Specials are a category of unlicensed medicines that are manufactured or procured specifically to meet the special clinical needs of an individual patient. Prescribers and pharmacists both have a responsibility to ensure that where specials are prescribed they are the most appropriate choice and patients are supported to use them effectively.  The Royal Pharmaceutical Society (RPS) has published updated professional guidance for the prescribers of Specials which is endorsed by the Royal College of GPs, the Academy of Medical Royal Colleges and the Royal College of Nursing.  The guidance aims to support prescribers in all professions and in all care settings in the safe and appropriate prescribing of Specials.

The supply chain encompasses manufacturing, prescribing, procuring and dispensing of specials. Pharmacists throughout the whole of the supply chain have a responsibility for procuring and supplying specials in a professional manner.  RPS guidance for the procurement and supply of pharmaceutical Specials aims to support pharmacists and their teams to work with prescribers, patients and carers to ensure the safe and appropriate procurement and supply of specials. We have also produced guidance to support you with the pharmaceutical issues to consider with crushing, opening or splitting oral dosage forms.

If you have any enquiries about this guidance, RPS members can contact the Professional Support service on 0845 257 2570


The use of specials presents the NHS and patients with specific challenges, particularly when patients move between care settings. The importance of ensuring that patients and prescribers are aware of the complexities and risks associated with transferring the prescribing and supply of specials across settings is also emphasised in this guidance.

The Society would like to thank the contributors from Hospital, Primary Care and Community practice, specials Manufacturers, NHS Quality Assurance, Department of Health, MHRA and PSNC for their help in developing this guidance 

Types of dosage form

There are certain types of dosage form that should never be split or crushed and this document aims to highlight these dosage forms, the science behind why they should remain intact, and the possible consequences of splitting or crushing various dosage forms.

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