📊 Days of Supply Reference

Comprehensive guide for calculating days of supply for all medication types

🖊️ Insulin Pens Multi-dose pen DOS calculation with wizard & calculator 💉 Insulin Vials Multi-dose vial DOS with live calculator

📋 General Rules & Overview

Rounding Rule

Always round DOWN to the previous whole number if the calculated DOS contains a decimal.

Example: 4.9 days → round down to 4 days

Key Guidelines

In-Use Guidelines: Follow manufacturer in-use (opened by patient) guidelines when calculating DOS for products with shortened expiration after opening
Plan Limits: If a third party plan rejects with "Plan Limits Exceeded," follow Unit of Use procedures or dispense less than prescribed quantity
Ambiguous Directions: Contact prescriber if directions are unclear or open to multiple interpretations
Insulin Prescriptions: Must have clear frequency with max daily dose to mitigate audit/chargeback risk

💊 Tablets, Capsules, Granules, Liquids, Suppositories

DOS = Total Quantity Dispensed ÷ Daily Dose

Example 1: Metformin 500mg tablets, "Take 1 tablet by mouth twice daily"
Dispense #60 tablets
60 tablets ÷ 2 tablets/day = 30 DOS

Example 2: Carafate oral suspension, "Take 10 mL by mouth four times daily"
Dispense 1200 mL
1200 mL ÷ 40 mL/day = 30 DOS

Example 3: Promethazine 25mg suppositories, "Insert 1 suppository rectally 2-3 times daily as needed"
Dispense #20
20 suppositories ÷ 3 (maximum per day) = 6.6 → 6 DOS

💨 Sprays and Inhalers

DOS = Total Doses in Container ÷ Daily Dose

Example 1: ProAir Inhaler (200 puffs), "Inhale 2 puffs by mouth twice daily as needed"
2 puffs × 2 times/day = 4 puffs/day
200 puffs ÷ 4 puffs/day = 50 DOS

Example 2: Fluticasone Nasal Spray (120 doses), "Spray once in each nostril twice daily"
(1 spray × 2 nostrils) × 2 times/day = 4 sprays/day
120 doses ÷ 4 sprays/day = 30 DOS

👁️ Eye and Ear Drops

DOS = (mL Dispensed × 20 drops/mL) ÷ Drops Used Daily

Note: Standard conversion is 20 drops per mL for most solutions and suspensions. Some medications have different drop conversions - IC+ will automatically calculate these.

Volume	# Drops (at 20/mL)
1 mL	20 drops
5 mL	100 drops
10 mL	200 drops
15 mL	300 drops

Example: Prednisolone Ophthalmic Suspension 5 mL, "Instill 2 drops in both eyes twice daily"
2 drops × 2 eyes × 2 times/day = 8 drops/day
5 mL × 20 drops/mL = 100 drops
100 drops ÷ 8 drops/day = 12.5 → 12 DOS

Important: For single-use vials (e.g., Restasis), use the number of vials per package to calculate DOS, not the drops/mL conversion.

📋 Ophthalmic Medication Reference

Comprehensive list of common ophthalmic medications with drops per mL conversions and package information.

Medication Name	NDC	Drops/mL	Package Size & Total Drops
Beta Blockers
Timolol 0.25% GF Ophth Soln	82260-0818-25	29	5mL = 145 drops
Timolol 0.5% GF Opth Soln	24208-0819-05	29	5mL = 145 drops
Timolol Maleate 0.5% Opht Soln	82260-0813-05	32	5mL = 160 drops
Timoptic 0.25% Opth Soln	24208-0812-05	32	5mL = 160 drops
Timoptic 0.5% Ophth Soln	24208-0813-05, 24208-0813-10	32	5mL = 160 drops, 10mL = 320 drops
Timoptic-XE 0.25% Ophth Sol	24208-0814-25	29	5mL = 145 drops
Levobunolol 0.5% Opth Soln	24208-0505-05	32	5mL = 160 drops
Istalol 0.5% Ophth Solution	24208-0004-01, 24208-0004-03	32	2.5mL = 80 drops, 5mL = 160 drops
Prostaglandin Analogs
Lumigan® 0.01% Ophth Soln	00023-3205-03, 00023-3205-05, 00023-3205-08	24	2.5mL = 60 drops, 5mL = 120 drops, 7.5mL = 180 drops
Xalatan 0.005% Ophth Soln®	00013-8303-04	33	2.5mL = 82 drops
Latanoprost 0.005% Ophth Soln (Bausch & Lomb)	24208-0463-25	36	2.5mL = 90 drops
Latanoprost 0.005% Ophth Soln (Greenstone)	59762-0333-02	20	2.5mL = 50 drops
Latanoprost 0.005% Ophth Soln (Sandoz)	61314-0547-01	36	2.5mL = 90 drops
Latanoprost 0.005% Ophth Soln (Somerset)	70069-0421-01, 70069-0421-03	36	2.5mL = 90 drops, 7.5mL = 270 drops
Vyzulta 0.024% Ophth Soln¹	24208-0504-02, 24208-0504-05	32	2.5mL = 80 drops, 5mL = 160 drops
Alpha Agonists
Brimonidine 0.2% Ophth Soln	24208-0411-05, 24208-0411-10, 24208-0411-15	30	5mL = 150 drops, 10mL = 300 drops, 15mL = 450 drops
Combination Products
Dorzolamide-Timolol Ophth Soln	24208-0486-10	28	10mL = 280 drops
Carbonic Anhydrase Inhibitors
Dorzolamide 2% Ophth Soln	24208-0485-10	28	10mL = 280 drops
Corticosteroids
Lotemax 0.5% Ophthalmic Susp	24208-0299-05, 24208-0299-10, 24208-0299-15	31	5mL = 155 drops, 10mL = 310 drops, 15mL = 465 drops
Lotemax 0.5% Opth Gel Drops	24208-0503-07	25	5GM = 125 drops
Lotemax SM® 0.38% Gel Drops	24208-0507-07	N/A	5gm = 131 drops
Loteprednol 0.2% Ophth Susp	82260-0361-05	31	5mL = 155 drops
Loteprednol 0.5% Opth Gel Drops	24208-0508-01	25	5GM = 125 drops
Alrex 0.2% Ophthalmic Susp	24208-0353-05, 24208-0353-10	32	5mL = 160 drops, 10mL = 320 drops
Dexamethasone 0.1% Ophth Soln	24208-0720-02	31	5mL = 155 drops
Antihistamines
Bepotastine 1.5% Opth Drops	24208-0630-05, 24208-0630-10	33	5mL = 165 drops, 10mL = 330 drops
Bepreve 1.5% Opth Drops	24208-0629-02, 24208-0629-01	33	5mL = 165 drops, 10mL = 330 drops
Antibiotics & Antivirals
Besivance 0.6% Opth Susp	24208-0446-05	31	5mL = 155 drops
Zirgan 0.15% Ophth Gel	24208-0535-35	27	5GM = 135 drops
Zylet Ophthalmic Suspension	24208-0358-05, 24208-0358-10	32	5mL = 160 drops, 10mL = 320 drops
NSAIDs
Bromfenac 0.07% Opth Solution	82260-0602-03	21	3mL = 63 drops
Diclofenac Sod 0.1% Ophth Soln	24208-0457-05	28	5mL = 140 drops
Prolensa 0.07% Opth Solution	24208-0602-03	19	3mL = 57 drops
Mydriatics/Cycloplegics
Atropine Sulf 1% Oph Soln	82260-0001-01	31	10mL = 310 drops
Cyclopentolate 1% Ophth Sol	24208-0735-01, 24208-0735-06	31	2mL = 62 drops, 15mL = 465 drops
Specialty & Other
Miebo 1.3gm/mL Opth Sol²	24208-0377-05	90	3mL = 272 drops
Vevye 0.1% Ophth Soln³	82667-0900-02	100	2mL = 200 drops

📋 Footnotes:
¹ Vyzulta: Latanoprostene bunod ophthalmic solution
² Miebo: Perfluorohexyloctane ophthalmic solution - unique viscosity requires different drop calculation
³ Vevye: Cyclosporine ophthalmic solution 0.1% - high concentration formulation

⚠️ Important Notes:
• Different manufacturers may have different drops/mL for the same generic medication
• Always verify NDC to ensure accurate drop calculation
• Gel formulations typically have fewer drops per gram than suspensions
• These values are for multidose bottles; single-use vials are calculated per unit

🧴 Topical Medications

Common Topical DOS Values

Most topicals have pre-populated DOS values in IC+. Always use default DOS unless otherwise specified by manufacturer or prescriber.

Package Size	DOS
Up to 29 grams	7 days
30-44 grams	15 days
45-59 grams	20 days
60-99 grams	25 days
100 grams or larger	30 days

Specific Medications

Bactroban 22g: 10 days
Duac Gel 45g: 30 days
Estrace Cream 42.5g: 90 days
Voltaren Gel 100g: 7 days

🩹 Transdermal Patches

DOS = Number of Patches × Frequency of Application (in days)

Example 1: Duragesic 50 mcg patches, "Apply one patch every 72 hours"
Dispense #10 patches
10 patches × 3 days = 30 DOS

Example 2: Climara patches, "Apply one patch weekly"
Dispense #4 patches
4 patches × 7 days = 28 DOS

💊 Ready to Use Injectables (Wegovy, Ozempic, Trulicity, etc.)

Single-Use Pens

DOS = (Pens per box × Days between doses)

Example: Wegovy 0.25mg (4 pens per box)
"Inject 0.25mg subcutaneously once a week"
1 pen × 7 days × 4 weeks = 28 DOS per box

Multi-Use Pens (Ozempic)

Calculate based on mL per dose and total mL in pen.

Maintenance Dose Example: Ozempic 2mg/3mL pen
"Inject 0.5mg subcutaneously once a week"
0.5mg = 0.75mL per dose
3mL ÷ 0.75mL = 4 doses
4 doses × 7 days = 28 DOS

Initiation vs. Maintenance: If prescription has both initiation/starter dose and maintenance dose, it CANNOT be refilled. Contact prescriber for separate prescriptions.

📱 Continuous Glucose Monitors & Insulin Pumps

CGM Devices

Dexcom G6 Transmitter: 90 DOS
Dexcom G6 Sensor: Apply 1 sensor every 10 days → 3 sensors = 30 DOS
FreeStyle Libre 3 Plus: Apply 1 sensor every 15 days → 2 sensors = 30 DOS

Omnipod

DOS = Number of PODs × Frequency Pod is Changed

Example: Omnipod 5 Pods, "Change pod every 3 days"
Dispense #45 pods
45 pods × 3 days/pod = 135 → typically dispensed as 90 DOS

🩹 Santyl (Collagenase) Ointment

Special Instructions: Use the Santyl Dosage Calculator to determine correct quantity and DOS based on wound width, length, and duration of therapy.

Wound Size Estimates

Small wound (<2 sq in): ~0.25g per application (¼ inch ribbon)
Medium wound (2-4 sq in): ~0.5g per application (½ inch ribbon)
Large wound (>4 sq in): ~1.0g per application (1 inch ribbon)

Example: Wound measures 1.2 × 1.2 cm, apply daily for 30 days
Santyl Calculator: 8 grams needed for 30 days
Dispense: 1 tube (30g)
30g tube ÷ 8g needed = 3.75 months
DOS = 90 days

💉 Multi-Dose Injectable Vials

General Formula

Step 1: (mLs per injection × Frequency per week) = Total mL/week
Step 2: (Total mL in vial ÷ Total mL/week) × 7 days = DOS

28-Day Rule: If MDV DOS exceeds 28 days, switch to single-dose vials (SDV) if available. If SDV not available, annotate prescription and add "Discard Remainder after 28 days" to directions.

Testosterone Example: Testosterone Cypionate 200mg/mL, 10 mL vial
"Inject 0.5mL IM twice weekly"

Step 1: mL per week
0.5mL × 2 = 1mL/week

Step 2: Calculate DOS
(10mL ÷ 1mL/week) × 7 days = 70 DOS

Problem: Exceeds 28-day limit!
Solution: Switch to 1mL SDV → Dispense 8mL for 28 DOS

🧪 Reconstitutable Medications

DOS = Total mL Dispensed ÷ Daily Dose (mL)

Special Rule: If prescriber indicates duration (e.g., "for 10 days") and not all quantity will be used, add "Discard Remainder" to directions and use prescriber's indicated duration as DOS.

Example 1: Amoxicillin 400mg/5mL suspension
"Take 5mL by mouth BID for 10 days"
Dispense 100mL
100mL ÷ 10mL/day = 10 DOS

Example 2: Cefdinir 250mg/5mL suspension
"Give 5mL by mouth daily for 10 days"
Dispense 60mL
60mL ÷ 5mL/day = 12 DOS
→ Update to 10 DOS with "Discard Remainder" added