Prescribing a Drug

Professional Practice Standard

Published: August 2018

Revised: June 2022

Introduction 

Under the Veterinarians Act and regulations, a veterinarian licensed by the College of Veterinarians of Ontario is authorized to prescribe and dispense a drug. More specifically, prescribing a drug is an important component of the practice of most veterinarians and one that requires appropriate knowledge and skill, and the use of professional judgment. In most circumstances, prescribing is coupled with the act of dispensing; however, there are acceptable instances when prescribing may be performed independently by a veterinarian. A veterinarian should acknowledge and manage the potential conflict of interest in assuming the dual role of prescriber and dispenser. 

The professional activity of veterinary prescribing is informed and regulated by a broad legislative framework provincially and federally. This legislation sets out the requirements for the prescribing, sale, and dispensing of a drug. The College Professional Practice Standard: Extra-Label Drug Use, Professional Practice Standard: Management and Disposal of Controlled Drugs, and Professional Practice Standard: Use of Compounded Products in Veterinary Practice also describe specific expectations in the prescribing of a drug in an extra-label manner, a controlled drug, and a compounded product, respectively. 

Definitions 

Client: Client means, with respect to a veterinarian, the owner of an animal(s) or group of animals that the veterinarian is treating, an authorized representative of the owner, or an individual who the veterinarian reasonably determines is acting in the interest of the animal(s) or group of animals. 

Drug: As per the Drug and Pharmacies Regulation Act, drug means any substance or preparation containing any substance (a) manufactured, sold or represented for use in (i) the diagnosis, treatment, mitigation or prevention of a disease, disorder, abnormal physical or mental state or the symptoms thereof, in humans, animals or fowl, or (ii) restoring, correcting or modifying functions in humans, animals or fowl, (b) referred to in Schedule I, II, or III, (c) listed in a publication named by the regulations made under the Drug and Pharmacies Regulation Act, or (d) named in the regulations made under the Drug and Pharmacies Regulation Act. 

Extra-Label Drug Use: Extra-label drug use (ELDU), also referred to as "off-label use", refers to the use or intended use of a drug approved by Health Canada in an animal(s) or group of animals in a manner not in accordance with the label or package insert, with respect to species, indication, dose, duration, and route of administration. It also includes the use of all unapproved drugs, including unapproved bulk active pharmaceutical ingredients (APIs) and compounded drugs.1 

Prescription/prescribing:  A direction from a veterinarian authorizing the dispensing of a drug or mixture of drugs to a client for an animal(s) or group of animals. 

Withholding Time: Withholding time means, in reference to a food producing animal that receives a drug or substance, the period of time for which the animal or the product(s) of the animal should be withheld or withdrawn from sale for consumption. 

Practice Expectations

A veterinarian meets the Professional Practice Standard: Prescribing a Drug when the veterinarian: 

• Has been retained by the owner of the animal(s) or group of animals an authorized representative of the owner, or an individual who the veterinarian reasonably determines is acting in the interest of the animal(s) or group of animals;
• Has advised the client that the veterinarian will only provide services in accordance with the standards of practice of the profession; 
• Has reached an agreement with the client as to the scope of the services to be provided by the veterinarian; and
• Has obtained the consent of the client for each service to be provided. 

B) Understands that additional requirements for prescribing a drug are that the veterinarian:

• has recent and sufficient knowledge of the animal(s) or group of animals by virtue of a history and inquiry and either in-person physical examination of the animal(s) or group of animals or medically appropriate and timely in-person visits to the premises where the animal(s) or group of animals is kept to reach at least a general or preliminary diagnosis;
• believes that the drug is prophylactically or therapeutically indicated for the animal(s) or group of animals; and
• is readily available in-person in case of adverse reactions to the drug or failure of the regimen of therapy.

C) Further understands that they may obtain recent and sufficient knowledge through a virtual     physical examination or virtual premise visit to prescribe a non-controlled drug to an animal(s)     or group of animals when the following conditions are met:  

• They conduct a virtual physical examination or virtual premise visit of an animal(s) or group of animals’ circumstances and condition to obtain sufficient information regarding its status and condition to indicate an immediate need for drug therapy;  
• The quantity of the drug prescribed is limited to an immediate, short-term need or is the minimum amount necessary to allow the client a reasonable opportunity to obtain in-person veterinary services for the animal(s) or group of animals; and 
• They are readily available in-person to manage adverse reactions to the drug or failure of the regimen of therapy.

5. Understands that an exception to the requirement that a VCPR must be established before a veterinarian can provide veterinary services (inclusive of prescribing a drug) includes where a veterinarian determines that there is an emergency situation and that an animal(s) or group of animals require(s) immediate veterinary services.