Schedule 4 monitored medicines (otherwise known as Schedule 4 Reportable poisons under the Medicines and Poisons legislation) are substances in Schedule 4 which are considered to have a higher risk of patient abuse, misuse and physical or psychological dependence.
Currently, the Western Australian legislation does not have a list included for Schedule 4 monitored medicines but upcoming changes to the Regulations towards the end of the year will list these medicines
They will include:
- all benzodiazepines in S4
- codeine-based preparations in S4
- gabapentin
- pregabalin
- quetiapine
- tramadol
- zolpidem
- zopiclone.
These monitored S4 medicines will be added to ScriptCheckWA so prescribers and pharmacists will have visibility of all prescribing and dispensing.
The current Schedule 8 Medicines Prescribing Code will be updated as Monitored Medicines Prescribing Code. It will include requirements for prescribers to have a documented plan to mitigate potential harms from these medicines in higher risk circumstances, such as for patients who are recorded as a ‘drug dependent person’, patients being prescribed benzodiazepines and opioids concurrently, and patients being treated with monitored medicines by multiple prescribers.
Prescribers will also have an obligation to report a person as a ‘drug dependent person’ if the patient is experiencing substance use disorder associated with a Schedule 4 monitored medicine and may not prescribe Schedule 4 monitored medicines for themselves except in an emergency.
The Medicines and Poisons Regulation Branch website will be updated to reflect the new Regulations once they are in effect.