NC State Health Director Standing Orders

All Standing orders signed by the North Carolina State Health Director were updated July 14, 2025, to reflect the current State Health Director's signature and national provider identifier (NPI).

Hurricane Helene Standing Orders

Epinephrine Orders

Pharmacist Order:

• North Carolina State Health Director’s Epinephrine Auto Injector Standing Order

Nursing Orders: 

• SWSO for Nursing Administration of Epinephrine 16.5 to 33 lbs
• SWSO for Nursing Administration of Epinephrine 33 to 66 lbs
• SWSO for Nursing Administration of Epinephrine 66 lbs or more

House Bill 96 Medication Protocols - SL 2021-110

House Bill 96 Standing Orders - SL 2021-110 have now been rescinded

Protocols and Tools replacing the standing orders from the Board of Pharmacy and the Medical Board have been established for the following medications. Review these protocols and tools.

• Nicotine replacement therapy that is approved by the United States Food and Drug Administration
• Self-administered oral or transdermal contraceptives
• Prenatal vitamins
• Post-exposure prophylaxis medications for the prevention of human immunodeficiency virus (HIV)
• Glucagon for the treatment of severe hypoglycemia

COVID-19 Related Standing Orders

Important Update: COVID-19 Statewide Standing Orders Expired Dec. 31, 2024

The COVID-19 Statewide Standing Orders (SWSOs) authorized under North Carolina Session Law 2022-74, Sec. 9G.7.(a)-(e) (PDF) and extended under Session Law 2023-65, Sec. 9G.7 (PDF), expired Dec. 31, 2024. Read the memo (PDF).

Opioid Antagonist Standing Orders 

• North Carolina's Standing Order for Opioid Antagonists
• List of Approved Products for Pharmacist Dispensing