{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/54.1-3303.1.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/54.1-3303.1.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/54.1-3303.1.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/54.1-3303.1.html"}],"law_id":86967,"edition_id":1,"section_id":86967,"structure_id":14382,"section_number":"54.1-3303.1","catch_line":"Initiating of treatment with and dispensing and administering of controlled substances by pharmacists","history":"2020, c. 731; 2021, Sp. Sess. I, c. 214; 2022, cc. 790, 791; 2023, cc. 171, 172.","full_text":"A\n\nNotwithstanding the provisions of \u00a7 54.1-3303, a pharmacist may initiate treatment with, dispense, or administer the following drugs, devices, controlled paraphernalia, and other supplies and equipment to persons 18 years of age or older with whom the pharmacist has a bona fide pharmacist-patient relationship and in accordance with a statewide protocol developed by the Board in collaboration with the Board of Medicine and the Department of Health and set forth in regulations of the Board:1\n\nNaloxone or other opioid antagonist, including such controlled paraphernalia, as defined in § 54.1-3466, as may be necessary to administer such naloxone or other opioid antagonist;2\n\nEpinephrine;3\n\nInjectable or self-administered hormonal contraceptives, provided the patient completes an assessment consistent with the United States Medical Eligibility Criteria for Contraceptive Use;4\n\nPrenatal vitamins for which a prescription is required;5\n\nDietary fluoride supplements, in accordance with recommendations of the American Dental Association for prescribing of such supplements for persons whose drinking water has a fluoride content below the concentration recommended by the U.S. Department of Health and Human Services;6\n\nDrugs as defined in § 54.1-3401, devices as defined in § 54.1-3401, controlled paraphernalia as defined in § 54.1-3466, and other supplies and equipment available over-the-counter, covered by the patient’s health carrier when the patient’s out-of-pocket cost is lower than the out-of-pocket cost to purchase an over-the-counter equivalent of the same drug, device, controlled paraphernalia, or other supplies or equipment;7\n\nVaccines included on the Immunization Schedule published by the Centers for Disease Control and Prevention and vaccines for COVID-19;8\n\nTuberculin purified protein derivative for tuberculosis testing;9\n\nControlled substances for the prevention of human immunodeficiency virus, including controlled substances prescribed for pre-exposure and post-exposure prophylaxis pursuant to guidelines and recommendations of the Centers for Disease Control and Prevention;10\n\nNicotine replacement and other tobacco cessation therapies, including controlled substances as defined in the Drug Control Act (§ 54.1-3400 et seq.), together with providing appropriate patient counseling;11\n\nControlled substances or devices for the initiation of treatment of the following diseases or conditions for which clinical decision making can be guided by a clinical test that is classified as waived under the federal Clinical Laboratory Improvement Amendments of 1988: group A Streptococcus bacteria infection, influenza virus infection, COVID-19 virus infection, and urinary tract infection; and12\n\nTests for COVID-19 and other coronaviruses.B\n\nNotwithstanding the provisions of \u00a7 54.1-3303, a pharmacist may initiate treatment with, dispense, or administer the following drugs and devices to persons three years of age or older in accordance with a statewide protocol as set forth in regulations of the Board:1\n\n(Contingent Effective Date) Vaccines included on the Immunization Schedule published by the Centers for Disease Control and Prevention and vaccines for COVID-19; and2\n\n(Contingent Effective Date) Tests for COVID-19 and other coronaviruses.C\n\nA pharmacist who initiates treatment with or dispenses or administers a drug or device pursuant to this section shall notify the patient’s primary health care provider that the pharmacist has initiated treatment with such drug or device or that such drug or device has been dispensed or administered to the patient, provided that the patient consents to such notification. No pharmacist shall limit the ability of notification to be sent to the patient’s primary care provider by requiring use of electronic mail that is secure or compliant with the federal Health Insurance Portability and Accountability Act (42 U.S.C. § 1320d et seq.). If the patient does not have a primary health care provider, the pharmacist shall counsel the patient regarding the benefits of establishing a relationship with a primary health care provider and provide information regarding primary health care providers, including federally qualified health centers, free clinics, or local health departments serving the area in which the patient is located. If the pharmacist is initiating treatment with, dispensing, or administering injectable or self-administered hormonal contraceptives, the pharmacist shall counsel the patient regarding seeking preventative care, including (i) routine well-woman visits, (ii) testing for sexually transmitted infections, and (iii) pap smears.D\n\nA pharmacist who administers a vaccination pursuant to subdivisions A 7 and B 1 shall report such administration to the Virginia Immunization Information System in accordance with the requirements of § 32.1-46.01.E\n\nA pharmacist who initiates treatment with, dispenses, or administers drugs, devices, controlled paraphernalia, and other supplies and equipment pursuant to this section shall obtain a history from the patient, including questioning the patient for any known allergies, adverse reactions, contraindications, or health diagnoses or conditions that would be adverse to the initiation of treatment, dispensing, or administration.F\n\nA pharmacist may initiate treatment with, dispense, or administer drugs, devices, controlled paraphernalia, and other supplies and equipment pursuant to this section through telemedicine services, as defined in § 38.2-3418.16, in compliance with all requirements of § 54.1-3303 and consistent with the applicable standard of care.G\n\nA pharmacist who administers a vaccination to a minor pursuant to subdivision B 1 shall provide written notice to the minor’s parent or guardian that the minor should visit a pediatrician annually.","order_by":null,"text":{"0":{"id":311378,"text":"Notwithstanding the provisions of \u00a7 54.1-3303, a pharmacist may initiate treatment with, dispense, or administer the following drugs, devices, controlled paraphernalia, and other supplies and equipment to persons 18 years of age or older with whom the pharmacist has a bona fide pharmacist-patient relationship and in accordance with a statewide protocol developed by the Board in collaboration with the Board of Medicine and the Department of Health and set forth in regulations of the Board:","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"A1"},"1":{"id":311379,"text":"Naloxone or other opioid antagonist, including such controlled paraphernalia, as defined in § 54.1-3466, as may be necessary to administer such naloxone or other opioid antagonist;","type":"section","prefixes":["A","1"],"prefix":"1","entire_prefix":"A1","prefix_anchor":"A1","level":2,"prior_prefix":"A","next_prefix":"A2"},"2":{"id":311380,"text":"Epinephrine;","type":"section","prefixes":["A","2"],"prefix":"2","entire_prefix":"A2","prefix_anchor":"A2","level":2,"prior_prefix":"A1","next_prefix":"A3"},"3":{"id":311381,"text":"Injectable or self-administered hormonal contraceptives, provided the patient completes an assessment consistent with the United States Medical Eligibility Criteria for Contraceptive Use;","type":"section","prefixes":["A","3"],"prefix":"3","entire_prefix":"A3","prefix_anchor":"A3","level":2,"prior_prefix":"A2","next_prefix":"A4"},"4":{"id":311382,"text":"Prenatal vitamins for which a prescription is required;","type":"section","prefixes":["A","4"],"prefix":"4","entire_prefix":"A4","prefix_anchor":"A4","level":2,"prior_prefix":"A3","next_prefix":"A5"},"5":{"id":311383,"text":"Dietary fluoride supplements, in accordance with recommendations of the American Dental Association for prescribing of such supplements for persons whose drinking water has a fluoride content below the concentration recommended by the U.S. Department of Health and Human Services;","type":"section","prefixes":["A","5"],"prefix":"5","entire_prefix":"A5","prefix_anchor":"A5","level":2,"prior_prefix":"A4","next_prefix":"A6"},"6":{"id":311384,"text":"Drugs as defined in § 54.1-3401, devices as defined in § 54.1-3401, controlled paraphernalia as defined in § 54.1-3466, and other supplies and equipment available over-the-counter, covered by the patient’s health carrier when the patient’s out-of-pocket cost is lower than the out-of-pocket cost to purchase an over-the-counter equivalent of the same drug, device, controlled paraphernalia, or other supplies or equipment;","type":"section","prefixes":["A","6"],"prefix":"6","entire_prefix":"A6","prefix_anchor":"A6","level":2,"prior_prefix":"A5","next_prefix":"A7"},"7":{"id":311385,"text":"Vaccines included on the Immunization Schedule published by the Centers for Disease Control and Prevention and vaccines for COVID-19;","type":"section","prefixes":["A","7"],"prefix":"7","entire_prefix":"A7","prefix_anchor":"A7","level":2,"prior_prefix":"A6","next_prefix":"A8"},"8":{"id":311386,"text":"Tuberculin purified protein derivative for tuberculosis testing;","type":"section","prefixes":["A","8"],"prefix":"8","entire_prefix":"A8","prefix_anchor":"A8","level":2,"prior_prefix":"A7","next_prefix":"A9"},"9":{"id":311387,"text":"Controlled substances for the prevention of human immunodeficiency virus, including controlled substances prescribed for pre-exposure and post-exposure prophylaxis pursuant to guidelines and recommendations of the Centers for Disease Control and Prevention;","type":"section","prefixes":["A","9"],"prefix":"9","entire_prefix":"A9","prefix_anchor":"A9","level":2,"prior_prefix":"A8","next_prefix":"A10"},"10":{"id":311388,"text":"Nicotine replacement and other tobacco cessation therapies, including controlled substances as defined in the Drug Control Act (§ 54.1-3400 et seq.), together with providing appropriate patient counseling;","type":"section","prefixes":["A","10"],"prefix":"10","entire_prefix":"A10","prefix_anchor":"A10","level":2,"prior_prefix":"A9","next_prefix":"A11"},"11":{"id":311389,"text":"Controlled substances or devices for the initiation of treatment of the following diseases or conditions for which clinical decision making can be guided by a clinical test that is classified as waived under the federal Clinical Laboratory Improvement Amendments of 1988: group A Streptococcus bacteria infection, influenza virus infection, COVID-19 virus infection, and urinary tract infection; and","type":"section","prefixes":["A","11"],"prefix":"11","entire_prefix":"A11","prefix_anchor":"A11","level":2,"prior_prefix":"A10","next_prefix":"A12"},"12":{"id":311390,"text":"Tests for COVID-19 and other coronaviruses.","type":"section","prefixes":["A","12"],"prefix":"12","entire_prefix":"A12","prefix_anchor":"A12","level":2,"prior_prefix":"A11","next_prefix":"B"},"13":{"id":311391,"text":"Notwithstanding the provisions of \u00a7 54.1-3303, a pharmacist may initiate treatment with, dispense, or administer the following drugs and devices to persons three years of age or older in accordance with a statewide protocol as set forth in regulations of the Board:","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A12","next_prefix":"B1"},"14":{"id":311392,"text":"(Contingent Effective Date) Vaccines included on the Immunization Schedule published by the Centers for Disease Control and Prevention and vaccines for COVID-19; and","type":"section","prefixes":["B","1"],"prefix":"1","entire_prefix":"B1","prefix_anchor":"B1","level":2,"prior_prefix":"B","next_prefix":"B2"},"15":{"id":311393,"text":"(Contingent Effective Date) Tests for COVID-19 and other coronaviruses.","type":"section","prefixes":["B","2"],"prefix":"2","entire_prefix":"B2","prefix_anchor":"B2","level":2,"prior_prefix":"B1","next_prefix":"C"},"16":{"id":311394,"text":"A pharmacist who initiates treatment with or dispenses or administers a drug or device pursuant to this section shall notify the patient’s primary health care provider that the pharmacist has initiated treatment with such drug or device or that such drug or device has been dispensed or administered to the patient, provided that the patient consents to such notification. No pharmacist shall limit the ability of notification to be sent to the patient’s primary care provider by requiring use of electronic mail that is secure or compliant with the federal Health Insurance Portability and Accountability Act (42 U.S.C. § 1320d et seq.). If the patient does not have a primary health care provider, the pharmacist shall counsel the patient regarding the benefits of establishing a relationship with a primary health care provider and provide information regarding primary health care providers, including federally qualified health centers, free clinics, or local health departments serving the area in which the patient is located. If the pharmacist is initiating treatment with, dispensing, or administering injectable or self-administered hormonal contraceptives, the pharmacist shall counsel the patient regarding seeking preventative care, including (i) routine well-woman visits, (ii) testing for sexually transmitted infections, and (iii) pap smears.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B2","next_prefix":"D"},"17":{"id":311395,"text":"A pharmacist who administers a vaccination pursuant to subdivisions A 7 and B 1 shall report such administration to the Virginia Immunization Information System in accordance with the requirements of § 32.1-46.01.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"E"},"18":{"id":311396,"text":"A pharmacist who initiates treatment with, dispenses, or administers drugs, devices, controlled paraphernalia, and other supplies and equipment pursuant to this section shall obtain a history from the patient, including questioning the patient for any known allergies, adverse reactions, contraindications, or health diagnoses or conditions that would be adverse to the initiation of treatment, dispensing, or administration.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D","next_prefix":"F"},"19":{"id":311397,"text":"A pharmacist may initiate treatment with, dispense, or administer drugs, devices, controlled paraphernalia, and other supplies and equipment pursuant to this section through telemedicine services, as defined in § 38.2-3418.16, in compliance with all requirements of § 54.1-3303 and consistent with the applicable standard of care.","type":"section","prefixes":["F"],"prefix":"F","entire_prefix":"F","prefix_anchor":"F","level":1,"prior_prefix":"E","next_prefix":"G"},"20":{"id":311398,"text":"A pharmacist who administers a vaccination to a minor pursuant to subdivision B 1 shall provide written notice to the minor’s parent or guardian that the minor should visit a pediatrician annually.","type":"section","prefixes":["G"],"prefix":"G","entire_prefix":"G","prefix_anchor":"G","level":1,"prior_prefix":"F"}},"ancestry":[{"id":14382,"edition_id":1,"name":"General Provisions","identifier":"1","label":"article","depth":4,"order_by":1,"parent_id":13496,"metadata":{},"date_created":"2026-06-26 03:47:57","date_modified":"2026-06-26 03:47:57","permalink":{"id":243095,"object_type":"structure","relational_id":14382,"identifier":"1","token":"54.1\/III\/33\/1","url":"\/54.1\/III\/33\/1\/","edition_id":1,"permalink":0,"preferred":1}},{"id":13496,"edition_id":1,"name":"Pharmacy","identifier":"33","label":"chapter","depth":3,"order_by":1,"parent_id":12758,"metadata":{},"date_created":"2026-06-26 03:45:04","date_modified":"2026-06-26 03:45:04","permalink":{"id":243093,"object_type":"structure","relational_id":13496,"identifier":"33","token":"54.1\/III\/33","url":"\/54.1\/III\/33\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12758,"edition_id":1,"name":"Professions and Occupations Regulated by Boards Within the Department of Health Professions","identifier":"III","label":"subtitle","depth":2,"order_by":1,"parent_id":12754,"metadata":{},"date_created":"2026-06-26 03:43:51","date_modified":"2026-06-26 03:43:51","permalink":{"id":241105,"object_type":"structure","relational_id":12758,"identifier":"III","token":"54.1\/III","url":"\/54.1\/III\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12754,"edition_id":1,"name":"Professions and Occupations","identifier":"54.1","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:51","date_modified":"2026-06-26 03:43:51","permalink":{"id":239313,"object_type":"structure","relational_id":12754,"identifier":"54.1","token":"54.1","url":"\/54.1\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":72064,"structure_id":14382,"section_number":"54.1-3300","catch_line":"Definitions","url":"\/54.1-3300\/","token":"54.1\/III\/33\/1\/54.1-3300","metadata":false},{"id":77902,"structure_id":14382,"section_number":"54.1-3300.1","catch_line":"Participation in collaborative agreements; regulations to be promulgated by the Boards of Medicine and Pharmacy","url":"\/54.1-3300.1\/","token":"54.1\/III\/33\/1\/54.1-3300.1","metadata":false},{"id":55719,"structure_id":14382,"section_number":"54.1-3301","catch_line":"Exceptions","url":"\/54.1-3301\/","token":"54.1\/III\/33\/1\/54.1-3301","metadata":false},{"id":68342,"structure_id":14382,"section_number":"54.1-3302","catch_line":"Restrictions on practitioners of the healing arts","url":"\/54.1-3302\/","token":"54.1\/III\/33\/1\/54.1-3302","metadata":false},{"id":85347,"structure_id":14382,"section_number":"54.1-3303","catch_line":"Prescriptions to be issued and drugs to be dispensed for medical or therapeutic purposes only","url":"\/54.1-3303\/","token":"54.1\/III\/33\/1\/54.1-3303","metadata":false},{"id":86967,"structure_id":14382,"section_number":"54.1-3303.1","catch_line":"Initiating of treatment with and dispensing and administering of controlled substances by pharmacists","url":"\/54.1-3303.1\/","token":"54.1\/III\/33\/1\/54.1-3303.1","metadata":false},{"id":58623,"structure_id":14382,"section_number":"54.1-3304","catch_line":"Licensing of physicians to dispense drugs; renewals","url":"\/54.1-3304\/","token":"54.1\/III\/33\/1\/54.1-3304","metadata":false},{"id":68921,"structure_id":14382,"section_number":"54.1-3304.1","catch_line":"Authority to license and regulate practitioners; permits","url":"\/54.1-3304.1\/","token":"54.1\/III\/33\/1\/54.1-3304.1","metadata":false}],"previous_section":{"id":85347,"structure_id":14382,"section_number":"54.1-3303","catch_line":"Prescriptions to be issued and drugs to be dispensed for medical or therapeutic purposes only","url":"\/54.1-3303\/","token":"54.1\/III\/33\/1\/54.1-3303","metadata":false},"next_section":{"id":58623,"structure_id":14382,"section_number":"54.1-3304","catch_line":"Licensing of physicians to dispense drugs; renewals","url":"\/54.1-3304\/","token":"54.1\/III\/33\/1\/54.1-3304","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/54.1-3303.1\/","history_text":"

This law was first created in 2020. The record of its establishment is cataloged in chapter 731<\/a> of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. It has been modified 2 times. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. Those modifications are as follows: in 2022, chapters 790<\/a> and 791<\/a>; in 2023, chapters 171<\/a> and 172<\/a>.<\/p>","references":[{"id":77747,"section_number":"32.1-325","catch_line":"Board to submit plan for medical assistance services to U.S. Secretary of Health and Human Services pursuant to federal law; administration of plan; contracts with health care providers","order_by":null,"url":"\/32.1-325\/"},{"id":72064,"section_number":"54.1-3300","catch_line":"Definitions","order_by":null,"url":"\/54.1-3300\/"},{"id":67267,"section_number":"54.1-3321","catch_line":"Registration of pharmacy technicians","order_by":null,"url":"\/54.1-3321\/"}],"refers_to":[{"id":61286,"section_number":"38.2-3418.16","catch_line":"Coverage for telemedicine services","order_by":null,"url":"\/38.2-3418.16\/"},{"id":85347,"section_number":"54.1-3303","catch_line":"Prescriptions to be issued and drugs to be dispensed for medical or therapeutic purposes only","order_by":null,"url":"\/54.1-3303\/"},{"id":77846,"section_number":"54.1-3400","catch_line":"Citation","order_by":null,"url":"\/54.1-3400\/"},{"id":59669,"section_number":"54.1-3401","catch_line":"Definitions","order_by":null,"url":"\/54.1-3401\/"},{"id":76941,"section_number":"54.1-3466","catch_line":"Possession or distribution of controlled paraphernalia; definition of controlled paraphernalia; evidence; exceptions","order_by":null,"url":"\/54.1-3466\/"}],"permalink":{"id":243117,"object_type":"law","relational_id":86967,"identifier":"54.1-3303.1","token":"54.1\/III\/33\/1\/54.1-3303.1","url":"\/54.1-3303.1\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/54.1-3303.1\/","token":"54.1\/III\/33\/1\/54.1-3303.1","dublin_core":{"Title":"Initiating of treatment with and dispensing and administering of controlled substances by pharmacists","Type":"Text","Format":"text\/html","Identifier":"\u00a7 54.1-3303.1","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> Notwithstanding the provisions of \u00a7 54.1-3303<\/a>, a pharmacist<\/span> may initiate treatment with, dispense<\/span>, or administer the following drugs, devices, controlled paraphernalia, and other supplies and equipment to persons 18 years of age or older with whom the pharmacist<\/span> has a bona fide pharmacist<\/span>-patient relationship and in accordance with a statewide protocol developed by the Board<\/span> in collaboration with the Board<\/span> of Medicine and the Department of Health and set forth in regulations of the Board<\/span>: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> Naloxone or other opioid antagonist, including such controlled paraphernalia, as defined in § 54.1-3466<\/a>, as may be necessary to administer such naloxone or other opioid antagonist; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> Epinephrine; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> Injectable or self-administered hormonal contraceptives, provided the patient completes an assessment consistent with the United States Medical Eligibility Criteria for Contraceptive Use; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> Prenatal vitamins for which a prescription is required; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

5.<\/span> Dietary fluoride supplements, in accordance with recommendations of the American Dental Association for prescribing of such supplements for persons whose drinking water has a fluoride content below the concentration recommended by the U.S. Department of Health and Human Services; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

6.<\/span> Drugs as defined in § 54.1-3401<\/a>, devices as defined in § 54.1-3401<\/a>, controlled paraphernalia as defined in § 54.1-3466<\/a>, and other supplies and equipment available over-the-counter, covered by the patient’s health carrier when the patient’s out-of-pocket cost is lower than the out-of-pocket cost to purchase an over-the-counter equivalent of the same drug, device, controlled paraphernalia, or other supplies or equipment; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

7.<\/span> Vaccines included on the Immunization Schedule published by the Centers for Disease Control and Prevention and vaccines for COVID-19; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

8.<\/span> Tuberculin purified protein derivative for tuberculosis testing; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

9.<\/span> Controlled substances for the prevention of human immunodeficiency virus, including controlled substances prescribed for pre-exposure and post-exposure prophylaxis pursuant to guidelines and recommendations of the Centers for Disease Control and Prevention; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

10.<\/span> Nicotine replacement and other tobacco cessation therapies, including controlled substances as defined in the Drug Control Act (§ 54.1-3400<\/a> et seq.), together with providing appropriate patient counseling; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

11.<\/span> Controlled substances or devices for the initiation of treatment of the following diseases or conditions for which clinical decision making can be guided by a clinical test that is classified as waived under the federal Clinical Laboratory Improvement Amendments of 1988: group A Streptococcus bacteria infection, influenza virus infection, COVID-19 virus infection, and urinary tract infection; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

12.<\/span> Tests for COVID-19 and other coronaviruses. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> Notwithstanding the provisions of \u00a7 54.1-3303<\/a>, a pharmacist<\/span> may initiate treatment with, dispense<\/span>, or administer the following drugs and devices to persons three years of age or older in accordance with a statewide protocol as set forth in regulations of the Board<\/span>: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> (Contingent Effective Date) Vaccines included on the Immunization Schedule published by the Centers for Disease Control and Prevention and vaccines for COVID-19; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> (Contingent Effective Date) Tests for COVID-19 and other coronaviruses. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> A pharmacist<\/span> who initiates treatment with or dispenses<\/span> or administers a drug or device pursuant to this section shall notify the patient’s primary health care provider that the pharmacist<\/span> has initiated treatment with such drug or device or that such drug or device has been dispensed or administered to the patient, provided that the patient consents to such notification. No pharmacist<\/span> shall limit the ability of notification to be sent to the patient’s primary care provider by requiring use of electronic mail that is secure or compliant with the federal Health Insurance Portability and Accountability Act (42 U.S.C. § 1320d et seq.). If the patient does not have a primary health care provider, the pharmacist<\/span> shall counsel<\/span> the patient regarding the benefits of establishing a relationship with a primary health care provider and provide information regarding primary health care providers, including federally qualified health centers, free clinics, or local health departments serving the area in which the patient is located. If the pharmacist<\/span> is initiating treatment with, dispensing, or administering injectable or self-administered hormonal contraceptives, the pharmacist<\/span> shall counsel<\/span> the patient regarding seeking preventative care, including (i) routine well-woman visits, (ii) testing for sexually transmitted infections, and (iii) pap smears. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> A pharmacist<\/span> who administers a vaccination pursuant to subdivisions A 7 and B 1 shall report such administration to the Virginia Immunization Information System in accordance with the requirements of § 32.1-46.01<\/a>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> A pharmacist<\/span> who initiates treatment with, dispenses<\/span>, or administers drugs, devices, controlled paraphernalia, and other supplies and equipment pursuant to this section shall obtain a history from the patient, including questioning the patient for any known allergies, adverse reactions, contraindications, or health diagnoses or conditions that would be adverse to the initiation of treatment, dispensing, or administration. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

F.<\/span> A pharmacist<\/span> may initiate treatment with, dispense<\/span>, or administer drugs, devices, controlled paraphernalia, and other supplies and equipment pursuant to this section through telemedicine services, as defined in § 38.2-3418.16<\/a>, in compliance with all requirements of § 54.1-3303<\/a> and consistent with the applicable standard of care. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

G.<\/span> A pharmacist<\/span> who administers a vaccination to a minor<\/span> pursuant to subdivision B 1 shall provide written notice to the minor<\/span>’s parent or guardian that the minor<\/span> should visit a pediatrician annually. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nINITIATING OF TREATMENT WITH AND DISPENSING AND ADMINISTERING OF CONTROLLED\nSUBSTANCES BY PHARMACISTS (\u00a7 54.1-3303.1)\n\nA. Notwithstanding the provisions of \u00a7 54.1-3303, a pharmacist may initiate\ntreatment with, dispense, or administer the following drugs, devices, controlled\nparaphernalia, and other supplies and equipment to persons 18 years of age or\nolder with whom the pharmacist has a bona fide pharmacist-patient relationship\nand in accordance with a statewide protocol developed by the Board in\ncollaboration with the Board of Medicine and the Department of Health and set\nforth in regulations of the Board:\n\n 1. Naloxone or other opioid antagonist, including such controlled\n paraphernalia, as defined in § 54.1-3466, as may be necessary to\n administer such naloxone or other opioid antagonist;\n\n 2. Epinephrine;\n\n 3. Injectable or self-administered hormonal contraceptives, provided the\n patient completes an assessment consistent with the United States Medical\n Eligibility Criteria for Contraceptive Use;\n\n 4. Prenatal vitamins for which a prescription is required;\n\n 5. Dietary fluoride supplements, in accordance with recommendations of the\n American Dental Association for prescribing of such supplements for persons\n whose drinking water has a fluoride content below the concentration\n recommended by the U.S. Department of Health and Human Services;\n\n 6. Drugs as defined in § 54.1-3401, devices as defined in §\n 54.1-3401, controlled paraphernalia as defined in § 54.1-3466, and other\n supplies and equipment available over-the-counter, covered by the\n patient’s health carrier when the patient’s out-of-pocket cost is\n lower than the out-of-pocket cost to purchase an over-the-counter equivalent\n of the same drug, device, controlled paraphernalia, or other supplies or\n equipment;\n\n 7. Vaccines included on the Immunization Schedule published by the Centers for\n Disease Control and Prevention and vaccines for COVID-19;\n\n 8. Tuberculin purified protein derivative for tuberculosis testing;\n\n 9. Controlled substances for the prevention of human immunodeficiency virus,\n including controlled substances prescribed for pre-exposure and post-exposure\n prophylaxis pursuant to guidelines and recommendations of the Centers for\n Disease Control and Prevention;\n\n 10. Nicotine replacement and other tobacco cessation therapies, including\n controlled substances as defined in the Drug Control Act (§ 54.1-3400 et\n seq.), together with providing appropriate patient counseling;\n\n 11. Controlled substances or devices for the initiation of treatment of the\n following diseases or conditions for which clinical decision making can be\n guided by a clinical test that is classified as waived under the federal\n Clinical Laboratory Improvement Amendments of 1988: group A Streptococcus\n bacteria infection, influenza virus infection, COVID-19 virus infection, and\n urinary tract infection; and\n\n 12. Tests for COVID-19 and other coronaviruses.\n\nB. Notwithstanding the provisions of \u00a7 54.1-3303, a pharmacist may initiate\ntreatment with, dispense, or administer the following drugs and devices to\npersons three years of age or older in accordance with a statewide protocol as\nset forth in regulations of the Board:\n\n 1. (Contingent Effective Date) Vaccines included on the Immunization Schedule\n published by the Centers for Disease Control and Prevention and vaccines for\n COVID-19; and\n\n 2. (Contingent Effective Date) Tests for COVID-19 and other coronaviruses.\n\nC. A pharmacist who initiates treatment with or dispenses or administers a drug\nor device pursuant to this section shall notify the patient’s primary\nhealth care provider that the pharmacist has initiated treatment with such drug\nor device or that such drug or device has been dispensed or administered to the\npatient, provided that the patient consents to such notification. No pharmacist\nshall limit the ability of notification to be sent to the patient’s\nprimary care provider by requiring use of electronic mail that is secure or\ncompliant with the federal Health Insurance Portability and Accountability Act\n(42 U.S.C. § 1320d et seq.). If the patient does not have a primary health\ncare provider, the pharmacist shall counsel the patient regarding the benefits\nof establishing a relationship with a primary health care provider and provide\ninformation regarding primary health care providers, including federally\nqualified health centers, free clinics, or local health departments serving the\narea in which the patient is located. If the pharmacist is initiating treatment\nwith, dispensing, or administering injectable or self-administered hormonal\ncontraceptives, the pharmacist shall counsel the patient regarding seeking\npreventative care, including (i) routine well-woman visits, (ii) testing for\nsexually transmitted infections, and (iii) pap smears.\n\nD. A pharmacist who administers a vaccination pursuant to subdivisions A 7 and B\n1 shall report such administration to the Virginia Immunization Information\nSystem in accordance with the requirements of § 32.1-46.01.\n\nE. A pharmacist who initiates treatment with, dispenses, or administers drugs,\ndevices, controlled paraphernalia, and other supplies and equipment pursuant to\nthis section shall obtain a history from the patient, including questioning the\npatient for any known allergies, adverse reactions, contraindications, or health\ndiagnoses or conditions that would be adverse to the initiation of treatment,\ndispensing, or administration.\n\nF. A pharmacist may initiate treatment with, dispense, or administer drugs,\ndevices, controlled paraphernalia, and other supplies and equipment pursuant to\nthis section through telemedicine services, as defined in § 38.2-3418.16,\nin compliance with all requirements of § 54.1-3303 and consistent with the\napplicable standard of care.\n\nG. A pharmacist who administers a vaccination to a minor pursuant to subdivision\nB 1 shall provide written notice to the minor’s parent or guardian that\nthe minor should visit a pediatrician annually.\n\nHISTORY: 2020, c. 731; 2021, Sp. Sess. I, c. 214; 2022, cc. 790, 791; 2023, cc.\n171, 172.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}