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Faxed Cotridin prescriptions: legitimate or forged?

May 12, 2021

What to look for when assessing faxed prescriptions.

Forged Cotridin prescriptions continue to appear in Alberta's pharmacies despite the TPP Alberta form requirement for oral liquids containing codeine. Recently, TPP Alberta reviewed every Cotridin prescription dispensed within the last three months. Multiple prescriptions were then confirmed to be forgeries.

Most forgeries were received by the pharmacy by fax. One of the easiest "red flags" that could indicate a faxed prescription has been forged is the header: make sure the fax number in the header matches the clinic's fax number. If it doesn't, check with the prescriber to confirm. If the prescription is confirmed to be a forgery, report the attempted forgery to ACP and the police.

This is a busy time for pharmacies, but in addition to the COVID-19 pandemic, Alberta continues to deal with the opioid crisis. Validating Cotridin prescriptions is an important step to help prevent drug diversion.

Some observations from TPP Alberta's audit of Cotridin prescriptions and tips for regulated members are as follows:

  • Forged TPP Alberta prescriptions often do not have clinic fax cover sheets included, originator fax numbers do not match that of the clinic, and some originating fax numbers are from out of province.
  • Ensure Netcare is always checked for prescriptions for opioids, regardless of the quantity of the prescription. For more information, refer to the ACP Guidance for Assessment and Monitoring: Individuals using Opioid Medications.
  • As required by Standards of Practice for Pharmacists and Pharmacy Technicians 8.1, always confirm the identity of the patient or their agent when a TPP medication is dispensed.

Odd spelling, quantities, and signatures are some other red flags that pharmacy professionals have noticed when looking at forged prescriptions. Other forgeries may be more difficult to spot but, when in doubt, pharmacists should contact the prescriber to confirm the authenticity of a prescription.

If you do confirm a forgery, remember to report it to the police and to ACP via the Forgery Alerts webpage. Those reports are compiled in a downloadable list available on the ACP website. The reports provide the prescriber’s name, the pharmacy involved, details of the forged prescription, and a brief outline of how the pharmacy determined the prescription was forged. Also, make sure you are signed up for the weekly Forgery Alerts email which will help keep you in the loop on recent forgery activity.


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