Under what circumstances is therapeutic substitution allowed?

Therapeutic substitution is allowed when no brand name is specified and a sign is displayed. This situation indicates that the prescriber has not mandated a specific brand, thus allowing the pharmacist the discretion to provide a different medication that has the same therapeutic effect, usually based on pharmacological considerations. Displaying a sign is essential because it informs patients of their options and the pharmacy's policy on therapeutic substitution.

The absence of a specified brand name implies that the prescriber is open to alternatives, and clearly visible signage supports informed consent from the patient, ensuring they understand the potential changes in their medication.

In contrast, requiring a brand name prohibits therapeutic substitution since the pharmacist must provide the exact product specified. Similarly, therapeutic substitution is not permitted for controlled substances, as these medications are subject to stricter regulations. Additionally, while verbal confirmation from a prescriber can allow for other forms of changes, it does not specifically apply to therapeutic substitutions if there is no brand name given and the proper communicative measures (like signage) are not in place.