In a Boxing Day emergency supply scenario for a patient with epilepsy, which drug would you NOT supply at the patient’s request without a local service?

• A. Carbamazepine
• B. Lamotrigine
• C. Gabapentin
• D. Levetiracetam

Answer: (C)

In emergency supply situations, safety and regulatory controls shape what you can provide without a local prescriber. Medicines that are tightly regulated or require initiation, titration, or ongoing specialist oversight are not suitable to supply without a clinician’s involvement.

Gabapentin is a Class C controlled drug in the UK, which means its supply is subject to stricter controls and typically requires a valid prescription and appropriate prescriber oversight. Because a Boxing Day emergency means limited access to a local prescriber, you would not supply a gabapentin emergency dose without arranging a local service first.

The other anti-epileptics listed are not controlled drugs and can be supplied as a short bridging supply if they are continuation of an existing therapy and dosing aligns with the patient’s usual regimen, with the caveat that initiating a new therapy or altering a dose would normally require a prescriber. The key idea is to ensure patient safety by avoiding initiation of a controlled or recently initiated therapy without proper medical oversight.