Labeling of Repackaged Medications

Purpose/ Applicability: To describe the procedure of labeling repackaged medications to be compliant with the Illinois Veterinary Practice Act

Scope: Applies to all repackaging within the VTH, VMSC, WMC and MWE.

Definition(s): 

• HIS: Health Information System

• Repackaged medication: A drug or medication removed from the original manufacturer’s container and placed into another container such as a pill bottle or unit dose packaging.

• Prescription label compliant with the Illinois Veterinary Practice Act: A label containing, at a minimum, the following information:

  • • Date on which the medication is dispensed
    • The name of the owner
    • The last name of the person dispensing the medication (e.g., the prescribing doctor)
    • Directions for use including dosage and quantity
    • The proprietary or generic name of the drug

Equipment: 

• Wasp label generator (unit-doses)

• Unit dose foam packer, roller, and dispensing containers

• Appropriately sized labels for use

• Printer

Policy (General):

All repackaged medication will be labeled with a prescription label compliant with the Illinois Veterinary Practice Act if being prescribed for a specific patient OR the following information if being repackaged for convenience in anticipation of future prescriptions.

• Drug name (generic or brand name), dosage form, and strength
• Date of repackaging
• Quantity of medication(s) in the new container
• Expiration date stated on the manufacturer’s original packaging
• Lot number stated on the manufacturer’s original packaging

If the medication is repackaged without a compliant prescription label, tamper-proof tape will be placed over the top to indicate unopened bottles.

The responsibility for ensuring all repackaged products are labeled in a compliant manner will fall to the person doing the repackaging.

Procedure (Repackaging chemicals):

1. Any repackaged chemical must have a GHS (Global Harmonized System) label with the name of chemical (strength or dilution if known) and marked with any known danger or warning hazards. Place clear tape over the GHS label so it does not rub off.
   1. GHS stickers and examples available outside the Medication Dispensary
2. Document the date of the repackage and expiration date (if applicable)
   
   

Procedure (Farms):

1. Doctor or Pharmacist enters a prescription in Vetstar and will pin them off the appropriate worklists. Printed labels will be printed to either the Large Animal label printer or the label printer in the Medication Dispensary. Once labels are printed, please affix them to the repackaged package.
   1. For the following, labels are available for reprinting through the Medication Dispensary
      1. Alkalosis
         1. 150 GM NaCl [Sodium Chloride]
         2. 20 GM KCL [Feed Grade]
         3. 10 GM CaCl [Calcium Chloride]
         4. Mix in S/M Whirlpacks. Add to 5GAL water - Give PO
      2. Acidosis
         1. 100 GM NaCl [Sodium Chloride]
         2. 30 GM KCL [Feed Grade]
         3. 100 GM NaBicarb [Sodium Bicarbonate]
         4. Mix in S/M Whirlpacks. Add to 5GAL water - Give PO
      3. Calcium Propionate
         1. 1.5 LB Calcium Propionate     WEAR MASK
         2. 100 GM KCL [Feed Grade]
         3. 200 GM MgSO4
         4. Add to at least 1.6GAL water – Give PO
      4. Sodium Bicarbonate
         1. 26 GM Baking Soda
2. Repackaged product will expire 1 year from the date repackaged, or prior if ingredient(s) expires before the 1 year mark. If an ingredient has a prior expiration date, then the prescription label “Discard after” must be crossed out and the true expiration date must be written. Adjust any other default labels to true expiration date.3. The process of verifying all ingredients are good for at least one year from repackaging will fall with the technician doing the repackaging.

Procedure (Equine):

1. Technician completing the repackaging will generate prescription labels utilizing the Zebra Software in LAC.  Labels must contain the following information:
   1. All ingredients and their quantities listed in the directions section of the label
   2. The common name of the product repackaged (e.g., electrolyte pack)
   3. The date repackaged as the dispensing date
   4. The expiration date (1 year from the date repackaged)
2. Once labels are printed, affix them to the repackaged product.
3. Repackaged product will expire 1 year from the date repackaged, or prior if ingredient(s) expires before the 1 year. If an ingredient has a prior expiration date, then the repackaged product will expire at the earliest ingredient expiration date.
4. The process of creating the labels and verifying all ingredients are good for at least one year from repackaging will fall with the technician doing the repackaging.

Procedure (Allergens):

1. Allergens are prepared and dispensed by the dermatology service
2. Patients will be tested for allergies and those items that they are allergic to will be drawn up in appropriate quantities to allow for immunotherapy processes to occur
3. Service will put in a prescription label using “RxOut” with the ingredients contained within the allergy shot and pick up the label from the Medication Dispensary
4. Repackaged products will have the label(s) affixed to them and will be placed within a brown bag and transferred up to the SAC front desk refrigerator for pickup

Procedure (Combined Medications):

1. When mixing multiple medications into a single container, or creating dilutions, services must review the planned mixture with a pharmacist to ensure it is chemically stable.  Each mixture will have a determined expiration date from date of mixture.
2. The person combining the medications is responsible for labeling the vial/bottle with all ingredients, the quantity of each ingredient, the date mixed and the expiration date.