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Good practice guidance for controlled drugs

For all staff responsible for prescribing, ordering, and administering controlled drugs in primary care.

You can download a full pdf version of this document by following the link on the right.

Schedule 2

  • Fentanyl
  • Methadone
  • Methylphenidate
  • Morphine (all strength tablets and ampoules and Oramorph concentrated
  • oral solution 20mg/ml
  • Oxycodone
  • Pethidine
  • Secobarbital

Schedule 3

  • Buprenorphine
  • Gabapentin
  • Midazolam
  • Phenobarbital
  • Pregabalin
  • Temazepam
  • Tramadol

Schedule 4 part I

  • Clobazam Clonazepam
  • Diazepam
  • Lorazepam Loprazolam
  • Nitrazepam Oxazepam
  • Zaleplon
  • Zopiclone Zolpidem
Designation CD POM CD NO REG POM  CD BENZ POM
Controlled drug prescription requirements apply

For example, strength and formulation to be stated (tablets, capsules and if modified-release is required this must be specified), total quantity of dosage units to be supplied must be specified in words and figures, for example 28 tablets.

 Yes Yes No
Prescription valid for 28 days 28 days 28 days
Maximum quantity to be prescribed 30 days 30 days 30 days
Allowed on EPS Yes  Yes Yes
Allowed on repeat dispensing No No Yes (first dispensing must be within 28 days of the date on the prescription³)
Safe custody required

For example, locked medicines cupboard designated for controlled drugs that complies with ‘The Misuse of Drugs (Safe Custody) Regulations 1971¹

 Yes No except  Temazepam and Buprenorphine No
Emergency supply allowed 

(From a community pharmacy without a prescription)

 No No (except for Phenobarbital for the treatment of epilepsy prescribed by a UK registered prescriber) Yes
Controlled drug requisition necessary to order stock, for example, for medical bag use Yes Yes No
Controlled drug register entry required to record drug supplies or issues Yes No No
Denaturing required before disposal² (Nursing homes only) Yes Yes Yes

¹The Misuse of Drugs Act (Safe Custody) Regulations 1971

²Controlled drug destruction kits (also known as DOOM/DOOP kits) must be used to render the drug(s) irretrievable following the instructions on the kit. You can get these from supplying pharmacies or licensed medicine waste contractors.

³Controlled drug prescription forms and validity

Legal requirements (The Misuse of Drugs Act 1971)

Prescription requirements for controlled drugs

  1. The presciber must sign prescriptions (digital signature for EPS prescriptions).
  2. Electronic prescription service allows dispensing of all schedule 2 and 3 controlled drugs.
  3. The NHS repeat dispnesing service can’t dispense schedule 2 and 3 controlled drugs
  4. Tablets and capsules must clearly state the formulation and strength
  5. Total quantity of dosage units must be in words and figures
  6. Prescribers must include dosage instructions on the prescription (with the maximum daily amount or frequency of doses) so that this can be included on the label when dispensed (NICE guidance (NG46) on prescribing ‘when required’ controlled drugs’)

Prescribers must justify the quantity requested on a clinical basis if more than 30 days’ supply is prescribed. This isn’t a legal requirement, but a strong recommendation issued by the Department of Health and Social Care).

Further reading

Controlled drugs: safe use and management

Managing medicines in care homes

References

  1. List of most commonly encountered drugs currently under the misuse of drugs legislation
  2. Medicines, Ethics & Practice, Edition Issue 42 July 2018
  3. Controlled drug prescription forms and validity

 

 

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