Pharmacists play an important role in reducing the risks of accidental overdose, misuse, and abuse, associated with BTODs. To help mitigate these risks, pharmacists should:

• Explain how to store BTODs safely out of the sight and reach of all others, especially children.
• Check the patient's prescription profile in the Prescription Drug Monitoring Program, as appropriate, and review all medications (e.g., benzodiazepines, other opioids, CNS depressants) to assess for appropriateness of co-prescribing.
• Keep in mind that a limited supply of BTODs should be dispensed during the initiation of therapy. This is due to the need of prescribers to closely and frequently assess the patients’ needs, their symptoms, and potential risk of misuse, diversion, and abuse.
• Provide the Medication Guide to patients each time the medicine is dispensed and discuss the risks and side effects associated with BTODs, including what to do if patients experience side effects.
• Discuss the availability of naloxone for the emergency treatment of opioid overdose with the patient and caregiver. Inform patients and caregivers of their options for obtaining naloxone.
• If the patient will have naloxone, also advise patients and caregivers:
  • How to treat with naloxone in the event of an opioid overdose.
  • To tell family and friends about their naloxone and to keep it in a place where family and friends can easily access it in an emergency.
  • To read the Patient Information (or other educational material) that will come with their naloxone. Emphasize the importance of doing this before an opioid emergency happens, so the patient and caregiver will know what to do.
• Remind patients who are picking up induction doses to return follow up as directed to the prescriber’s office so that they can be supervised while taking the medication.
• Provide appropriate patient counseling on safe use of BTODs and encourage patients to seek psychosocial counseling and support for safe and effective treatment.
• Be vigilant in detecting fraudulent prescriptions or simultaneous prescriptions for the same patient from multiple prescribers.
• Review the brochure Important Drug Safety Information for Pharmacists for additional information.

Click here for a complete list of products covered under the BTOD REMS.