Long-Acting Injectable Medication Administration

No. Pharmacists must be currently registered and have a certificate of administration issued by the State Education Department (SED).  Pharmacists with a certificate of administration are known as certified pharmacists and carry the designation of an “I” on their registration certificates (this is the same designation pharmacists providing immunizations in New York State utilize). 

Certified pharmacists seeking to administer LAIs to patients are not required to take additional training. However, certified pharmacists that administer LAIs are required to maintain continued competency regarding the populations served and the medications available for injectable administration.  One way that certified pharmacists can maintain such competency is through the completion of continuing education courses on these subjects.

Certified pharmacists may administer LAIs that are approved by the Federal Food and Drug Administration (FDA) for the treatment of mental health and substance use disorders.

Yes. The administration of an LAI medication can only be conducted pursuant to a valid patient-specific prescription or patient-specific order issued by a prescriber acting within their scope of practice.

In addition to certified pharmacists, certified pharmacy interns can administer LAIs to patients.  Administration by certified pharmacy interns can only occur if they are under the immediate, personal supervision of a certified pharmacist.

Yes. Administration by a certified pharmacy intern shall not occur unless the patient has been informed and has consented to such administration. If the patient does not consent to the administration of an LAI by a certified pharmacy intern, a certified pharmacist shall be present to administer the injectable medication to the patient.

Patients receiving their LAI from a certified pharmacist must have already received their initial dose of medication from their prescriber and be deemed eligible for maintenance treatment by them.

Patient eligibility can be communicated by the prescriber to a certified pharmacist either in writing, electronically or via fax.  In instances where such means of communication are not available, a prescriber may notify a certified pharmacist verbally provided that the certified pharmacist documents the notification within the patient’s medication profile.

Yes. After administering an LAI to a patient, the certified pharmacist or their designee must notify the patient’s prescriber of the administration.  While certified pharmacists have up to five days to notify the prescriber, to ensure the best possible care for the patient, it is recommended that, if possible, such notification occur immediately after the administration of the LAI.

Yes. If a patient does not receive their LAI when scheduled, the certified pharmacist is required to notify the patient’s prescriber as soon as possible, but no later than 72 hours after the medication was scheduled to be administered.

Certified pharmacists can notify a patient’s prescriber via electronic medical records, electronic transmission, or facsimile.  In instances where such means of communication are unavailable, a certified pharmacist may notify the patient’s prescriber via telephone.

If a patient experiences side effects or has an adverse reaction to an LAI, the certified pharmacist must notify the patient’s prescriber immediately, making themselves available to discuss the adverse reaction or side effect with the prescriber.

If a patient experiences an anaphylactic reaction, certified pharmacists are authorized to administer medication for the emergency treatment of anaphylaxis. In addition to notifying the prescriber and making themselves available to discuss the patient’s anaphylactic reaction, certified pharmacists are required to:

1. Document such administration within the patient’s profile. Such documentation record shall include, but not be limited to, the recipient’s name, the date and address of the administration, the name of the administering pharmacist, the name of anaphylaxis treatment agent administered, its manufacturer, and lot number;
2. Contact local emergency medical services following the administration of the anaphylaxis treatment agent, or ensure that equivalent follow-up care is provided through other arrangements; 
3. Report to the local emergency medical system or other provider of equivalent follow-up care information concerning the anaphylaxis treatment that was administered including, but not limited to:  the name of the agent, when it was administered, the dosage, strength, and route of administration; and
4. Certified pharmacists shall also report such information to the patient’s primary health care practitioner if one exists, unless the patient is unable to communicate the identity of their primary health care practitioner.

Yes. A certified pharmacist can refuse to administer an LAI to a patient, if in their professional judgment, potential adverse effects, interactions, or other therapeutic complications could endanger the health of the patient.