NY MPJE 2026 Updates: Controlled Substances, Prescriptions, and Pharmacy Regulations

What is the mandatory substitution rule in NY when a generic is unavailable?

Pharmacist must wait for the generic or contact prescriber for a DAW-1.

What is required labeling for all controlled substances (CII-CV) in NY?

Specific orange label or label with an orange background/header.

Can an out-of-state NP (not registered in NY) prescribe amoxicillin to a NY pharmacy?

Yes, if they are authorized to prescribe in their home state.

Do pharmacy interns count toward the 1:4 pharmacist-to-unlicensed personnel ratio?

No, interns are excluded from this supervision ratio.

What is the 2026 update on prescription transfers for non-controlled substances?

Pharmacists must transfer all authorized refills upon request, not just one.

What code is required for a 90-day supply of Adderall (ADHD) in NY?

Code B.

Can a pharmacy stay open during a pharmacist's meal break?

Yes, if the pharmacist stays on the premises for emergencies.

What is the 2026 minimum age for pharmacist-administered flu/COVID vaccines under standing order?

2 years old.

Who can receive oral prescriptions over the phone in NY?

Only a pharmacist or a pharmacy intern.

What is the preferred date for biennial controlled substance inventory in NY?

May 1st of odd-numbered years.

What is the record-keeping duration for all NY pharmacy records?

5 years (stricter than federal 2-year rule).

How many times can a CIII-CV prescription be transferred?

One time (unless pharmacies share a real-time database).

What is the status of a paper prescription for Lisinopril on plain white paper?

Invalid; NY mandates electronic prescribing (exceptions require serialized ONYSO forms).

Is a silent waiver/clipboard signature sufficient for counseling on new scripts?

No; NY requires a face-to-face, in-person offer by the pharmacist or intern.

What is required for selling 10 hypodermic syringes without a prescription?

Must be 18+ and provided with a mandatory educational safety insert.

What is the limit for controlled substances in a nursing home EMK?

10 items, with at least 3 in injectable form.

What is the expiration of a CIV prescription (e.g., Ativan) with 5 refills?

6 months from the date of issuance.

Can a prescription for a partner's STI treatment be filled without a name?

Valid if labeled 'EPT' or 'Expedited Partner Therapy.'

What is the minimum sensitivity required for a pharmacy weighing device/balance?

6 mg.

What is the initial fill limit for opioids for acute pain?

7-day supply.

Can an intern counsel on a new medication?

Yes, under direct supervision of a pharmacist.

What is the medication term for a product that is moldy, wet, or decomposed?

Adulterated.

What is the minimum square footage for a NY pharmacy department?

300 square feet.

Is a pharmacist legally mandated to check I-STOP before every fill?

No; the legal mandate applies to the prescribing practitioner.

What labeling is required for a brand name product when a patient insists?

Label with brand name and charge brand price.

Can an unfilled C4 prescription be transferred?

No; it must be filled at least once at the originating pharmacy.

What is the violation when a tech performs a complex dosage calculation?

Professional conduct violation; calculations are professional/clinical duties.

What is required for pharmacist-administered Shingrix vaccine to an adult?

Non-patient-specific regimen (standing order).

What is the opioid limit for a 10-year-old child's acute dental pain?

7-day supply (the acute pain limit applies regardless of age).

How often must a pharmacy renewal registration occur?

Every 3 years.

Can a NY pharmacist fill a C2 from Pennsylvania on a standard PA pad?

Yes (out-of-state practitioners are exempt from NY's serialized form requirement).

What happens if the sign line says 'substitution permissible' but the body says 'Brand Medically Necessary'?

Dispense brand (handwritten BMN acts as a DAW-1).

What is the status of C2 invoices/DEA 222s from 4 years ago during an audit?

Must be available; NY requires 5 years of records.

What is the required aux label unique to NY for controlled substances?

'Controlled substance, dangerous unless used as directed.'

Can an unlicensed clerk pull a stock bottle for a technician?

No; clerks cannot physically touch the medication/stock (counting/pouring).

What is Code C for in NY?

Chronic or intractable pain (allows for 90-day supply).

What is the definition of Misbranding?

Label is false/misleading (e.g., incorrect strength listed on label vs. bottle).

What is the physical requirement for a pharmacy when no pharmacist is present?

Floor-to-ceiling partition must be locked.

What is the restock deadline for a nursing home EMK after it's opened?

24 hours.

What is the expiration date for a C2 prescription in NY?

30 days from the date of issuance.

What is the mandatory temperature for medication refrigerators?

2°C to 8°C (36°F to 46°F).

What is the consent rule for reporting adult RSV vaccine to NYSIS?

Consent is mandatory for adults 18+; reporting is mandatory for those under 19.

What is Code F for?

Anabolic steroids/male hormone deficiency (allows up to 180-day supply).

Can a pharmacist add a patient's address to a C2 prescription?

Yes, after verifying with the patient.

What is the ratio violation for 1 pharmacist, 3 technicians, and 1 clerk?

Violation; max of 2 registered technicians in the 1:4 unlicensed ratio.

Who oversees pharmacist licensing and professional conduct in NY?

The New York State Board of Pharmacy.

What does the PMP/I-STOP registry track?

C2, C3, and C4 controlled substances dispensed in NY.

What is the status of a 12-syringe purchase without a prescription?

Illegal; non-prescription sales are limited to 10 syringes.

What is Code A for?

Panic disorders.

What is the reporting time for immunizations for patients

Within 14 days.

Can an intern count C2 tablets?

Yes, under direct supervision.

What is the record requirement for non-resident (out-of-state) pharmacies shipping to NY?

Must be registered with the NYS Board of Pharmacy.

What does 'Copy' marked on a script given to a patient indicate?

Must be clearly marked 'For information purposes only.'

What is Code E for?

Narcolepsy.

What is the deadline to notify NYSED of a change of name or address?

30 days.

What is the emergency oral C2 limit in NY?

5-day supply.

Who can sign for a C2 shipment (DEA 222/CSOS)?

Only the registrant or Power of Attorney (POA) holder.

What is the opioid limit for acute postsurgical pain?

7-day supply.

What is the filing requirement for C2 invoices?

Must be filed separately from all other records.

What is the medication guide requirement for monthly maintenance meds?

Must be provided every time the medication is dispensed.

Can a pharmacist add a missing date to a C2?

No; date of issuance is a core element and cannot be added/changed.

What does a 'Void' pantograph visible on a paper C2 indicate?

Indicates it is a photocopy and not a valid original.

What is the refill limit for a C3 with Code B for a 90-day supply?

Only 1 refill (total supply cannot exceed 180 days).

What is the requirement for non-sterile compounding supervision?

Pharmacist must be in the immediate vicinity to supervise the physical preparation.

What is the minimum area for a grandfathered pharmacy registered before 1980?

May be allowed to operate under 300 sq ft if continuously registered.

What is the reporting requirement for pseudoephedrine sales in NY?

Must be kept for 5 years (stricter than federal).

Can a clerk hand out a new prescription at a drive-thru?

Only if the pharmacist has already made the face-to-face offer to counsel.

Is naloxone available without an individual prescription?

Yes, via the NY statewide standing order.

Who oversees USP 797 sterile compounding compliance in NY?

NY explicitly follows USP standards for compounding.

What is the status of a non-controlled script from 2021 with refills?

Expired; non-controlled scripts are valid for 1 year from issuance.

Can a pharmacist call to clarify an ICD-10 code for a C2?

Yes, and they may add/clarify Codes A-F with oral authorization.

What is the required garbing for sterile compounding in NY?

Must follow USP 797 (gown, mask, gloves, and hair cover).

Can a pharmacy dispense more than a 30-day supply of a C3 for vacation?

Generally no; supply >30 days requires an A-F code from the prescriber.

What is the status of a drive-thru signature as a counseling waiver?

Invalid for new prescriptions; counseling offer must be proactive/face-to-face.

What is required for the sale of pseudoephedrine to a Florida resident in NY?

Valid if follow federal/state tracking and record for 5 years.

What does it mean if a label says Brand, but the bottle contains Generic?

Misbranded.

What is the violation if a pharmacist's desk is located outside the partition?

Violation; all pharmacy operations/drugs must be within the floor-to-ceiling partition.

What is the refill limit for C3 and C4?

Max 5 refills.

Can an intern initial an oral prescription they took?

Yes.

Who can resolve a DUR drug interaction alert?

Only a pharmacist or intern can perform clinical interpretation of DUR alerts.

What is the filing requirement for pseudoephedrine logs?

5 years.

What is required on the label for STI Expedited Partner Therapy?

Partner name not required; label with 'EPT' or 'Expedited Partner Therapy.'

What is the maximum number of unlicensed staff per pharmacist if no techs?

4 clerks.

What is Code D for?

Chronic pain or conditions expected to last >3 months.

What is the status of a 72-hour fast supplement inquiry?

Pharmacist context: Verify ingredients for caloric/fast-breaking impact (user preference).

What is the label requirement for testosterone gel in NY?

Orange label with 'Controlled substance, dangerous unless used as directed.'

What is the rule regarding the transfer of all refills for Leinipril (2026 rule)?

Mandatory for non-controlled substances.

Can an out-of-state pharmacy ship to NY without a toll-free number?

No; must provide a toll-free number for patient access to a pharmacist.

What is the required sensitivity for a balance in a community pharmacy?

6 mg.

Can a clerk enter patient history?

Yes (non-clinical data entry).

What is the prescription limit for 90 days of Vicodin with Code C?

Permissible for debilitating chronic pain.

What is the violation if a tech weighs active ingredients while the pharmacist is at lunch?

Violation; tech cannot compound without immediate supervision.

What is the maximum day supply for C2 for acute pain?

7 days.

What is the requirement for a pharmacist to leave the building?

Pharmacy must be closed and partitioned.

What is the expiration of C3 with 5 refills?

6 months.

Can an intern receive a phoned-in C4?

Yes.

What is the reporting requirement for controlled substance theft/loss?

Report to BNE and DEA.

What must the transferring pharmacist record according to the 2026 rule?

Receiving pharmacist's name and receiving pharmacy info.

What is the difference between Adulteration and Misbranding?

Adulteration = product itself (filthy/moldy); Misbranding = label/container (wrong info).

What is the core focus for passing the NY MPJE?

Repetition of numbers, codes (A-F), and 2026 5-year record-keeping rules.