By Berlanga                                     H.B. No. 2571

      75R7055 JMM-F                           

                                A BILL TO BE ENTITLED

 1-1                                   AN ACT

 1-2     relating to the substitution of certain drugs by a pharmacist.

 1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

 1-4           SECTION 1.  Section 40(l), Texas Pharmacy Act (Article

 1-5     4542a-1, Vernon's Texas Civil Statutes), is amended to read as

 1-6     follows:

 1-7           (l)  Drug product selection as authorized in this section

 1-8     shall not apply to enteric-coated tablets;  controlled release

 1-9     products;  injectable suspensions, other than antibiotics;

1-10     suppositories containing active ingredients for which systemic

1-11     absorption is necessary for therapeutic activity;  narrow

1-12     therapeutic index drugs;  and different delivery systems for

1-13     aerosol or nebulizer drugs.  This  subsection shall not apply to

1-14     any drug product which is determined to be generically equivalent

1-15     to the brand prescribed, except for narrow therapeutic index drugs.

1-16     The interchange of narrow  therapeutic index drugs requires

1-17     specific written authorization by the prescribing physician.  In

1-18     this subsection, "narrow therapeutic index drugs" means medications

1-19     defined by the  federal Food and Drug Administration as having a

1-20     narrow therapeutic index, including digoxin, phenytoin, warfarin

1-21     sodium, theophylline, levothryroxine, carbamazine, valproic acid,

1-22     and lithium.

1-23           SECTION 2.  This Act takes effect September 1, 1997.

1-24           SECTION 3.  The importance of this legislation and the

 2-1     crowded condition of the calendars in both houses create an

 2-2     emergency and an imperative public necessity that the

 2-3     constitutional rule requiring bills to be read on three several

 2-4     days in each house be suspended, and this rule is hereby suspended.