VA SB418

Authorizes pharmacists to perform therapeutic interchange by substituting a prescribed drug with another drug in the same therapeutic class when the substitution lowers costs, is cost-neutral to the patient, or occurs during a drug shortage as listed by the FDA or American Society of Health System Pharmacists.

Permits pharmacists to adapt prescriptions by changing drug name, strength, directions, quantity, or dosage form when in the patient's best interest, provided the equivalent amount of medication is dispensed.

Requires pharmacists to notify the prescriber within 24 hours when a therapeutic interchange substitution is made.

Preserves prescriber authority to prevent substitutions by checking the "Dispense as Written" box on prescriptions.

Directs the Board of Pharmacy to promulgate regulations determining which therapeutic drug classes are eligible for interchange and which are prohibited.