Alabama Administrative Code › Title 540 - ALABAMA BOARD OF MEDICAL EXAMINERS › Chapter 540-X-17 - GUIDELINES AND STANDARDS FOR THE UTILIZATION OF CONTROLLED SUBSTANCES FOR WEIGHT REDUCTION › Section 540-X-17-.05 - Continued Use Of A Controlled Substance For The Purpose Of Weight Reduction Or Treatment Of Obesity

Current through Register Vol. 42, No. 9, June 28, 2024
(1) A
			 physician should not prescribe, order or dispense a controlled substance for
			 the purpose of weight reduction or treatment of obesity in an amount greater
			 than a thirty-five (35) day supply.
(2) Within the first thirty-five (35) days
			 following initiation of a controlled substance for the purpose of weight
			 reduction or treatment of obesity, the patient should be seen by the
			 prescribing physician, a physician assistant supervised by the prescribing
			 physician, or a certified registered nurse practitioner collaborating with the
			 prescribing physician, and a recording should be made of weight, blood
			 pressure, pulse, and any other tests which may be necessary for monitoring
			 potential adverse effects of drug therapy.
(3) Continuation of the prescribing,
			 ordering, dispensing or administering of a controlled substance to a patient
			 for the purpose of weight reduction or treatment of obesity should occur only
			 if the patient has continued progress toward achieving or maintaining medically
			 established goals and has no significant adverse effects from the
			 medication.
(4) A patient continued
			 on a controlled substance for the purpose of weight reduction or treatment of
			 obesity should undergo an in-person re-evaluation at least once every
			 thirty-five (35) days. Once medically established goals have been met for an
			 individual patient, it is strongly recommended that reduced dosing and drug
			 holidays be implemented for those patients who need maintenance
			 medication.
(5) If the
			 re-evaluation is delegated to a physician assistant or certified registered
			 nurse practitioner, then the prescribing physician should personally review the
			 resulting medical records prior to the continuance of the patient on a
			 controlled substance for the purpose of weight reduction or treatment of
			 obesity.
(6) For the prescribing of
			 only non-controlled drugs for the weight reduction or the treatment of obesity,
			 the following applies:
(a) Five (5) refills
			 of non-controlled drugs for weight reduction or the treatment of obesity are
			 allowed after an initial prescription and one follow up visit for an in-person
			 re-evaluation. The five (5) refills shall not extend past a period of six (6)
			 months from the date of issue of the original prescription.
(b) Continued prescribing/refills of
			 non-controlled drugs for weight reduction or the treatment of obesity must
			 occur in accordance with any Risk Evaluation and Mitigation Strategy (REMS)
			 required by the Federal Food and Drug Administration (FDA).
(c) Refills allowed pursuant to this rule are
			 specific for non-controlled drugs for weight reduction or the treatment of
			 obesity. This rule in no way amends, alters, or applies to the refilling of
			 individual prescriptions for controlled substances.