What we can do. What we can’t. No grey areas.
Since November 2023, Registered Nurses in Ontario who complete College of Nurses of Ontario–approved education can prescribe from a defined list of medications and communicate the diagnosis that goes with them. This page is that list, in plain language, and the limits that come with it.
The list
Medications an RN prescriber may prescribe
Appendix A of the CNO practice standard, by category. The first five are our services; the last three support them.
Contraception & Birth Control
The pill, the ring and the injection — new starts, switches and renewals, plus emergency contraception.
Service details Before you goTravel Health
Itinerary-based consults, travel vaccines, and prescriptions for malaria prevention and travellers’ diarrhea.
Service details PreventionVaccines & Immunizations
Flu, shingles, pneumonia, Tdap, HPV, hepatitis and catch-up schedules, assessed, prescribed and given at home.
Service details A plan that fits youQuit Smoking Support
A personal quit plan with prescription support — varenicline or bupropion — plus nicotine replacement guidance and follow-up.
Service details Skin and woundTopical Wound Care
Minor wound assessment, topical antibiotic and odour-control prescriptions, and nipple care for breastfeeding parents.
Service detailsTopical anesthetics
For pain relief during immunization and topical wound care.
Epinephrine
To treat anaphylaxis — our prescriber is trained and equipped for it at every vaccine visit.
Over-the-counter medication
Medication you can pick off a pharmacy shelf, prescribed rather than just recommended when your drug plan only covers it with a prescription.
In detail
- Immunization: any vaccine for the prevention of bacterial and viral disease.
- Contraception: hormonal contraceptives for systemic use, oral and injectable, and intravaginal contraceptives such as the ring. IUDs and implants are excluded.
- Travel health: malaria prevention (aminoquinolines, biguanides, methanolquinolines, doxycycline) and the prevention or treatment of travellers’ diarrhea (norfloxacin, ciprofloxacin, levofloxacin, azithromycin, rifaximin).
- Topical wound care: topical antibiotics, topical metronidazole for odorous wounds, and the betamethasone–mupirocin–miconazole combination for cracked nipples.
- Smoking cessation: bupropion and varenicline.
- Anesthetics: topical anesthetics for pain relief related to immunization and wound care.
- Allergic reaction: epinephrine to treat anaphylaxis.
- Over-the-counter medication: anything lawfully available without a prescription and self-selected in a pharmacy.
Also part of the authority
- Communicating to you a diagnosis the RN made, where the purpose is prescribing one of these medications.
- Dispensing, or administering by injection or inhalation, a medication the RN prescribed — so we give the vaccines we prescribe ourselves, at home.
An RN prescriber must have completed CNO Council-approved education, have a nurse–client relationship with you, prescribe for therapeutic purposes only, and keep a copy of every prescription in your record. Each prescription carries your name and address; the medication, strength, quantity and directions; the date and any refills; and the prescriber’s name, address, phone number, title, CNO registration number and signature.
RN prescribing is regulated by the College of Nurses of Ontario. Any nurse’s prescribing authorization can be checked on the CNO’s public register, Find a Nurse.
The limits
What Ontario law doesn’t allow RN prescribers to do
These aren’t our policies — they’re the law and the standard, and we think you should know them before you book. When your care needs any of these, we tell you right away and help you find the right provider.
- Order lab or diagnostic tests
Ontario law doesn’t allow RNs to order blood work, swabs or imaging. When your care depends on a test, we refer you to a physician, nurse practitioner or walk-in clinic rather than guess.
- Prescribe outside the RN list
No antibiotics by mouth, no blood pressure or diabetes medication, no antidepressants, no controlled substances or narcotics. If you need those, you need a physician or nurse practitioner — and we’ll help you get there.
- Insert or prescribe IUDs and implants
Long-acting contraceptives are outside RN prescribing. We can discuss them honestly as options and point you to a provider who inserts them.
- Sell or compound medication
Prescriptions are sent to the pharmacy you choose. We don’t sell medication and have no financial interest in where you fill it.
- Act as your family doctor
We’re a focused service for specific needs, not a replacement for primary care. We’re glad to share visit summaries with your doctor or NP when you ask us to.
How a prescribing visit works
Assess. Diagnose. Prescribe. Record.
The CNO standard sets out what competent RN prescribing looks like. Here is how that plays out in the room.
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Health assessment
Your history, current medications, allergies and relevant measurements — the information needed to decide safely, including the best possible medication history.
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Diagnosis, where needed
A clinical judgment our prescriber makes and explains to you, for the purpose of the medication being considered — never for anything outside the list.
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Treatment plan, together
Options, cost, side effects, interactions and what to expect, agreed with you. Informed consent, every time.
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Prescription and record
A complete prescription to your pharmacy, a copy in your health record, and follow-up arranged — or a referral if the right answer is outside our scope.
Questions
Frequently asked, honestly answered.
The CNO’s practice standard is the source for everything on this page.
Is an RN prescriber the same as a nurse practitioner?
No. Nurse practitioners (NPs) have a broader scope: they can diagnose generally, order tests and prescribe most medications. An RN prescriber is a Registered Nurse with additional, CNO-approved education who may prescribe from a specific list for non-complex conditions. We’re clear about which one we are.
Can you diagnose me?
Only for the purpose of prescribing a medication on the RN list, and only a diagnosis our prescriber made. For example, assessing you and determining that hormonal contraception is appropriate, or that a wound needs a topical antibiotic. We can’t diagnose or treat conditions beyond that list.
Can you renew my blood pressure, thyroid or antidepressant prescription?
No. Those are outside RN prescribing. Your pharmacist can often extend a prescription in Ontario, and your family doctor, a nurse practitioner or a walk-in clinic can renew it.
Can you treat a urinary tract infection or strep throat?
No. Oral antibiotics are not on the RN prescribing list. Ontario pharmacists can now assess and prescribe for several minor ailments, including uncomplicated UTIs; otherwise see a physician or NP.
Can you give me a sick note or fill out forms?
We document every visit, and Ontario’s Employment Standards Act counts a registered nurse as a “qualified health practitioner” for notes — though since October 2024 employers can’t require a note for the three ESA sick days at all. We complete forms that accept an RN’s signature and write to your doctor or NP when a form needs theirs. Details on our notes and letters page.
Where is this written down?
In the Nursing Act, 1991 and Ontario Regulation 275/94, and in the College of Nurses of Ontario’s practice standard “Registered Nurse (RN) Prescribing”, whose Appendix A lists the medications. Both are public, and we link to the standard on this page.
Within scope?
If it’s on the list, let’s get it done.
Birth control, travel, vaccines, quitting smoking, minor wounds — request a time and we’ll confirm within one business day.