Certified registered nurse practitioners engaged in collaborative practice with
physicians may be granted prescriptive authority upon submission of evidence of
completion of an academic course in pharmacology or evidence of integration of
pharmacology theory and clinical application in the certified registered nurse
Certified registered nurse practitioners practicing under protocols approved in
the manner prescribed by Code of Ala. 1975
et seq. may prescribe legend drugs to their patients, subject to the following
(a) The drug shall be included in
the formulary recommended by the Joint Committee and adopted by the Board of
Nursing and the State Board of Medical Examiners.
The drug type, dosage, quantity
prescribed, and number of refills shall be authorized in an approved protocol
signed by the collaborating physician and the certified registered nurse
practitioner. This requirement may be met if written prescriptions adhere to
the standard recommended dosages of legend drugs as identified in the
Physicians Desk Reference or Product Information Insert, and do not:
1. Exceed the recommended treatment regimen
2. Include United States
Food and Drug Administration (FDA) non-approved supplements, drug products,
medication, and off label medications.
(c) Drugs and medications that do not have
FDA approval may be prescribed through protocol registration in a United States
Institutional Review Board or Expanded Access authorized clinical
"Off label" use or
prescription of FDA-approved medications for uses other than that indicated by
the FDA is permitted when such practices are:
1. Within the current standard of care for
treatment of disease or condition.
2. Supported by evidence-based
3. Approved by the
collaborating physician and entered into the patient record.
(3) A certified
registered nurse practitioner may not initiate a call-in prescription in the
name of a collaborating physician for any drug, whether legend or controlled
substance, which the certified registered nurse practitioner is not authorized
to prescribe under the protocol signed by the collaborating physician and
certified registered nurse practitioner and approved under this section unless
the drug is specifically ordered for the patient by the physician, either in
writing or by a verbal order which has been transcribed in writing, and which
has been signed by the physician within seven working days or as otherwise
specified by the Board of Nursing and the Board of Medical Examiners.
(4) A written prescription for any drug that
the certified registered nurse practitioner is authorized to prescribe may be
called in to a pharmacy, provided the prescription is entered into the
patient's record and signed by the certified registered nurse
registered nurse practitioner in collaborative practice with prescriptive
privileges shall not engage in prescribing for:
(b) Immediate family members.
(c) Individuals who are not patients of the
practice, except in cases, where a certified registered nurse practitioner is
prescribing for the sexual partner(s) of a patient in accordance with an
Expedited Partner Therapy (EPT) protocol for the prevention of transmission and
spread of sexually transmitted disease(s).
(6) The certified registered nurse
practitioner who is in collaborative practice and has prescriptive privileges
may receive and sign for samples of legend drugs that are authorized in the
approved formulary for the collaborative practice, provided the certified
registered nurse practitioner complies with all applicable state and federal
laws and regulations.
prescribing legend drugs a certified registered nurse practitioner shall use a
prescription form which includes all of the following:
(a) The name, medical practice site address
and telephone number of the collaborating physician or covering
(b) The name of the
certified registered nurse practitioner;
(c) The medical practice site address and
telephone number of the certified registered nurse practitioner if different
from that of the collaborating physician;
(d) The certified registered nurse
practitioner's registered nurse license number assigned by the Board of
(e) The words "Product
Selection Permitted" printed on one side of the prescription form directly
beneath a signature line;
words "Dispense as written" printed on one side of the prescription form
directly beneath a signature line.
(g) The date that the prescription is issued
to the patient.
Ala. Admin. Code r.
New Rule: Filed June 20,
1996; effective July 26, 1996. Amended: Filed August 25, 2003; effective
September 29, 2003.
Administrative Monthly Volume XXXIII, Issue No. 10, July 31,
2015, eff. 8/6/2015.
Administrative Monthly Volume XXXV, Issue No. 01, October 30,
2016, eff. 12/4/2016.
Administrative Monthly Volume XXXVII, Issue No. 09, June 28,
2019, eff. 8/3/2019.
Administrative Monthly Volume XXXIX, Issue No. 07, April 30,
2021, eff. 6/14/2021.
Author: Alabama Board of Medical
Statutory Authority: Code of Ala.