, dose, route of administration, length of treatment and quantity prescribed.
When can they act for patient safety?
- To manage adverse effects or drug interactions.
- To prevent organ failure.
- To change the dosage regimen based on kidney or liver function, or on weight.
- To improve tolerance of a drug.
- To correct an obvious dosing error.
What about treatment effectiveness?
They may change a prescription to reach the desired targets, whether objective, such as blood sugar or blood pressure, or subjective, such as sleep quality or appetite.
How is the decision framed?
As with the other activities, the pharmacist assesses the patient, checks for red flags and determines whether the situation falls within their competence. The prescribing guide also asks them to avoid duplicating work: for example, not adjusting the therapy of a patient closely followed by a nursing colleague without speaking to that colleague first.
What happens with a designated substance?
The pharmacist may change the form, dose or dosage regimen, provided they do not exceed the total quantity in milligrams originally prescribed. They take into account what the patient has already used.
Will the prescriber be told?
The pharmacist informs them if they judge it relevant, particularly if it may influence their future decisions. They record the interventions and follow-up, and refer the patient if the situation worsens.
Sources: OPQ, practice guide on professional activities (in French) · OPQ, practice guide on professional activities (in French) · OPQ, practice guide on prescribing (in French) · OPQ, practice guide on professional activities (in French)
General information based on the publications cited. This text does not replace professional or legal advice, or the Ordre’s guides.