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How to Prescribe a Medication Off-Label

  • Updated

By default, the medication search on the script pad filters by the patient's species, so a product labeled for a different species won't appear (for example, a canine-labeled product won't show for a feline patient). To prescribe off-label, you remove the species filter to surface the product, then complete the Reason for Overriding Patient Species field that SmartScribe Conflict Detection requires before you can authorize. The same steps apply to any species combination.

Important to Know Before You Start

  • The medication search defaults to the patient's species (shown as a species filter chip, such as Cat or Dog), which hides products labeled for other species.
  • SmartScribe Conflict Detection flags a Patient Species conflict when the product's labeled species differs from the patient (for example, Expected: Dog / Selected: Cat).
  • You must complete the Reason for Overriding Patient Species field before the Authorize button becomes active.
  • Off-label prescribing is a clinical decision; document the justification clearly in the override reason.

How to Prescribe a Medication Off-Label

Step 1: Open the Patient and Start the Rx

  1. From the left navigation, click Client List and select the client.
  2. Open the patient's Patient Profile.
  3. Click Create Rx — from the left navigation, or the Create Rx button in the Products panel on the patient profile.

Step 2: Confirm the Patient (Select Patient)

  1. Confirm the patient and client shown at the top (name, species, breed, sex, age, weight, allergies, medications, health conditions).
  2. Proceed to Select Product.

Step 3: Search and Remove the Species Filter

  1. In Search by name or active ingredient, type the medication name.
  2. Note that with the patient's species filter applied (for example, Cat), a product labeled for another species does not appear.
  3. Click Show Filters, then remove the species filter: click the x on the species chip or use Clear All (you can also change Species Type in the filter drop-down).
  4. With the species filter cleared, search again: products labeled for other species now appear (for example, searching "adequan" for a cat now returns Equine Adequan I.M. and Canine Adequan).

Step 4: Select the Product

  1. Select the appropriate product for the off-label prescription.
  2. A "Conflict: Patient species" notice appears because the product isn't labeled for the patient's species: this is expected for off-label use.
  3. Proceed to Write Prescription.

Step 5: Complete the Prescription

  1. Under Product Details, confirm the Product and select the Strength.
  2. Set Maximum Units Per Fill and Refills.
  3. Confirm the Expiration Date and Client Notification Date.
  4. Under Prescription Notes, enter Directions (use SIG Shortcuts if desired) and any Notes to Client or Notes to Pharmacy.
  5. Select the Authorizing Veterinarian.

Step 6: Complete the Species Override

  1. Under SmartScribe Conflict Detection, review the Patient Species conflict (Expected vs. Selected species).
  2. In the Reason for Overriding Patient Species field, enter the clinical justification (for example, "this is required off label").
  3. Once the reason is completed, the Authorize button becomes active.

Step 7: Authorize and Submit

  1. Click Authorize to issue the prescription (or Save as Draft if you're not ready).
  2. Submit the prescription as normal through the online Rx workflow.

How to Verify

  1. Confirm the prescription shows the off-label product for the patient.
  2. Confirm the Reason for Overriding Patient Species is recorded on the Rx.
  3. Confirm the prescription authorized and moved through the workflow.

Troubleshooting

The medication doesn't appear when you search:

  • The species filter is still applied: click Show Filters and remove the species chip or Clear All, then search again.

The Authorize button is grayed out:

  • Complete the Reason for Overriding Patient Species field: SmartScribe requires it before you can authorize an off-label species.

You see a "Conflict: Patient species" message:

  • This is expected when prescribing off-label: it flags that the product's labeled species differs from the patient. Document the override reason to proceed.

The medication still won't appear after clearing the filter:

  • Confirm the product exists in the catalog and that the override reason is completed; if it persists, contact Covetrus Vet RxPro support.

When to Escalate

  • The medication won't appear after removing the species filter: contact Covetrus Vet RxPro support for help with the integration.
  • The prescription won't authorize even after completing the override reason: contact Covetrus Vet RxPro support.