How to Check In Off-Cycle, New, or Updated Medications
What to do when you receive medications outside of the regular cycle. These include new starts, dose changes, or urgent fills.
👥 Who This Is For
Direct Support Professionals (DSPs), nurses, program directors
📘 What You’ll Learn
How to safely check in medications that are delivered outside the normal cycle, including new medications, dose changes, and urgent fills.
When Meds Come Outside the Regular Cycle
- Off-cycle deliveries are common when a doctor changes or starts a new medication
- These meds may arrive in a unit-dose pack or bulk bottle
- Always review these meds as soon as they arrive to ensure safe and timely use
📝 Note: Neighborhood LTC Pharmacy will often use med change kits to remove any discontinued medications when updates are needed between cycles.
How to Check In Off-Cycle or New Meds
- Confirm the individual’s name on all packaging
- Check the medication name, strength, and directions
- Look for the start date or “Start Now” instructions
- Confirm whether this med replaces a current one or is in addition to the existing regimen
- Store the new meds in the proper med storage area, grouped with the individual’s other medications
💡 Tip: Use the accompanying paperwork, consult form, or pharmacy label to identify whether a medication is new or replacing an existing one.
How to Handle Different Packaging Types
Unit-Dose
- Check each blister card for accuracy
- Match the new or changed med with the order or consult note
- Separate from the old med if it’s replacing something and do not discard unless instructed
Bulk Meds
- Check for labeling with name, medication, strength, and directions
- Look for short-term use or special instructions on the pharmacy label
⚠️ Caution: Bulk items are often given for short-term needs like antibiotics, creams, or as-needed meds so make sure you understand when and how they should be given.
🚨 Coordinating Med Discontinuations and Dose Changes
- If a medication is being discontinued and replaced (such as a dose change), do not start the new medication without confirming the process
- Staff and the pharmacist must coordinate the med change together through a virtual med change call
- The pharmacist will guide you through:
- Removing the discontinued medication
- Storing or labeling the updated card correctly
- Ensuring documentation is accurate
⚠️ Caution: Never give both the old and new med at the same time unless the doctor explicitly orders it. Always wait for the pharmacist to walk you through the change.
📝 Note: For Dispill packaging, the med change process is especially important. The pharmacist must see the packaging via Zoom to verify and document the update correctly.
What to Do with the Old Medication
- Do not give the old medication if a new one has replaced it
- Store old meds according to your agency’s policy until a nurse or pharmacy provides disposal instructions
- Never throw away or return medications unless directed
🚨 Warning: Giving both the old and new med by mistake can cause serious harm. Always confirm what the update is for.
Important Reminders
- Check in new or off-cycle meds right away
- Review directions carefully to see if the med starts now or with the next cycle
- When in doubt, contact the nurse or pharmacy before giving the med
- Document the medication check-in according to your agency’s procedures
💡 Tip: Keep a running log of med changes in your med area so all staff stay updated on what’s new, replaced, or discontinued.