What should be done if a practitioner specifies a manufacturer on a prescription?

• A. The pharmacist must not interchange the drug.
• B. The pharmacist should interchange with any other manufacturer unless patient objects.
• C. Interchange is allowed if the cost is lower.
• D. Interchange is allowed if prescriber approves over the phone.

Answer: (A)

When a prescription specifies a particular manufacturer, the pharmacist must not substitute another brand or a generic. The instruction to use that exact manufacturer signals that the prescriber intends a specific drug product, with its unique formulation, excipients, and potentially patient-specific considerations. Substitution is only appropriate if the prescriber explicitly allows it (or if local policy permits generic substitution when no brand is specified). If that manufacturer isn’t available, the correct step is to contact the prescriber for guidance or a new prescription rather than substituting. Cost savings or offhand phone approvals do not override the prescriber’s specified manufacturer.