Stock control

• Efficient stock control ensures that the right medicine is available at the right place and the right time.
• Efficient stock control ensures that capital is not tied up unnecessarily and protects against problems arising in the supply chain.
• It is good practice to:

– Set stock levels to allow accurate stock holding
– Have a named person responsible for stock control
– Store medicines in a logical order and in their original packaging
– Supply a product leaflet or summary of product characteristics (SPC) with all medicines dispensed
– Dispense medicines with the shortest expiry date first
– Store medicines with the same batch number together.

• The date of delivery from the manufacturers or wholesalers should be recorded, unless this information is on the invoice or delivery note which is retained.
• Packs with damaged or defaced packaging and out-of-date stock should be stored separately whilst awaiting disposal.
• Once stock has been dispensed it should not be accepted back into the medicines store.
• The date of first use of each batch should be recorded.

Premises

• All premises from which veterinary medicinal products (VMPs) are to be supplied must be registered with the Royal College of Veterinary Surgeons (RCVS).

Storage conditions

• Medicines should be stored at the temperature recommended in the SPC, usually under 25oC (ambient room temperature) or between 2oC and 8oC in a refrigerator.
• Any medicine requiring refrigeration should be removed from the delivery cool chain protection as soon as possible and placed in the refrigerator.
• Biological samples and food should not be stored in refrigerators used to hold medicines.
• Ambient temperature should be monitored if it goes out with normal limits for any significant period of time.
• Fridges should be checked daily by a named person and a log made of maximum and minimum temperatures. This log can be recorded on paper or electronically.
• If the refrigerator temperature goes outside 2–8oC, information should be sought from the manufacturer(s) as to the safety of the medicine(s) for use and the new expiry date(s).
• Cars should be fitted with refrigeration units and the temperature of these should be checked daily.
• To protect medicines from extremes in humidity, autoclaves should not be used in the medicines store.
• Many medicines are sensitive to light, so blinds should be fitted at any windows and medicines should be stored in their outer protective containers.
• Flammable medicines must be stored in an appropriate flammables cupboard, preferably situated on the floor to prevent breakages.

Return of medicines

• As correct storage conditions (and therefore safety and efficacy) of medicines returned by owners cannot be guaranteed, such medicines should be disposed of and not accepted back into stock.
• Medicines supplied for animals on the premises can be accepted back into stock, providing the storage conditions are known to be acceptable.
• Returns to wholesalers should be completed as soon as possible. There may be restrictions on such returns as returned VMPs are usually destroyed.

Expiry dates

• A named person should be in charge of date-checking the medicines store once a month.
• A log should be kept of this check.
• Short-dated stock should be marked as such and brought to the front of the shelf to be used first.
• Any stock that has gone out of date should be separated and recorded before destruction.
• Multi-dose vials should be marked with the date of first opening and the date of expiry. Bright stickers can be useful to draw attention, but all multi-dose vials with an in-use shelf-life now have a space to write this information. Any drug left in the vial after the specified time must be discarded.
• Any medicine remaining in a single-use ampoule should be discarded once the required dose has been withdrawn.
• Administering a medicine that is past its expiry date or obscuring the expiry date is an offence.

Labelling

• Unless the prescribing veterinary surgeon administers the VMP themselves, it should be labelled.
• Administration of the medicine, even if not performed by the prescribing veterinary surgeon, remains the responsibility of the veterinary surgeon.
• The supplier has a responsibility to ensure that the owner understands any instructions from the prescribing veterinary surgeon.

Containers

• Medicines should be stored in their original packaging with the lid tightly closed.
• Where possible, medicines should be dispensed in their original container.
• If a medicine is repacked or prepared extemporaneously, it should be placed in a container suitable for the medicine and the user.
• All containers should be stored in such a way that they remain free from contaminants.
• Suitable containers for solid dosage forms include paper envelopes, paperboard wallets, paperboard boxes and glass/plastic amber bottles.
• Paper wallets and plastic bags are only suitable as containers for blister packs and should not be used as the sole packaging.
• Liquid preparations should be dispensed in amber bottles.
• Bottles containing topical preparations should be fluted to allow recognition by touch.
• This requirement does not apply to containers over 1.14 litres or to pre-packaged eye/ear drops.
• Some tablets or capsules are adversely affected by moisture and are supplied with a desiccant. This desiccant should not be dispensed; the quantities and packaging of such medicines should be such that deterioration after supply is prevented.
• Medicines sensitive to light should be supplied in suitably opaque or coloured containers.
• Creams, ointments, powders, granules, dusting powders, etc., should be dispensed in glass or plastic wide-mouthed jars.

Personnel

• All those involved in the supply of medicines should be suitably trained.
• A pharmacy manual should be prepared containing standard operating procedures and Control of Substances Hazardous to Health (COSHH) assessments. This manual should be available to, and read by, all those involved in dispensing medicines.
• One person should be responsible for ensuring that the legal requirements, safety assessments and best practice procedures are carried out.
• Medicines should only be administered by a suitably competent person or under the supervision of a veterinary surgeon.
• A high standard of personal cleanliness is required and hands should be washed regularly.
• Any infections or open wounds should be reported to the responsible person. Open wounds must be covered at all times when dispensing VMPs.
• Protective clothing should be worn when recommended in the COSHH assessments, and staff should avoid direct contact with all medicines, including tablets, either by wearing gloves or by using a tablet counter and spatula.

Advertising

• ‘Advertising’ means the provision of any information on the medicine, including prices, summary of product characteristics (SPC) leaflets, advertisements in journals/magazines and materials from the manufacturer or its representative including electronic data.
• It is an offence to advertise a VMP if the advertisement is misleading or contains a medicinal claim that is not in the SPC.
• It is an offence to advertise an authorized human medicine for administration to an animal, except when wholesalers supply a price list of, or including, authorized human medicines at the request of a veterinary surgeon.
• VMPs available only on prescription can not be advertised except in the following circumstances:
  – In the case of medicines containing psychotropic drugs or narcotics, the advertisement is aimed at veterinary surgeons or pharmacists
  – In the case of POM-V medicines, the advertisement is aimed at veterinary surgeons, pharmacists, veterinary nurses or professional keepers of animals
  – In the case of POM-VPS medicines, the advertisement is aimed at veterinary surgeons, pharmacists, suitably qualified persons (SQPs), veterinary nurses or professional keepers of animals.
• It is accepted that advertisements in professional journals, newsletters and websites, etc. may be read by those other than the target audience.
• These regulations do not apply to price lists displayed in veterinary practices.
• Publications for health education are not considered advertising, provided that there is no promotion other than the name of the company and medicine.
• There are no restrictions on the advertising of NFA-VPS or AVM-GSL medicines.There are no restrictions on veterinary surgeons providing information to clients during a consultation.