A prescription written in Spanish from a doctor in Spain for midazolam 5mg/1mL oromucosal solution for status epilepticus. What is the most appropriate course of action?

• A. Supply the medication and counsel the patient
• B. Refuse to dispense
• C. Advise cannot legally dispense this item and refer to a UK prescriber
• D. Ask for UK prescriber approval first

Answer: (C)

The key idea here is that dispensing medicines must be based on a valid prescription issued by a prescriber who is authorized to prescribe in the UK. For a controlled benzodiazepine like midazolam, used as rescue therapy in status epilepticus, the UK system requires a prescription that is issued within the UK (or under tightly defined, EU-recognized arrangements). A prescription written in Spanish by a doctor in Spain does not meet UK legal requirements, and language and jurisdiction issues raise safety and regulatory concerns. Because of this, a pharmacist cannot legally dispense the item on that foreign prescription. The correct course is to advise the patient that you cannot legally dispense the medicine from that prescription and to refer them to a UK prescriber who can issue a compliant UK prescription (for example, the patient’s GP or a neurology/EP team). If the situation is urgent, the patient should be directed to urgent medical care or an appropriate UK service to obtain a valid supply.