Prescribing 90-Capsule Bottle for 30-Day Titration
Yes, you can prescribe a 90-capsule bottle for a 30-day titration requiring 69 capsules of 200 mg (maximum three capsules per day), as this provides adequate supply with minimal waste compared to prescribing a 60-capsule bottle (insufficient) or a 100-capsule bottle (excessive waste).
Practical Prescribing Logic
The 60-capsule bottle is insufficient for your titration schedule requiring 69 capsules total, leaving the patient 9 capsules short before completing the 30-day titration 1
The 90-capsule bottle provides exactly what you need with only 21 capsules remaining after the 69-capsule titration, which can serve as a buffer for missed doses or continuation if the patient tolerates the medication well 1
The 100-capsule bottle creates unnecessary waste with 31 unused capsules after the titration period, representing poor resource utilization and increased medication cost 2
Titration Schedule Considerations
Gradual dose escalation over 30 days with a maximum of three 200 mg capsules daily allows assessment of tolerability while minimizing adverse effects, consistent with standard titration principles for medications requiring dose adjustment 2, 3
The 90-capsule supply accommodates flexible titration if you need to slow the escalation due to side effects or hold at a lower dose temporarily before advancing 2
Most insurance formularies and pharmacy systems accept 90-day supplies as standard dispensing quantities, making this a routine prescription request 2
Documentation for Prior Authorization
Specify "90 capsules for 30-day titration protocol" on the prescription to clarify the medical necessity if questioned by pharmacy or insurance 2
Note the maximum daily dose of three capsules (600 mg total) to justify the quantity prescribed relative to the titration duration 1
Document that standard bottle sizes of 60 or 100 capsules do not align with your evidence-based titration schedule requiring exactly 69 capsules over 30 days 2