NC State Health Director Standing Orders
New: Pharmacist Test and Treat
Pursuant to S.L. 2025-37, the North Carolina State Health Director has issued standing orders to implement the influenza test and treat authority provided in Part V of SL 2025-37. Standing orders and supporting documents are linked below. These orders will be used until the North Carolina Medical Board and North Carolina Board of pharmacy adopt rules to implement Pharmacist Test and Treat as directed in Section 5.3(b). Upon rule adoption, these standing orders will be rescinded.
- Standing Order for Influenza Testing and Treatment (9/30/2025)
- Standing Order for Influenza Prophylaxis (9/30/2025)
- Assessment and Attestation Forms for the Patient to Complete
- Evaluation and Plan of Care Forms for the Pharmacist to Complete
- Additional Resources and Handouts Links
COVID-19 Vaccine Standing Orders - 25-26 Season
On Sept. 12, 2025, Governor Josh Stein directed the State Health Director, as a measure for the prevention and control of communicable disease, to issue statewide standing orders to facilitate access to the COVID-19 vaccine in accordance with NC laws and FDA approvals for those who wish to receive it.
The following orders allow an immunizing pharmacist licensed with the NC Board of Pharmacy and practicing in North Carolina in accordance with the conditions of their licensure to administer COVID-19 Vaccines approved by the FDA per the conditions outlined in the orders.
- COMIRNATY manufactured by Pfizer (Sept. 12, 2025)
- MNEXSPIKE manufactured by Moderna (Sept. 12, 2025)
- NUVAXOVID manufactured by Novavax (Sept. 12, 2025)
- SPIKEVAX manufactured by Moderna (Sept. 12, 2025)
Hurricane Helene Standing Orders
Epinephrine Orders
Pharmacist 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House Bill 96 Standing Orders - SL 2021-110 have now been rescinded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
Opioid Antagonist Standing Orders
This page was last modified on 09/30/2025