1. (1) A physician should not prescribe, order or dispense a controlled substance for the purpose of weight reduction or treatment of obesity in an amount greater than a thirty-five (35) day supply.
2. (2) Within the first thirty-five (35) days following initiation of a controlled substance for the purpose of weight reduction or treatment of obesity, the patient should be seen by the prescribing physician, a physician assistant supervised by the prescribing physician, or a certified registered nurse practitioner collaborating with the prescribing physician, and a recording should be made of weight, blood pressure, pulse, and any other tests which may be necessary for monitoring potential adverse effects of drug therapy.
3. (3) Continuation of the prescribing, ordering, dispensing or administering of a controlled substance to a patient for the purpose of weight reduction or treatment of obesity should occur only if the patient has continued progress toward achieving or maintaining medically established goals and has no significant adverse effects from the medication.
4. (4) A patient continued on a controlled substance for the purpose of weight reduction or treatment of obesity should undergo an in-person re-evaluation at least once every thirty-five (35) days. Once medically established goals have been met for an individual patient, it is strongly recommended that reduced dosing and drug holidays be implemented for those patients who need maintenance medication.
5. (5) If the re-evaluation is delegated to a physician assistant or certified registered nurse practitioner, then the prescribing physician should personally review the resulting medical records prior to the continuance of the patient on a controlled substance for the purpose of weight reduction or treatment of obesity.

6. (6) For the prescribing of only non-controlled drugs for the weight reduction or the treatment of obesity, the following applies:

   1. (a) Five (5) refills of non-controlled drugs for weight reduction or the treatment of obesity are allowed after an initial prescription and one follow up visit for an in-person re-evaluation. The five (5) refills shall not extend past a period of six (6) months from the date of issue of the original prescription.
   2. (b) Continued prescribing/refills of non-controlled drugs for weight reduction or the treatment of obesity must occur in accordance with any Risk Evaluation and Mitigation Strategy (REMS) required by the Federal Food and Drug Administration (FDA).
   3. (c) Refills allowed pursuant to this rule are specific for non-controlled drugs for weight reduction or the treatment of obesity. This rule in no way amends, alters, or applies to the refilling of individual prescriptions for controlled substances.

Author: Alabama Board of Medical Examiners

Statutory Authority: Code of Ala. 1975, §34-24-53.

History: New Rule: Filed December 16, 2011; effective January 20, 2012. Amended: Filed March 21, 2013; effective April 25, 2013. Amended: Filed August 21, 2014; effective September 25, 2014. Amended: Filed April 15, 2016; effective May 30, 2016. Amended: Published August 31, 2020; effective October 15, 2020.