Understanding Pharmacy Lingo: What is DNF on Prescriptions?

It is estimated that adherence to chronic medications is around 50%, even though rates of 80% or more are often needed for the best results. One term patients might encounter that affects access is DNF. So, what is DNF on prescriptions? It stands for 'Do Not Fill'.

Quick Summary

DNF, or 'Do Not Fill,' is an instruction from a prescriber to a pharmacist not to dispense a medication until a specified future date. This is common for controlled substances to ensure medication safety.

Key Points

• What DNF Means: DNF stands for 'Do Not Fill,' an instruction from a prescriber to a pharmacist not to dispense a medication until a specific date.

• Primary Use: It is most often used for managing Schedule II controlled substances, which cannot be refilled, by allowing a doctor to issue multiple scripts at once with future fill dates.

• DNF vs. Refusal: A DNF date is a planned instruction from a doctor, whereas a pharmacist's refusal to fill is based on professional judgment regarding safety, validity, or other concerns.

• Pharmacist's Role: Pharmacists have a legal and ethical responsibility to verify the legitimacy and safety of all prescriptions before dispensing.

• Patient Actions: If a prescription is marked DNF, wait for the date. If a pharmacist refuses to fill it, ask for the reason, contact your doctor, and if necessary, try another pharmacy.

• Insurance Issues: Many prescription rejections are due to insurance requirements like prior authorizations or non-formulary medication status.

• Safety is Paramount: Reasons for refusal often relate to patient safety, such as potential drug interactions, incorrect dosages, or suspected alterations to the script.

Decoding Prescription Instructions

In the complex world of healthcare, prescriptions come with their own language of abbreviations and instructions. One such instruction is 'DNF,' which stands for 'Do Not Fill'. This directive from a healthcare provider indicates that a valid, signed prescription should not be dispensed until a specified future date. This practice is common with controlled substances, especially Schedule II drugs, where federal law prohibits refills. By using multiple prescriptions with sequential DNF dates, doctors can provide a continuous supply (e.g., a 90-day supply via three 30-day prescriptions) without requiring monthly visits, while preventing early refills. This is distinct from illegal post-dating.

Why Would a Prescription Be Marked DNF?

A prescriber uses a DNF date primarily to manage controlled substances safely. This allows for a legitimate medical need to be met while preventing misuse and abuse. For example, a patient needing monthly medication might receive three separate prescriptions at one appointment. The first can be filled immediately, while the others have 'Do not fill until...' dates. The DEA supports this practice, provided it complies with state laws. Electronic prescribing systems often have a dedicated field for prescribers to enter a 'Do Not Fill Before' date.

Pharmacist's Discretion and Reasons for Refusal

A pharmacist can also independently decide not to fill a prescription for professional and safety reasons, known as exercising professional judgment. Pharmacists have a responsibility to ensure every prescription is valid and for a legitimate medical purpose.

Reasons a pharmacist might refuse to fill a prescription include:

• Suspected Forgery or Alteration: If a prescription seems changed, damaged, or lacks security features.
• Safety Concerns: If it could cause harmful drug interactions, is an excessive dose, or if the patient has a known allergy.
• Illegible or Incomplete Information: Missing or unreadable information like the doctor's signature, drug strength, or quantity.
• Insurance Rejection: Issues such as needing prior authorization or the medication not being covered.
• Out of Stock: Due to drug shortages or supply issues.
• Conscience or Personal Beliefs: In some states, pharmacists can refuse based on personal objections, although they may need to refer the patient elsewhere.

DNF vs. Other Pharmacy Rejections

It's important to distinguish a prescriber-initiated DNF from a pharmacist's refusal or an insurance rejection. A DNF date is a planned instruction, while other rejections require resolution.

Rejection Type	Primary Cause	Initiator	Patient Action
Do Not Fill (DNF) Until	To control dispensing schedule, especially for controlled substances.	Prescriber	Wait until the specified date to fill the prescription.
Refill Too Soon	Patient attempts to refill a prescription before the allowed time has passed per insurance or pharmacy policy.	Pharmacy/Insurance	Wait until the eligible date for a refill.
Prior Authorization (PA) Required	Medication requires pre-approval from the insurance company.	Insurance Company	Contact the prescriber's office to initiate the PA process with the insurer.
Pharmacist Refusal	Professional judgment flags a safety, validity, or legal concern.	Pharmacist	Speak with the pharmacist to understand the reason and contact the prescriber if needed.

What Should a Patient Do?

If your prescription has a DNF date, wait for that date. If a pharmacist refuses to fill it for other reasons, communication is crucial.

1. Ask for Clarification: Politely ask the pharmacist why the prescription can't be filled. It might be a resolvable issue like an insurance problem.
2. Contact Your Doctor: If the issue needs the prescriber's help (e.g., prior authorization), contact your doctor's office.
3. Explore Other Options: If the pharmacy is out of stock, ask if they can transfer the prescription. If the refusal is due to personal beliefs, ask if another pharmacist can fill it or go to a different pharmacy.
4. File a Complaint: If you believe the refusal was unfair, you can file a complaint with the state's Board of Pharmacy.

Understanding 'DNF' and the reasons for prescription refusals helps patients navigate the system, ensuring they receive their medication safely and on time. Resolving these issues promptly is vital, as not taking medication as prescribed can lead to poor health outcomes.

---

For more information on prescription drug regulations, you can visit the DEA Diversion Control Division.

Frequently Asked Questions

What does DNF stand for on a prescription?

DNF stands for 'Do Not Fill.' It is a directive from a prescriber to the pharmacy to not dispense the medication until a specified future date.

Is a 'Do Not Fill' date legal for prescriptions?

Yes, the DEA has authorized the practice of issuing multiple prescriptions for a controlled substance with 'Do Not Fill until' dates, provided it complies with state law. It is considered different from illegal post-dating.

Why would a doctor put a DNF date on my prescription?

Doctors use DNF dates primarily to manage the supply of controlled substances (like Schedule II drugs) that cannot have refills. This allows them to give you a 60 or 90-day supply via multiple individual prescriptions while ensuring you don't fill them all at once.

Can a pharmacist refuse to fill a prescription even if it doesn't have a DNF date?

Yes, pharmacists can and must use their professional judgment. They can refuse to fill a prescription if they have concerns about its legitimacy, patient safety (e.g., drug interactions, incorrect dose), or if it appears altered.

What should I do if my pharmacist won't fill my prescription?

First, ask the pharmacist for the reason. If it's an issue like needing a prior authorization, contact your doctor's office. If it's a stock issue, ask if they can order it or transfer the script. You also have the right to take your prescription to a different pharmacy.

Is 'DNF' the same as 'Refill Too Soon'?

No. A 'DNF' date is a future fill date set by the prescriber. A 'Refill Too Soon' rejection comes from the pharmacy or insurance company because you are trying to get a refill before the allowed time has passed on your current supply.

Does DNF apply to all medications?

While it can technically be used for any medication, the DNF instruction is most commonly and importantly used for Schedule II controlled substances because federal law prohibits them from being refilled.