The Maine Board of Licensure in Medicine, Board of Osteopathic Licensure, State Board of Nursing, and Board of Pharmacy have adopted guidance for their licensees regarding prescribing hydroxychloroquine, chloroquine, and azithromycin for prophylactic purposes in response to the COVID-19 outbreak.

These statements are in response to reports nationally and in Maine, that health care providers with prescriptive authority are prescribing these medications for themselves, family members or for patients without a COVID-19 diagnosis, which may lead to stockpiling of medication, inappropriate use and potential drug shortages for patients with a legitimate need.

"I am grateful to the Boards for their quick action to address the importance of adherence to evidence-based prescribing of medications during the COVID pandemic" said Dr. Lisa Letourneau, DHHS Senior Advisor. The Boards play an essential role in protecting patients by assuring that their licensees maintain high standards of care, especially during this health emergency.

For Prescribers (Physicians, Physician Assistants and Advanced Practice Registered Nurses with Prescriptive Authority):

• Prescribing for self or family is considered unethical and unprofessional (except in acute or emergency circumstances)

• Prescribing chloroquine, hydroxychloroquine, and azithromycin for prophylactic purposes in response to the COVID-19 outbreak may be considered unprofessional conduct, may negatively impact drug supplies impacting the health of existing patients who are established on these medications for treatment of their disease, and may lead to improper use which can cause patient harm.
• Prescribers are reminded to prescribe appropriately and to consider medication side effects, drug interactions, contraindications, and appropriate monitoring requirements (e.g. laboratory and cardiac testing). Meeting appropriate monitoring requirements for patients may be limited or restricted during this pandemic. You must exercise sound professional judgment and adhere to evidence-based standards of practice in making your prescribing and treatment decisions.

For Pharmacists:

• Pharmacists should use their professional judgment to verify that prescriptions for chloroquine, hydroxychloroquine, and azithromycin are issued for legitimate medical purposes and not for prophylactic treatment unless consistent with prescribing guidelines of the Food and Drug Administration and the Centers for Disease Control and Prevention.

• To prevent drug shortages, pharmacists should contact prescribers to confirm the diagnoses of patients newly prescribed these medications, and pharmacies should refrain from inappropriately stockpiling these medications.
• A prescription for these medications for purposes of treating COVID-19 should contain a diagnosis code of an active or presumed case of COVID-19 and be limited to a 14-day supply.
• Pharmacists should continue to fill prescriptions for up to 90-day supplies for patients who have existing prescriptions for any of these medications for treatment of conditions other than COVID-19.

Each of the board's statements is effective immediately. The statements can be read in their entirety at these links:

Joint">https://www.maine.gov/md/sites/maine.gov.md/files/inline-files/Joint%20Statement.pdf">Joint Statement of the Board of Osteopathic Licensure and the Board of Licensure in Medicine

Maine">https://www.maine.gov/boardofnursing/news.html?id=2400450">Maine State Board of Nursing

https://www.maine.gov/pfr/professionallicensing/professions/pharmacy/pdf/statement_chloroquine_4_11_2020.pdf">Maine Board of Pharmacy