9-6. EXCEPTIONS TO THE ACT
Some patients (that is, those who have arthritis) may find child-resistant
packaging too difficult to open. Furthermore, some patients (for example: those with
certain types of heart conditions) may wish to obtain their medications from the
container in a short period of time when they need them. For these types of patients,
alternatives to child--resistant packaging are available.
a. Nitroglycerin Must NOT be Dispensed in Child--Resistant Packaging.
This drug is for patients who have certain types of heart conditions. These patients
must be able to obtain their nitroglycerin quickly in the event they need it.
b. Alternative Packaging. The manufacturer can market one size of a product
in conventional (not child-resistant) packaging--if the same product is also available in
child-resistant packaging. However, the conventional packaging must have a label
which clearly states:
This packaging for household without young children or if the package is small:
Package not child-resistant
c. Patient or Physician Request. The patient or prescribing physician may
request that prescription medicines be put into ordinary packaging without safety
features. Although some pharmacists may ask for a written statement from a patient
before providing a conventional closure, this is not a requirement of the Federal law.
9-7. CONSIDERATIONS FOR THE OUTPATIENT PHARMACY
Child--resistant packaging has been in use for quite some time. It has, without a
doubt, decreased the number of cases of accidental poisonings. If you have purchased
items or received prescriptions packaged in child-resistant containers, you are aware of
the advantages and disadvantages of this means of preventing accidental poisonings.
In your position in the pharmacy, you may hear comments about the packaging. Some
patients are quick to complain about the packaging. Here are some considerations
about the act that are pertinent to you:
a. You should be very familiar with your pharmacy's policies regarding child-
resistant packaging. For example, if a patient requests conventional packaging for a
prescription item, does your pharmacy require the patient to sign or initial the
prescription or a special form? You should carefully read and study your local Standing
Operating Procedures (SOP) to insure you do what is required.
b. Some patients may request conventional packaging. Suppose a retired
individual asks you to package his prescription in a conventional container. Does this
person have grandchildren who frequently come to the home? Remember, many