Pharmacist prescriptive authority has expanded beyond the well-known examples of hormonal contraceptives and naloxone.
PrEP and PEP
Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) for HIV prevention are increasingly within pharmacist authority. California’s SB 815 (effective July 2026) grants pharmacists independent prescribing authority for PrEP and PEP without a CPA. Several other states have similar legislation under consideration or recently passed.
Smoking cessation medications
Several states authorize pharmacists to prescribe or dispense NRT, varenicline, and bupropion for smoking cessation under protocol — typically under a standing order from a state health authority.
Travel health medications
Some states authorize pharmacists to dispense travel health medications — including altitude sickness prophylaxis, traveler’s diarrhea treatment, and malaria prophylaxis — under standing order. This authority is still emerging and varies significantly by state.
Epinephrine auto-injectors
Many states now allow pharmacists to dispense epinephrine auto-injectors without a patient-specific prescription under standing orders for anaphylaxis treatment.
The trajectory
The trend toward expanded pharmacist prescriptive authority is clear and accelerating. For pharmacists, staying current on authority expansions in your practice states creates both clinical opportunities and compliance obligations. Always verify current authority with your state board before initiating therapy under new authority.