The Latvian Cabinet of Ministers has approved new Regulations on Prescription Forms and the Handling of Prescriptions, introducing stricter controls on the use and distribution of paper prescriptions, expanding the range of healthcare professionals authorised to prescribe medicines, and changing the retention periods and dispensing procedures for certain types of prescriptions. The new rules came into force on 2 September.
The new regulations were developed because the previous Regulations on the Production and Storage of Prescription Forms and the Issuing and Storage of Prescriptions had expired.
Going forward, the National Health Service (NHS) will be able to limit the number of paper prescription forms issued to healthcare institutions. The tighter controls are based on violations identified by the NHS and the Health Inspectorate (HI).
The number of forms issued will generally be calculated based on the number of paper prescriptions issued during the previous quarter, applying a coefficient of 0.7, or following an assessment of the healthcare institution’s justification for the requested quantity. The NHS will be able to revise the quantity if it identifies an unjustified request, significant discrepancies, or changes in the volume of the healthcare institution’s activities.
Paper prescriptions may now only be used in specific circumstances, such as during prolonged disruptions to the E-health system when a patient urgently needs medication, or when a prescription is to be used in a country with which Latvia does not have cross-border e-prescription exchange arrangements. This represents a gradual transition towards e-prescriptions as the primary method of prescribing medicines.
Going forward, the system will process identification data relating to patients and healthcare professionals, information on prescriptions and diagnoses, prescribed and dispensed medicines, reimbursement, as well as information about people purchasing medicines on behalf of patients.
This data is required to process prescriptions, monitor the circulation of medicines, and prevent potential violations.
Dentists will also be authorised to prescribe medicines within the scope of their professional competence. Residents and trainee doctors with a registered workplace will be able to prescribe medicines under the supervision of a certified specialist.
Psychiatrists, narcologists, addiction psychiatrists, neurologists, pain specialists and family doctors will be able to prescribe psychotropic medicines and narcotic analgesics for treatment courses of up to three months, regardless of whether the medicines are reimbursed.
General care nurses and physician assistants, including those working in healthcare institutions operated by the Prison Administration, will also be able to participate electronically in the prescribing of reimbursable medicines and medical devices in cooperation with a doctor. Midwives will be able to do so within the scope of their professional competence.
Doctors and physician assistants (feldshers) who do not work at a healthcare institution but have valid professional registration will be able to prescribe medicines for themselves under the Recipe pro me system. Within a 12-month period, a doctor will be able to issue up to 50 standard prescriptions, while a physician assistant will be able to issue up to 30. Medicines may be prescribed for a maximum of one month’s supply.
For these professionals, Recipe pro me will be listed as their workplace in the healthcare professionals’ register. This information will not be publicly available but will enable the E-health system to identify the prescriber.
To obtain new prescription forms, these professionals will be required to return unused or invalid forms to the NHS and submit a request.
Healthcare professionals will be required to document the reason for issuing a prescription in the patient’s medical records, in accordance with the patient’s diagnosis. Only one medicine may be prescribed on each prescription. Patient identification requirements have also been clarified.
The provisions concerning the physical handling of repeat-use paper prescriptions have not been retained, as their use and tracking will now be managed electronically.
Narcotic and psychotropic medicines, as well as medicines classified by the State Agency of Medicines as narcotic analgesics, may now only be prescribed using a special e-prescription.
The electronic system makes it possible to identify the prescriber, check medicines previously prescribed to the patient, monitor dosages and prescribing frequency, and identify potentially suspicious cases more quickly.
Narcotic or equivalent psychotropic medicines prescribed on special paper prescriptions before the new rules came into force may be dispensed for three months from the date the prescription was issued. The seven-day validity period for prescriptions for high-risk medicines remains unchanged.
Special prescriptions for narcotic or equivalent psychotropic medicines must be retained for five years, while other special prescriptions must be retained for three years. Standard prescriptions must be retained for one year.
Prescriptions issued in other European Union or European Economic Area countries or in Switzerland must be retained for three years.
The Latvian Verification Organisation for Medicines, established by the Latvian Association of Pharmaceutical Care, has compiled data showing that during the first six months of 2026, a total of 60.5 million transactions were recorded in the Latvian Medicines Verification System (LZVS). These transactions relate to the verification of medicine packages, of which 14.6 million involved the decommissioning of packages when medicines were dispensed to patients.
Although the total number of transactions increased by 4% compared with the same period last year, the number of medicine packages dispensed to patients remained broadly unchanged from the first half of 2025. This indicates a stable situation in Latvia’s medicines market.
