Can a pharmacy fill a prescription early?

If you’re wondering whether you can refill a prescription early, the short answer is yes, under the right circumstances. Early refills may be essential when you're traveling, lose your medication, or need to stay on track with a chronic treatment plan.

Every time you skip or delay a dose, it may negatively impact the effectiveness of your treatment. According to the Centers for Disease Control and Prevention (CDC), about 3.8 billion prescriptions are written in the U.S. each year, but up to 20% of new prescriptions are never filled, often due to cost barriers. Of those filled, approximately 50% are not taken as prescribed, which includes improper timing, dosage, and duration. There is a higher risk of not filling new prescriptions with increasing age and number of medications.

A U.S. review highlights that non-adherence affects up to 50% of people with chronic conditions and causes around 125,000 deaths annually. After many years working as a pharmacy technician, I saw firsthand how skipped medications often led to worsening health outcomes.

How do I fill a prescription?

To fill a prescription, you can request a physical copy and bring it to your local pharmacy, or your health care provider can telephone, fax, or send an electronic prescription to your local pharmacist. In 2018, electronic prescriptions were mandated for controlled drugs covered by Medicare plans. You should have your prescription insurance information on hand if you are a new patient at the pharmacy. This way, the pharmacy can check your coverage and help you receive your medication in a timely manner. Once you drop off your prescription, you can either wait for it in the pharmacy or come back at a later time to pick it up.

How long is a prescription good for? 

Pharmacies must follow both federal and state guidelines when it comes to the validity of a prescription. For non-controlled prescriptions, the general rule is that a prescription will be valid for one year after the date the doctor wrote the prescription. Six states – Idaho, Illinois, Iowa, Maine, South Carolina, and Wyoming — extend the prescription validity for noncontrolled substances beyond one year. Some states — like Alabama — do not define a time frame for prescription validity at all.

For controlled substances, pharmacies must follow the guidelines set forth in the Controlled Substances Act of 1971. Prescription validity ranges from 30 days to 6 months, depending on the prescribed medication schedule. For schedule II drugs, the validity length is based on individual state boards of pharmacy. For example, a schedule II prescription (like Adderall) in Massachusetts is valid for 30 days, but a prescription written in California would be valid for 6 months. 

It is always best to check with your pharmacist if you have questions regarding the validity of your prescription. Pharmacists are expected to exercise professional judgment to ensure prescriptions are filled within a reasonable time frame to prevent misuse.

How long will a pharmacy hold a filled prescription?

This varies from pharmacy to pharmacy, so make sure you contact your pharmacist as soon as possible regarding your filled prescription. In my experience, most pharmacies will hold your filled prescription for 2-7 days. 

How do you calculate how long your filled prescription will last?

According to the Code of Federal Regulations Title 21, pharmacists in the United States must adhere to specific prescription requirements, including the drug’s classification. In addition to federal regulations, the pharmacist must also consider state laws, such as the differing prescriptive authority depending on the type of prescriber. 

Your prescription must have the following information to make it a legal prescription for the pharmacy to fill:

• Your name
• Address
• Date the prescription was written
• Doctor’s name, address, and DEA # (if a controlled substance)
• Drug name
• Drug strength
• Drug form
• Quantity
• Directions for patient usage
• Number of refills
• Signature of the Doctor prescribing

The pharmacy will use its pharmacy software to enter all of this information into your patient profile. The quantity prescribed and the directions will be used to calculate the number of days the prescription is supposed to last you; this is known as the “day supply”. For example, if you were prescribed Losartan 50mg #90 to be taken once daily, the pharmacy would divide 90 by 1 and enter a day supply of 90 days for this prescription. If insured, the day supply would be submitted through a claim to your insurance company for a 90-day supply of Losartan 50mg on the date the pharmacy runs the claim (not the date the doctor wrote the prescription).

What makes my prescription too soon to fill?

Now you understand how a pharmacy determines how long a filled prescription will last you, but how does a pharmacy determine when they can fill that prescription again? It depends on whether you’re paying with insurance.

If you’re uninsured

If you’re uninsured or paying with a drug discount coupon, the pharmacist refilling your prescription will use their clinical judgment to determine whether the prescription is at an appropriate interval to be refilled. A part of the pharmacist's role is to determine safe and effective drug usage. During the refill process, the prescription will be checked to determine safety, effectiveness, and appropriateness for you. Part of that check will be to determine if you are refilling your medication at a reasonable interval based on the way the medication was prescribed by your doctor. 

If you’re insured (How U.S. Insurance Dictates Prescription Refills)

If you pay for your prescriptions in conjunction with insurance, your insurance company determines your refills. When the prescription is being processed, it is sent electronically to your insurance company for approval. Your insurance company is going to look at all the other claims you have had for that medication. 

Insurance plans may use 75% as the percentage to allow a refill to proceed. Suppose you have submitted a refill before 75% of your medication is completed. In that case, chances are the insurance is going to block that prescription from being paid for and will give the pharmacy a notice that your medication is “too soon” to fill. 

Of course, there are exceptions to everything. Pharmacies may have their own internal policies when it comes to refilling medications too soon, especially controlled substances, as defined by the U.S. Drug Enforcement Administration (DEA). Although a pharmacist can refuse to fill a prescription based on their own medical judgement, this varies slightly under the law from state to state. A 2021 review also shows how pharmacists can use the conscience clause to refuse in different states.

When is it ok to get an early refill, and how do I do so?

There are a few scenarios in which the insurance and/or your pharmacy will authorize an early refill, but a little legwork on your part is likely. This can include calling the doctor, your pharmacy, and in some cases, your insurance company.

Yes, because you’re leaving town for a while (The Vacation Override) 

Pharmacies understand that patients sometimes are away from home for a long time due to extended vacations or work travel. In this situation, at your request, a pharmacy may use a “Vacation Override” to get you the medication you need. This is the official pharmacy term that means you need a large refill of your medication due to an upcoming vacation. 

• If you usually pay cash for your prescriptions, you would simply explain to the pharmacist you are traveling and need an early refill.
• If you’re insured, your insurance may ask for some details about your trip, such as the dates of your vacation, to initiate the override. If your medication is a controlled substance, you may not get an early refill (See below for more about controlled drugs).

Yes, because your medication has been lost or stolen 

Patients sometimes find that their medication has been lost or even stolen. In those cases, they would need an early refill to make sure they don’t miss a dose. In any case, this type of refill takes place when your prescription medication is no longer available to you. Believe it or not, a medicine cabinet by a bathroom sink is not a good place to store your medication. As a pharmacy technician, I have called many insurance companies because medications were accidentally dropped down a bathroom sink! Further, the heat and moisture may damage your medication and make it less effective. 

As long as it is not a controlled substance, you can ask your pharmacy to initiate a lost or stolen medication override. Insurance may limit how often this override can be used.

Yes, because you need a dosage change

You can refill a prescription early if either your dosage or the directions on how you take your medication have changed. Usually, this change takes place because your doctor has called or sent the pharmacy a new prescription for you. With the change in dose or directions, the pharmacy or insurance company will approve the medication to be filled early so that you may start the new therapy as prescribed. 

Normally, how many days early can I refill a prescription? 

Prescriptions are refilled by pharmacists based on day supply, which is calculated by dividing the total quantity the prescription is written for by the number of times you take the medication per day. How early you can fill your prescription will vary based on your insurance, the type of medication, and even the pharmacy’s specific practices. 

From my experience, most insurances and pharmacies will allow you to refill routine medications up to five days early. For example, routine maintenance medications, such as for high blood pressure and diabetes, can often be refilled as early as day 25 (of 30 days total). This is to ensure that you do not have an interruption in your routine medication therapy.

Prescriptions may also be refilled based on the percentage of medication used. Insurance often uses a 75% refill allowance. If the insurance and pharmacy use this percentage method, your chronic medication might be refilled as early as day 22.5 of a 30-day supply. For example, a maintenance medication picked up on July 1st can be refilled again on July 22nd.

How soon can I refill my controlled medication (like Adderall, Vicodin, or Xanax)?

This is a common question, and in today's world of drug shortages, I can appreciate a patient’s desire to make sure that they do not run out of their medications. 

As I’m sure you can imagine, controlled substances have stricter rules and restrictions around refills. Controlled drugs contain chemicals regulated not just by the U.S. Food and Drug Administration (FDA) but also by the U.S. DEA. Pharmacies are stricter when it comes to early refills of such medications to ensure that patients do not start abusing or diverting them.

Because of these restrictions, insurance may only cover an early refill when 85% of the controlled medication is used. In my experience, however, most pharmacies will not fill a controlled medication more than three days before you are to run out based on your doctor’s prescribed directions. 

We are asked about Adderall a lot. Adderall is a Schedule II federally regulated controlled substance. Under federal law, Schedule II prescriptions cannot be refilled. For this reason, your prescriber will usually provide multiple prescriptions with “Do not fill until X date” written on them. This notifies your pharmacist of the appropriate date to fill your Schedule II prescriptions.

There are no federal limits regarding the quantity of Schedule II controlled substance prescriptions dispensed, but the amount prescribed by a practitioner must be consistent with a legitimate medical purpose.

According to the Code of Federal Regulations Title 21, Schedules III, IV, and V controlled substances may be refilled, but only up to five times within six months after the date of issue. Once the five refills are finished or after six months, whichever occurs first, a new prescription is needed.

Most local pharmacies will allow you to fill Schedule III & IV meds two days before you should run out, or on day 28 of a 30-day supply. If you are running short on a controlled medication, it’s best to call your doctor and discuss the situation with them directly. 

How do I get an emergency prescription?

What happens when you urgently need a refill of your medication? An emergency prescription refill may be necessary if prescriber outreach was unsuccessful. A pharmacist may authorize a one-time refill of a maintenance medication to prevent an interruption in therapy or patient suffering. Typically, pharmacies can refill a prescription for a 72-hour fill to avoid a lapse in medication therapy. 

In March 2010, the DEA published the “Electronic Prescriptions for Controlled Substances” rule. As a result, your pharmacy can now accept an electronic prescription (not just a handwritten hard copy) of your controlled medication. To receive electronic prescriptions, however, the pharmacy must have the appropriate electronic applications and software systems in place. In case you need an emergency refill for a controlled medication, you should work with your doctor and your pharmacy to get a new prescription sent to the pharmacy. 

How do I refill a prescription early if I order through an accredited international online pharmacy?

PharmacyChecker verifies online pharmacies for high standards of pharmacy practice to help patients worldwide avoid rogue websites and counterfeit drugs. The National Bureau of Economic Research had a working paper based on an audit of test samples of brand-name prescription medications from U.S. and international websites. The results of this paper strongly demonstrate the safety of ordering medications from an international online pharmacy approved in the PharmacyChecker (PC) International Pharmacy Verification Program (IPVP). 

Most online pharmacies accredited through the PC IPVP advise that the average international shipping time ranges between four to six weeks. 

We encourage you to work directly with the pharmacy to ensure you remain adherent to your medications and prevent gaps in therapy. The pharmacy will fill a maximum of 90 days for you at a time and allow a refill in enough time for international mailing. 

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