New Rules for Hydrocodone

Published on 06 October 2014

In Missouri, there were more than 830,000 prescriptions filled for hydrocodone in 2011 under Medicare Part D. The total number of prescriptions filled for the pain medication, which is combined with acetaminophen or ibuprofen, is much higher.

Starting today, hydrocodone is now classified as a schedule II drug under new Food and Drug Administration (FDA) rules. For patients, this will change the way prescriptions are filled during the next visit to the pharmacy.

Amy Tiemeier, Pharm.D., BCPS, associate professor of pharmacy practice at St. Louis College of Pharmacy, says patients can now expect the following  when filling a hydrocodone prescription:

  • No automatic refills
  • Patients need to have a written copy of the prescription each time
  • Prescriptions must be filled within six months of the date prescribed
  • In Missouri, prescriptions for hydrocodone must be made by physicians, not nurse practitioners or physicians assistants

“The main reason behind the move is to reduce the amount of hydrocodone being used illegally in the community,” Tiemeier says. “Pharmacies take extra precautions when dealing with medications in this category.”

Tiemeier says hydrocodone used to be a Schedule III medication, but the U.S. Drug Enforcement Administration recommended changing the classification to increase control. Under FDA rules, a Schedule II medication has a high potential for abuse and may lead to severe psychological or physical dependence.  Other Schedule II medications include Ritalin (methylphenidate) and OxyContin (oxycodone). The FDA says Schedule III medications still have a potential for abuse and dependence, but at a lower level than Schedule II medications.   Medications classified as Schedule III include Suboxone (buprenorphine), codeine, and testosterone.

“Hydrocodone containing medications are effective for treating temporary pain following an injury or surgery,” Tiemeier says. “Health care providers should focus on other options for long -term pain relief.”

Patients with leftover hydrocodone have several options to safely remove it from their homes. lists the locations of three dozen permanent disposal sites around the St. Louis area. 

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