Which medications can be prescribed for 12 months in NZ?

Most non-controlled medications can be prescribed for up to 12 months at prescriber discretion. Controlled drugs are excluded: Class B (e.g. morphine, methylphenidate) maximum 1 month, Class C (e.g. tramadol, benzodiazepines) maximum 3 months. Medications requiring regular monitoring (warfarin, lithium, methotrexate, etc.) are generally unsuitable. Statins, inhaled corticosteroids, beta blockers, and oral contraceptives are generally suitable for stable patients.

Are there mandatory patient eligibility criteria for 12-month prescriptions?

No. The Medicines Regulations 2025 grant prescribers full clinical discretion. There are no mandatory patient eligibility criteria in law. The widely referenced "6 months stable" criterion in RNZCGP materials is professional guidance, not a legal requirement.

Can patients collect 12 months of medication at once?

No. Pharmacies can only dispense a maximum of 3 months supply per occasion (6 months for oral contraceptives). Patients collect repeats every 3 months from the same pharmacy and pay a single $5 co-payment when first collecting.

Do I have to issue 12-month prescriptions if patients ask?

No. The law permits up to 12 months but does not require it. You have full discretion to issue 3, 6, 9, or 12 month prescriptions based on clinical judgement. RNZCGP recommended 6 months as safer in their October 2024 submission.

What are the controlled drug prescription limits in NZ?

Controlled drugs are excluded from 12-month prescriptions. Class B drugs (morphine, oxycodone, fentanyl, methylphenidate, dexamphetamine) have a maximum of 1 month. Class C drugs (tramadol, codeine combinations, benzodiazepines, zopiclone, zolpidem) have a maximum of 3 months.

ClinicPro

12-Month Prescriptions:
Safe Implementation Framework

Clinical decision support for choosing appropriate prescription durations. 3–6 months remains a completely appropriate default.

Start Decision Tool ↓

Guidance · Resources

Interactive Decision Tool

✓ 3 months remains a completely appropriate default

This tool helps you make safe decisions across the 3-12 month range. RNZCGP recommended 6 months as safer than 12 months.

Step 1 of 5

Is the patient on any controlled drugs?

Controlled drugs have legal maximum durations

Controlled drugs:

Max 1 month: All opioids (morphine, oxycodone, fentanyl, codeine, tramadol)
Max 3 months: ADHD stimulants (methylphenidate, dexamfetamine), benzodiazepines, zopiclone, cannabis preparations

📋 Medication Reference Guide

🔴 Generally NOT Suitable for Extended Duration

Why NOT suitable: Requires monitoring more often than annually

Controlled Drugs (Legal Exclusion)

Maximum duration: 1-3 months (law, not clinical judgment)

Class	Max Duration	Examples
Class B	1 month	Morphine, oxycodone, fentanyl, methadone, methylphenidate, dexamphetamine
Class C	3 months	Tramadol, codeine (prescription strength), diazepam, lorazepam, clonazepam, zopiclone

Source: Misuse of Drugs Act 1975

High-Risk Medications Requiring Regular Monitoring

Typical maximum: 3 months. These need regular blood tests or monitoring that can't wait 12 months.

Warfarin – INR monitoring (weekly to monthly depending on stability)
Lithium – Levels 3-monthly, renal + thyroid function 3-6 monthly
Digoxin – Levels + renal function 3-6 monthly, ECG annually
Methotrexate – FBC + LFTs monthly initially, then 2-3 monthly
Azathioprine – FBC + LFTs monthly initially, then 3-monthly
Amiodarone – TFTs + LFTs 6-monthly, CXR + ECG annually
Sodium valproate – LFTs + FBC 6-monthly
Carbamazepine – FBC + LFTs + Na+ 6-monthly
Insulin – Regular dose adjustments needed

→ Check NZF for specific monitoring schedules and dose adjustments.

🟡 Requires Individual Assessment

Suitability depends on patient parameters (eGFR, age, etc.). Check patient's specific values before deciding duration.

Metformin: eGFR >45 generally 12mo; eGFR 30-45 max 6mo; eGFR <30 contraindicated. → Check NZF
ACE Inhibitors / ARBs: eGFR ≥60 generally 12mo; 45-59 consider 6-12mo; 30-44 max 6mo; <30 max 3-6mo. → Check NZF
DOACs: CrCl ≥50 generally 12mo (varies by drug); CrCl <50 shorter or dose adjust. → Check NZF
Sulfonylureas: Age <70 + eGFR >60 generally 12mo; age ≥70 or eGFR <60 consider 6mo. → Check NZF
NSAIDs: With ACEi/ARB ("double whammy") max 6mo; with ACEi/ARB + diuretic ("triple whammy") max 3mo. → Check BPAC
Spironolactone: MAX 6 months even when stable (K+ monitoring). → Check NZF
Allopurinol: eGFR >60 generally 12mo; eGFR <60 consider 6mo. → Check NZF
Other: SGLT-2 inhibitors, gabapentin/pregabalin, bisphosphonates, loop diuretics (max 6mo), levothyroxine (12mo OK if dose stable 6+ months). Always check NZF.

🟢 Generally Suitable for 12 Months

If patient stable: these typically require only annual monitoring. "Generally suitable" does NOT mean automatically 12 months for everyone.

Common examples by category:

Cardiovascular: Statins, CCBs (amlodipine, felodipine), beta blockers, aspirin (antiplatelet)
Respiratory: ICS, ICS/LABA, LAMA (tiotropium), salbutamol
Gastrointestinal: PPIs (omeprazole, esomeprazole)
Hormonal: Oral contraceptives (annual BP), levothyroxine (if dose stable)
Mental health: SSRIs/SNRIs (annual discussion about ongoing need), mirtazapine
Diabetes: DPP-4 inhibitors (vildagliptin, sitagliptin)
Other: Calcium + Vitamin D, montelukast

Typical annual monitoring:

BP (cardiovascular), lipid profile (statins), TSH (levothyroxine)
Spirometry and inhaler technique (respiratory, if available)

→ Check NZF to confirm annual monitoring is sufficient for your patient.

🔴 Important Notes:

These are EXAMPLES, not comprehensive lists. Always check NZF.
Lists are GUIDANCE, not rules. You have full clinical discretion.
NZF is the authoritative source.
When in doubt: Prescribe a shorter duration (3 or 6 months).
6 months is completely acceptable. RNZCGP recommended 6 months as safer than 12 months.

Why we link to NZF instead of listing all medications

The New Zealand Formulary is the gold-standard, authoritative source for medication information in NZ. It's updated monthly and includes monitoring requirements, dose adjustments, interactions, and latest safety alerts.

We've requested API access from NZF to integrate medication data directly. If approved, future versions will auto-populate monitoring requirements.

Open NZF

Disclaimer: This medication reference is for educational purposes only and does not replace clinical judgment or official prescribing guidance. Always consult the New Zealand Formulary, Medsafe data sheets, and relevant clinical guidelines. Medication lists were compiled from RNZCGP guidance, BPAC resources, and clinical consensus as of February 2026.

Understanding Extended Prescriptions

What Changed on 1 February 2026

From 1 February 2026, prescriptions can be written for up to 12 months (increased from 3 months for most medicines). Pharmacies still dispense a maximum of 3 months' supply at a time, so patients collect repeats every 3 months. The change reduces prescription co-payments from $5 quarterly to $5 once per year.

Learn more about the policy →

Two Perspectives

🏛️ Government Rationale

• Cost savings for patients ($5 once vs $20 yearly; fewer prescription consults)
• Improved access (fewer pharmacy trips)
• Reduced GP appointment burden
• Aligns with international practice

Source: Ministry of Health Regulatory Impact Statement

⚕️ RNZCGP Position

Formally recommended 6 months as safer alternative

• Patient safety concerns (less frequent monitoring)
• Equity risks for Māori and Pacific peoples
• Practice financial sustainability
• 6 months balances benefits with safety

Source: RNZCGP Submission, October 2024

You have full clinical discretion to prescribe 3, 6, 9, or 12 months based on individual patient assessment.

Understanding Your Authority: What Must You Follow?

🔴 Legal Requirements - You MUST Comply

Controlled drugs: max 1 month (opioids) or max 3 months (e.g. stimulants, benzodiazepines, zopiclone, cannabis preparations)
Dispensing limit: 3 months per occasion (6mo for oral contraceptives)
First dispensing within 3 months of prescription date
Special Authority must be valid for funded repeats
Prescriber has full discretion on duration (3-12 months)

Source: Medicines Regulations 2025, Misuse of Drugs Act 1975

🟡 Professional Standards - Required for RNZCGP Accreditation

If your practice is RNZCGP-accredited (or seeking accreditation):

Documented repeat prescribing policy with clear criteria
Annual audits of prescribing activity
Audits must differentiate Māori from non-Māori results
Minimum annual review for patients on repeat prescriptions
Measures to optimise Māori access to repeat prescriptions

Source: RNZCGP Foundation Standard 9.1

🟢 Clinical Guidance - Recommended Best Practice

RNZCGP and clinical consensus recommend considering:

Patient Suitability Checklist

✓ Medication considerations:

Does NOT require monitoring more often than annually
Not a controlled drug
Dose has been stable (RNZCGP patient materials suggest 6+ months)

✓ Patient considerations:

Condition stable and well-controlled
Good medication adherence
Able to attend annual review (minimum)
Age and life stage appropriate (careful consideration for <18, pregnant, 65+)
Not polypharmacy requiring more frequent reconciliation

Note: These are considerations, NOT mandatory criteria. You determine suitability.

Key principle: RNZCGP recommended 6 months as safer than 12 months. Prescribing 6 months aligns with professional college guidance.

Source: RNZCGP Position Statement, Healthify, clinical consensus

🔵 Your Clinical Decision - Individual Practice Judgment

You decide based on individual patient assessment:

Prescription duration (3, 6, 9, or 12 months)
Review frequency (may be more frequent than annual minimum)
Face-to-face vs telehealth review requirements
Documentation approach for your practice
Practice-specific medication lists or protocols

When in doubt: choose a shorter duration. You can always extend next time.

Resources & Downloads

Organised by how you'll use them. Print the waiting room materials, hand patients the FAQ, and use the practice manager section for policy and audit work.

📌 Waiting Room & Reception

Print and display

→ HealthEd A4 poster (HE2964) — Official government-branded poster
→ HealthEd A5 patient flyer — Take-home flyer for patients
→ RNZCGP patient poster (PDF)
→ Pinnacle practice poster (PDF, 4.8 MB) — Alternative design

💬 Patient Conversations

Share during consultations or via patient portal

→ RNZCGP patient FAQ sheet (PDF) — Printable handout
→ HealthEd patient flyer — Take-home
→ Healthify patient guide — Link for portal or email to patients

📋 Practice Managers & Policy

Policy, audit, and accreditation

→ RNZCGP sample repeat prescribing policy (PDF) — 2018 version; needs updating for 12-month context
→ RNZCGP repeat prescribing audit template (PDF)
→ Foundation Standard 9.1: Repeat Prescribing — Updated November 2025
Dr Jo Scott-Jones practice pack — Draft policy, consent form, and patient leaflet. Email Sarah.Wotherspoon@pinnacle.health.nz to request.

🎓 Prescriber Education

Webinars, guidance, and position statements

💊 Pharmacy Liaison

Share with your dispensing pharmacy

12-Month Prescriptions:Safe Implementation Framework