8.5 Partial Fills: Schedule II (72-Hour, 30-Day CARA & 60-Day LTCF/Terminal) and Schedules III–V
Key Takeaways
When a pharmacy can't supply a full Schedule II quantity, the remainder must be filled within 72 hours or the pharmacist must notify the prescriber.
When a patient or prescriber requests a Schedule II partial fill, the remaining portions must be filled within 30 days of the date written (72 hours for an emergency oral order).
For LTCF residents or terminally ill patients, Schedule II partial fills may continue for up to 60 days from issue, and the prescription must be marked 'LTCF patient' or 'terminally ill'.
A caregiver named in a medical power of attorney, or a minor's parent or guardian, may request a Schedule II partial fill, but not more than the prescriber specified per fill.
Schedule III–V partial fills are recorded like refills, may not exceed the total prescribed and must stop six months after issue; Oregon applies the same limit to Schedule V.
Why this matters
Partial filling is another dispensing exception tested in Area 3.4. Schedule II drugs can never be refilled, but they can be partially filled under three different federal frameworks, each with its own clock. Oregon adopts these rules through OAR 855-080-0085. Its self-inspection form checks the long-term care and terminal-illness notations.
Framework 1: The pharmacy cannot supply the full quantity (21 CFR 1306.13(a))
| Element | Rule |
|---|---|
| Trigger | The pharmacist is unable to supply the full quantity of a written, electronic or emergency oral Schedule II prescription |
| Notation | The quantity supplied is recorded on the prescription or in the electronic record |
| Deadline | The remainder may be filled within 72 hours of the first partial fill |
| After 72 hours | No further quantity without a new prescription, and the pharmacist must notify the prescriber |
Framework 2: The patient or prescriber asks for less (21 CFR 1306.13(b); CARA, 21 U.S.C. 829(f))
The Comprehensive Addiction and Recovery Act (CARA) of 2016, carried out by DEA's 2023 final rule, allows a Schedule II prescription to be partially filled at the request of the patient or the prescribing practitioner if all of the following hold:
- State law doesn't prohibit it (Oregon doesn't).
- The prescription is valid.
- The total dispensed never exceeds the quantity prescribed.
A caregiver named in an adult patient's medical power of attorney, or a parent or guardian of a minor, may make the request.
- Deadline: remaining portions must be filled no later than 30 days after the date the prescription was written. For an emergency oral prescription, the deadline is 72 hours after it was issued.
- If the prescriber asks for partial fills, they write the quantity for each partial fill on the prescription. A patient may not then ask for more per fill than the prescriber specified. After consulting a pharmacist, a prescriber may authorize a partial fill at a later date, but still within the 30 days.
- Records: for a patient request, the pharmacist notes "The patient [or caregiver or parent] requested partial fill on [date]" and the quantity dispensed. Each partial dispensing is recorded with the date, quantity and dispensing pharmacist. For electronic prescriptions, these records must be linked to the prescription record.
Note
The 30-day clock starts on the date written, not the date of the first partial fill. A prescription written June 1 and first partially filled June 20 can be completed only through July 1.
Framework 3: LTCF residents and terminally ill patients (21 CFR 1306.13(c)–(d))
| Element | Rule |
|---|---|
| Eligible patients | Residents of a long-term care facility (LTCF), or patients with a documented terminal illness |
| Notation | The pharmacist must record "terminally ill" or "LTCF patient" on the prescription. A partial fill without the notation is deemed a violation |
| Increments | Partial fills may be in quantities down to single dosage units |
| Records for each fill | Date, quantity dispensed, remaining quantity authorized, and the dispensing pharmacist's identity |
| Total | May not exceed the quantity prescribed |
| Validity | Up to 60 days from the issue date, unless the medication is discontinued sooner |
| Doubt about terminal status | The pharmacist must contact the practitioner before partially filling. Both share corresponding responsibility |
A computerized system may keep these records if it can display the original prescription number, the issue date, the prescriber, the patient, the LTCF or patient address, the medication, and every partial fill, with real-time updating.
Partial fills of Schedules III–V (21 CFR 1306.23)
Partial fills are allowed if:
- Each partial fill is recorded like a refill.
- The total quantity of all partial fills does not exceed the total prescribed, including refills.
- No dispensing occurs more than six months after the date of issue.
In Oregon this six-month limit also applies to Schedule V prescription drugs (ORS 475.185(3)).
Comparison table
| Out of stock | Patient or prescriber request | LTCF / terminally ill | |
|---|---|---|---|
| Clock starts | First partial fill | Date written (or oral order issued) | Issue date |
| Deadline | 72 hours | 30 days (72 hours for an emergency oral order) | 60 days |
| Required notation | Quantity supplied | Who requested it, the date, the quantity | "LTCF patient" / "terminally ill" |
| If the deadline passes | Notify the prescriber; the remainder is void | The remainder is void | The prescription expires |
Exam scenario
A post-surgical patient presents oxycodone 5 mg #30, written September 1, and asks for only 10 tablets. On September 25 she returns for 10 more, and on October 5 she asks for the last 10. The September 25 fill is lawful, because it falls within 30 days of the date written. The October 5 request is not: the 30-day window from September 1 closed on October 1, so the remaining 10 tablets cannot be dispensed. The pharmacist records each request and partial dispensing. If the pharmacy, rather than the patient, had been short of stock, the remainder would have been due within 72 hours of the first fill.
An oxycodone prescription was written on March 3. The patient requested a partial fill on March 10. What is the latest date the remaining quantity may be dispensed under 21 CFR 1306.13(b)?
March 13 (72 hours after the first fill)
April 9 (30 days after the first fill)
April 2 (30 days after the date written)
May 2 (60 days after the date written)
A pharmacy has only 20 of 60 prescribed hydromorphone tablets and dispenses 20. Its wholesaler delivers the rest four days later. What must the pharmacist do?
Dispense the remaining 40 because supply problems extend the deadline
Not dispense the remainder, because the 72-hour period has passed, and notify the prescriber
Dispense the remainder within 30 days of the date written
Dispense half the remainder and void the rest
Which notation must appear on a Schedule II prescription that is partially filled in increments for a nursing home resident over several weeks?
'Partial fill authorized by caregiver'
'Do not fill before' date
'Authorization for Emergency Dispensing'
'LTCF patient', with each partial fill's date, quantity, remaining quantity and dispensing pharmacist recorded
Sections you finish are checked off in the contents.