# Anticancer treatment prescribing and pharmacy verification before each cycle

Source: https://onco.cc/protocols/sact-prescribing-and-pharmacy-verification/  
OnCo record `sact-prescribing-and-pharmacy-verification` (Protocol). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Before any cancer drug is made up for you, the prescription is written from an agreed treatment plan and then checked by a specially trained pharmacist or pharmacy technician: that it is the right treatment for your cancer, that the dose is worked out correctly from your height, weight and kidney function, and that your blood results are good enough for treatment that day.

## Summary

The US standard is the ASCO-ONS Antineoplastic Therapy Administration Safety Standards (2024), which replaced the 2016 ASCO/ONS standards; the UK standard for the pharmacy step is BOPA's Standards for the Pharmacy Verification of Prescriptions for Cancer Medicines, version 5.0 (June 2025). Neither grades its standards: ASCO-ONS combined a systematic review (2015 to 2023) with panel opinion and public comment.

Both require prescribing from approved, standard regimens on electronic or preprinted order sets, by authorised prescribers. ASCO-ONS bans verbal orders except to hold or stop treatment, requires a supporting reference or a second practitioner for orders that depart from the standard regimen, and asks that height and weight be measured in metric units and verified by two people before a new plan. Its order must state the calculation method and variables, and how often they are rechecked.

The two differ on who verifies. BOPA says no anticancer treatment may be given or taken until a trained registered pharmacy professional has verified the prescription, and sets out checks for cycle 1 (consent, the regimen against the treatment plan, eligibility, allergies, interactions, critical tests such as cardiac function or genomic results) and for every cycle (dose calculation and units, blood results, renal and hepatic function, cumulative doses, supportive medicines, then a signature). ASCO-ONS requires a licensed pharmacist to verify all parenteral orders only where children under 18 are treated; for adults its first verification, before preparation, may be done by any personnel the organisation approves to prepare or give the treatment. BOPA asks for adult doses to be banded where national bands exist.

## Fields

- Kind: Protocol
- Last checked: 2026-11-11
- Also known as: chemotherapy order verification; SACT prescription verification; clinical screening of chemotherapy prescriptions; pharmacist chemotherapy check; chemotherapy order set; first verification; SACT clinical check

## Connected records

- protocols: [Anticancer treatment administration checks at the chair: assessment, independent double checks and line tracing](https://onco.cc/protocols/sact-administration-checks-at-the-chair/), [Aseptic compounding of hazardous anticancer drugs in the pharmacy](https://onco.cc/protocols/aseptic-compounding-of-hazardous-anticancer-drugs/), [Body surface area and weight-based dose calculation for anticancer drugs, including full doses in obesity](https://onco.cc/protocols/body-size-based-dose-calculation/), [Carboplatin dose calculation by the Calvert formula and kidney function](https://onco.cc/protocols/carboplatin-dose-calculation/), [Consent and education before anticancer treatment](https://onco.cc/protocols/consent-and-education-before-anticancer-treatment/), [Dose banding of anticancer drugs](https://onco.cc/protocols/dose-banding-of-anticancer-drugs/), [DPD deficiency testing before fluorouracil, capecitabine or tegafur, and dosing by the result](https://onco.cc/protocols/dpyd-testing-before-fluoropyrimidines/), [Drug, herbal and food interaction review for anticancer treatment](https://onco.cc/protocols/anticancer-drug-interaction-review/), [Hepatic dose adjustment of anticancer drugs in reduced liver function](https://onco.cc/protocols/hepatic-dose-adjustment-of-anticancer-drugs/), [Intrathecal chemotherapy safety and vinca alkaloids given only by minibag](https://onco.cc/protocols/intrathecal-chemotherapy-and-vinca-alkaloid-safety/), [Medicines reconciliation at the start of anticancer treatment and at each move between care settings](https://onco.cc/protocols/medicines-reconciliation-in-cancer-care/), [Premedication against infusion reactions before taxanes, antibodies and other reaction-prone anticancer drugs](https://onco.cc/protocols/premedication-before-reaction-prone-anticancer-drugs/), [Renal dose adjustment of anticancer drugs in reduced kidney function](https://onco.cc/protocols/renal-dose-adjustment-of-anticancer-drugs/)
- technologies: [Body-surface-area dosing](https://onco.cc/technologies/body-surface-area-dosing/), [Carboplatin dosing by kidney function: the Calvert formula and how kidney function is measured](https://onco.cc/technologies/carboplatin-calvert-dosing/), [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Full weight-based chemotherapy dosing for people with obesity](https://onco.cc/technologies/chemotherapy-dosing-in-obesity/), [Oncology pharmacy automation and compounding robots](https://onco.cc/technologies/pharmacy-automation/)
- terms: [Dose reduction, interruption and discontinuation](https://onco.cc/terms/dose-modification/)

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