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Texas Pharmacist Naloxone Standing Order Application
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For the purpose of facilitating the prescribing of opioid antagonists to combat the effects of opioid overdose, the Texas Pharmacy Association has obtained a physician-signed standing order. The standing order authorizes a pharmacist that is active and in good standing with the Texas State Board of Pharmacy to dispense an opioid antagonist to a recipient in any of the following formulations:

  • Intramuscular Naloxone aqueous solution multi-dose vial or pre-filled syringe (EXCLUDING auto-injector such as Evzio or equivalent);
  • Intranasal Naloxone (for administration by mucosal atomization device or other available method or device);
  • Naloxone Nasal Spray, (such as Narcan or equivalent).

A Pharmacist may also dispense any other items necessary for the administration of opioid antagonists as determined by the Pharmacist (including, but not limited to, syringes and mucosal atomization devices).

Prior to dispensing or administering an opioid antagonist pursuant to this Standing Order, a Pharmacist shall complete and obtain a certificate of completion of a one-hour, Texas-accredited course provided by an Accreditation Council for Pharmacy Education-approved provider in coordination with the Texas Pharmacy Association for the purpose of establishing a statewide standard of care. At a minimum the training shall include when a pharmacist should or should not dispense Naloxone/Narcan under this standing order, how to work with the patient when selecting which opioid antagonist to dispense and when to administer the Naloxone/Narcan.

Once completed and obtained the standing order shall be maintained at the pharmacy during the term of the standing order. The Pharmacist working under the standing order must maintain an active license and remain in good standing with the Texas State Board of Pharmacy. All information required must remain up-to-date and current while the pharmacist is practicing under this standing order.

Once this form is completed and verified, TPA members will receive the link to the one-hour accredited course for no charge. This CE must be completed before receiving the Standing Order.

Non-members may use this link to complete the online CE or join TPA as a member to receive it at no cost.


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