A prescription for tramadol 50 mg capsules for a patient is dated 20 March 2025. The patient collects it on 21 April 2025, and this is their first collection. What is the most appropriate course of action?

• A. Dispense the tramadol as prescribed since it is within a month
• B. Refuse to dispense as the prescription has expired under CD regulations
• C. Dispense but contact the prescriber for confirmation
• D. Offer a non-opioid alternative without consulting the prescriber

Answer: (B)

Tramadol is a Schedule 3 controlled drug, and prescriptions for CDs have a strict validity window: they must be dispensed within 28 days of the date on the prescription. In this case, the prescription is dated 20 March 2025 and the first collection is on 21 April 2025, which is 32 days later. That goes beyond the 28-day limit, so the prescription has expired under CD regulations. The appropriate action is to refuse dispensing and tell the patient that a fresh prescription from the prescriber is required before the medication can be supplied.