Can an NP prescribe Tramadol in North Carolina?

Yes — North Carolina nurse practitioners may prescribe tramadol, a Schedule IV controlled substance,³ when the prescription is within the NP's population focus, education, national certification, competence, and scope and is authorized by the collaborative practice agreement.¹²

For tramadol prescribing, the NP must have North Carolina NP approval with controlled-substance prescriptive authority, DEA authority, and a primary supervising physician whose controlled-substance authority is at least equal to the NP's DEA registration.²

Controlled-substance prescriptions must include the NP's DEA number and be documented in the patient record.

North Carolina NPs may not prescribe controlled substances for themselves, their supervising physician, immediate family members, household members, or intimate partners.

The STOP Act targeted-controlled-substance limits cited by the Board focus on Schedule II and III opioids and narcotics, so those Schedule II/III rules are not a general Schedule IV tramadol limit.⁴