Can U.S. doctors and pharmacies send or transfer prescriptions to Canadian pharmacies?

Written by Jeffrey Poirier, MBA, RPh | Reviewed by Gabriel Levitt, MA | Posted diciembre 03, 2021 | Updated mayo 31, 2022

Generally, U.S. pharmacies will not transfer your prescription to a Canadian pharmacy.

If you decide to buy a medication from a pharmacy in Canada and you have a prescription with a U.S. pharmacy, you'll most likely need to request a new prescription from your provider.

Canadian and International Mail Order Pharmacies That Accept U.S. Prescriptions

U.S. doctors can send prescriptions to Canadian pharmacies.

Canadian pharmacies require a prescription from an authorized Canadian practitioner before dispensing a prescription drug. So, how is it that Americans are buying prescription drugs from licensed pharmacies in Canada?

Canadian pharmacies work with Canadian doctors to facilitate the processing of a valid, U.S. prescription. When the U.S. doctor sends the prescription to the pharmacy in Canada, it is then reviewed by a Canadian physician. Based on that review, which includes the patient’s medical information, a Canadian prescription is written. This practice is often referred to as “cosigning.” We view the cosigning process as an additional review of the patient's health profile by a licensed practitioner to determine the suitability of the recommended treatment. 

To be clear, a patient or doctor in the U.S. only has to send a prescription. PharmacyChecker-accredited Canadian online pharmacies accept your U.S. prescription, and it is then their role to properly process the order.

U.S. Prescription Transfer Regulations

Regulations vary from state to state. U.S. pharmacies are permitted to transfer prescriptions, including refills, for non-controlled drugs under most circumstances, however, transferring prescriptions to foreign pharmacies may not be permitted for various reasons. 

Even though many states have not explicitly banned transferring U.S. prescriptions to non-U.S. pharmacies, pharmacists may be reluctant to do so due to corporate rules or professional discretion. In most cases it remains technically illegal under U.S. federal law to import medication for personal use from other countries, however, enforcement is rare for quantities that don’t exceed a 90-day supply. 

Interestingly, Texas pharmacists are expressly permitted to fill prescriptions written by Canadian or Mexican practitioners for non-controlled substances; however, pharmacies are only permitted to transfer authorized refills for those prescriptions between Texan pharmacies.

More about Texas Pharmacy Laws

More about Drug Importation Laws, Regulations, and Policies

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Canadian Prescription Transfer Regulations

Canadian pharmacies are generally not permitted to accept prescription transfers from U.S. pharmacies. Canadian provinces require that pharmacies dispense medications pursuant to a valid prescription authorized by a Canadian practitioner. Therefore, U.S. prescriptions received by a Canadian pharmacy must be approved by a Canadian physician prior to being filled. This requires that the pharmacy receive a health history survey and an original signed prescription, which can be faxed by your doctor or mailed—either by yourself or your doctor on your behalf. Additionally, a licensed pharmacy can work directly with your doctor to facilitate the receipt of the prescription and/or arrange refills when necessary. 

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Americans Can Order Prescription Medications from Canadian and Other International Online Pharmacies

Millions of Americans have ordered medication from Canada, even though it's technically prohibited under most circumstances. That's because it's legal in Canada for licensed pharmacies, meeting the laws of their provinces, to dispense prescription drugs to Americans.

We recommend that you stick to PharmacyChecker-accredited  Canadian online pharmacies. Patients use to compare prices among verified pharmacies. Many people that use our comparison tool find their medications at over an 80% discount vs. the prices they see at their local CVS or Walgreens.

Please know that many Canadian online pharmacies fill your orders with pharmacies outside of Canada. For those that are in the PharmacyChecker Verification Program, the partner pharmacies (not just the ones in Canada) are also verified by PharmacyChecker.

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Can my international prescription drugs order get stuck at Customs?

While the law allows the FDA and U.S. Customs and Border Patrol to detain and refuse international prescription orders arriving through the mail, less than one percent of medication orders are actually stopped, at least for orders where a prescription is required. If that happens, you will receive a letter from the FDA that your drug order was detained or refused. You are allowed to challenge the FDA’s decision and try and have it released. To learn how to provide testimony to the FDA if they take your medication, you can go to the website of Prescription Justice to reclaim your import.

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Frankly, I trust Canada more than I do the US FDA. And congratulations on the Nobel Prize in Physics. Fred Banting is beaming.
Recently, quality manufacturers like Sandoz and Mylan have discontinued lorazepam (generic) and I have tried the other generics but they do not work for me. I will have to go back to the brand but can't really afford it but I do not meet the financial requirements for assistance.
I order other drugs online from Canada and others using my UHC insurance but it will not reimburse most brand names including Ativan.
The Canadian pharmacy says they can't ship drugs like Ativan. How can I get Ativan? Online? From another country? Thanks, Dena
"To be clear, a patient or doctor in the U.S. only has to send a prescription. You do not need to worry about finding a Canadian practitioner. The pharmacy will take care of the approval process from there."Nonsense.When I asked at both Jean Coutu and Shoppers Drug Mart in QC and ON they acted like I was crazy. Absolutely will not do it!
Hi John -- This post is specific to international online pharmacies accredited in the PharmacyChecker Verification Program. See list: We see how this post can be confusing so will update it to clarify. Thank you for your comment.
Thank you for replying so quickly!
My 92 yr old father is staying with us in Canada during the Covid19 crisis. He actually lives in New York State. His prescriptions will start to run out in a couple weeks. We will try to get a Canadian physician to somehow cosign the prescriptions I guess. Any suggestions? Thank you.
Hi John-- If you're having trouble working with pharmacies located in Canada, a last-resort solution could be to see a local Canadian doctor to explain your father's medical condition and get a new prescription that can be filled at a Canadian pharmacy. Considering the rapid development of the crisis, perhaps there are waived regulations in Canada that would allow filling an out-of-country prescription directly, but we are unable to confirm this at this time. We wish you and your father all the best. Stay safe.
Thanks for your feedback. Yes, that is more or less what we did. My father called my own doctor, they chatted a bit and my father told him what meds he needed and they then sent the prescriptions to the local pharmacy (who even delivered). Pretty painless once we got the doctor on the phone. All the best.
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