657—23.11(124,155A) Drugs dispensed—general requirements.
	23.11(1) Labeling. All prescription containers, other than those dispensed pursuant to 657—Chapter 22,  rule 657—23.13(124,155A), or rule 657—23.14(124,155A), shall be properly labeled in accordance with 657—subrule 6.10(1).
	a. 	If a label change is required to reflect a change in directions, the pharmacist shall be responsible for affixing the correct label to the container. Care facility personnel shall not be directed by the pharmacy to affix such a label to the drug container.
	b. 	Direction change labels that notify care facility personnel that a change in directions for the drug has taken place may be used and affixed to the container by facility personnel so as not to deface the original label.
	23.11(2) Medication order required. Dispensing of all drugs to the facility shall be pursuant to a medication order for an individual resident except as provided in rules 657—23.5(124,155A) and 657—23.14(124,155A).
	23.11(3) Prescription containers. All prescription containers utilized for dispensing drugs to a care facility shall meet minimum requirements as established by the United States Pharmacopoeia and 657—Chapter 22. When applicable, light-resistant packaging shall be used.
	23.11(4) Floor stock. Prescription drugs, as defined by Iowa Code section 155A.3(38), shall not be floor-stocked in a care facility except as provided in this subrule or in subrule 23.5(2). Bulk supplies of nonprescription drugs may be maintained as provided in subrule 23.13(3). Any pharmacy that utilizes a floor stock distribution system pursuant to this subrule shall develop and implement procedures to accurately establish proof of use of prescription drugs and shall maintain a perpetual inventory, whether by electronic or manual means, of all prescription drugs so dispensed. A floor stock distribution system for prescription drugs may be permitted only under the following circumstances:
	a. 	A licensed pharmacy under the direct supervision and control of a pharmacist is established in the facility; or
	b. 	The facility and the hospital wherein the licensed pharmacy is located are both licensed under Iowa Code chapter 135B with a single hospital license.
[ARC 2408C, IAB 2/17/16, effective 3/23/16; ARC 3859C, IAB 6/20/18, effective 7/25/18]