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Appendix B of the Poisons and Therapeutic Goods Regulation 2008 (Regulation) lists Schedule 4
substances (prescription-only medicines) that have more stringent controls on possession and supply
because they are liable to abuse, misuse and diversion. These substances are referred to under the
Regulation as special restricted substances, and are more commonly referred to as Schedule 4
Appendix B (S4B) medicines.
S4B medicines are a subset of medicines listed in Appendix D of the Regulation (S4D medicines) and
have more stringent dispensing requirements than other S4D medicines. For more information about
S4D medicines see Schedule 4 Appendix D drugs - Prescribed restricted substances
[https://www.health.nsw.gov.au/pharmaceutical/Pages/sch4d.aspx] .
The following additional restrictions apply to prescribing and dispensing of S4B medicines:
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An electronic prescription for a S4B medicine with repeats must have an interval for repeats,
in the same way as a prescription for a S8 medicine. This includes all electronic prescriptions
in the community. The prescriber must ensure the instruction is entered. If no repeat intervals
appear on the electronic prescription, directions for any repeat supplies are invalid and no
repeats can be dispensed. The pharmacist may only dispense a single supply. The
prescription should be electronically cancelled to prevent a new token from being issued.
Conformant systems retain details of dispensed prescriptions therefore there is no need for a
pharmacist to keep any paper copies of dispensed S4B medicine prescriptions.
References
1. when included in Schedule 4 of the Poisons List* (i.e. when for injection)
2. included in Schedule 4 of the Poisons List*, except when referred to elsewhere in the Appendix
3. except when included in Schedule 6 of the Poisons List* (i.e. when in implants for animals)
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