White, green and yellow prescriptions: what's the difference and how they're dispensed

Prescriptions in Romania have well-defined colour codes — and each colour means a different type of medicine, a different dispensing regime, and different obligations for the doctor and the pharmacist. Here is what you need to know about the white, green and yellow prescription, plus the reimbursed SIPE prescription.

The regulatory framework — Order 75/2010

Prescription types are set by Order MS 75/2010 (Ordinul MS 75/2010, the Ministry of Health order on prescribing medicines) and by Law 339/2005 (Legea 339/2005) on the legal regime of narcotic and psychotropic plants, substances and preparations. Each form (colour) corresponds to a distinct category:

• White prescription — Rx medicines with no special regime;
• Green prescription — psychotropic substances (schedule III);
• Yellow prescription with embossed stamp — narcotic substances (schedule I, II);
• Electronic SIPE prescription (Sistemul Informatic de Prescripție Electronică — Romania's electronic prescribing system) — all reimbursed prescriptions covered by CNAS (Casa Națională de Asigurări de Sănătate — Romania's National Health Insurance House), regardless of the type of medicine.

The white prescription — standard Rx

The white prescription is the most common. It is used for:

• antibiotics (amoxicillin, clarithromycin, ciprofloxacin);
• antihypertensives, statins, non-chronic antidiabetics;
• strong anti-inflammatories (systemic diclofenac, ketorolac);
• systemic antifungals (fluconazole);
• oral contraceptives;
• prescribed dermatological medicines (oral retinoids, isotretinoin under special conditions).

It contains: patient name + CNP (cod numeric personal — personal ID number), age, ICD-10 diagnosis (optional for non-reimbursed prescriptions), the name of the medicines (DCI or brand name), the strength, the form, the quantity, the route of administration, the doctor's signature + stamp (parafă), the date. Valid for 30 days for acute treatments.

The green prescription — psychotropics (schedule III)

The green prescription is printed on green paper and contains additional elements. It is used for psychotropic substances in schedule III (annex of Law 339/2005):

• benzodiazepines — diazepam, alprazolam, lorazepam, clonazepam, midazolam;
• non-benzodiazepine hypnotics — zolpidem (Stilnox), zopiclone;
• tramadol (a weak opioid analgesic);
• phenobarbital, primidone (antiepileptics);
• buprenorphine (a partial agonist opioid).

Differences compared with the white prescription:

• maximum quantity per prescription: 30 days of treatment;
• it is not renewed automatically — a new consultation is required;
• the pharmacy keeps the copy in a special register, retained for 5 years on the premises;
• the doctor's stamp code + the prescription number are recorded in a national register for psychotropics, managed by the county DSP (Direcția de Sănătate Publică — county public health directorate).

The yellow prescription with embossed stamp — narcotics (schedule I, II)

The most restricted form. It is printed on a form with a dry embossed stamp and unique numbering, controlled by the DSP. It is used for:

• strong opioids — morphine, fentanyl (Durogesic, Actiq), oxycodone, hydromorphone;
• pethidine;
• methadone (in opioid substitution programmes);
• ketamine (used in hospitals, but also in outpatient settings for a few indications);
• cocaine (very rarely — a local ENT anaesthetic in specialised hospitals);
• authorised amphetamines (methylphenidate — Concerta — for ADHD).

Strict rules:

• maximum quantity: 30 days of treatment — sometimes reduced to 7 days for patients new to opioids;
• mandatory completion of the quantity in both words and figures (anti-forgery);
• the doctor holds a special authorisation to prescribe narcotics (issued by the DSP);
• the pharmacy keeps the copy in the safe (iron cabinet), with strict records;
• monthly reporting to the DSP by the pharmacy on narcotic consumption.

Patients with advanced oncological pain, postoperative pain, cystic fibrosis, or degenerative neurological diseases are the main beneficiaries. Non-stop pharmacies are required to be equipped to dispense narcotics 24/7 under CNAS contracts.

The electronic SIPE prescription — all reimbursed prescriptions

Regardless of the type of medicine (white, green, yellow), if the prescription is reimbursed by CNAS, it goes through SIPE. The printed form contains the 1D barcode and the 2D Datamatrix code needed for dispensing.

For reimbursed yellow prescriptions (usually oncological with opioids, or ADHD with methylphenidate), the prescription is double: the white-pink SIPE CNAS form plus the yellow form with the special stamp. Both are presented at the pharmacy. See our article about the electronic prescription for the details of the SIPE flow.

The simple (non-reimbursed) prescription

For Rx medicines on which you do not want reimbursement (e.g. antibiotics bought privately, non-reimbursed oral contraceptives, cosmetic medicines), the doctor can write you a white prescription without ICD-10. You pay the full PVA (prețul cu amănuntul — retail price). Valid for 30 days, dispensed at any pharmacy.

Visual example — what each form looks like

In practice, if you collect a prescription at the pharmacy, you will see distinct papers depending on the content. Here are the visual details for each:

• White SIPE prescription — a white-pink A4 form with the CNAS header, the logo of the County House in the corner. It has space for the CNP, age, up to 7 medicines, the ICD-10 diagnosis, the doctor's digital signature printed as a hex string, a 1D barcode + a 2D Datamatrix code at the bottom.
• Classic green prescription — an A5 or A6 form on light green paper. Unique numbering (e.g. „NR. RV/2026/XXXXXX"). Mandatory fields: patient name + CNP, the name of the medicine in words and figures, quantity in words and figures, the doctor's stamp. The doctor's seal and signature. Two copies — one for the patient, one stays with the doctor.
• Yellow prescription with dry stamp — an A5 form on yellow paper with an official perforated stamp („dry stamp" — a tactile relief of the MS, the Ministry of Health). Triple numbering (CNP + prescription NR + pharmacy code). Three copies: one stays with the doctor, one for the patient, one (after dispensing) reported to the county DSP.
• Combined yellow SIPE prescription — for rare cases (reimbursed oncology with opioids), two sheets: white-pink SIPE + yellow with dry stamp. They must be presented together at the pharmacy.

If the prescription you received does not match these descriptions (missing dry stamp on the yellow one, missing Datamatrix code on the SIPE, non-standard formats), suspect an administrative error — call the doctor to check or ask the pharmacist when you present it.

Who does what — doctor vs pharmacist vs SIPE

Many patient confusions arise from mixing up the roles. For clarity:

• The doctor — diagnoses (assigns the ICD-10), prescribes (chooses the DCI, dose, duration), validates the prescription with an electronic signature in SIUI (Sistemul Informatic Unic Integrat — Romania's integrated health-insurance IT system). Decides between the white, green and yellow prescription depending on the molecule. Decides reimbursement (sublist) depending on the diagnosis. Can note „do not substitute" to force a particular brand.
• The pharmacist — checks the validity of the prescription (SIPE code, signature), scans the EMVS (European Medicines Verification System) Datamatrix code for authenticity, proposes a generic substitution where allowed, dispenses the prescribed quantity, records the dispensing in SIPE to close the cycle. On the fiscal receipt they show the price, the reference price, the reimbursement, and the patient's payment.
• SIPE — the IT system that links the doctor, the pharmacy and CNAS. All reimbursed prescriptions go through it. It validates quantities (you cannot collect more than what the doctor prescribed), automatically applies the reimbursement, and settles directly with the pharmacy the amount from CNAS. The patient does not interact directly with SIPE — the interface is the health card.
• CNAS — pays the pharmacy for the reimbursed part, tracks consumption in national programmes, and manages the reimbursement list (the sublists) through the annual framework contract.
• ANMDMR (Agenția Națională a Medicamentului și a Dispozitivelor Medicale din România — the National Agency for Medicines and Medical Devices of Romania) — authorises the medicine (APP — autorizația de punere pe piață, marketing authorisation), monitors safety (pharmacovigilance — adverse-reaction reporting), manages the Nomenclature, and authorises online pharmacies.

How long records are kept in the pharmacy

For each type of prescription, the pharmacy is obliged to keep the record physically or digitally for specific periods:

• White prescriptions (non-reimbursed) — kept for 3 years or electronically in the pharmacy's ERP system.
• Reimbursed SIPE prescriptions — kept in the system and physically for 5 years, for CNAS audits.
• Green prescriptions (psychotropics) — kept for 5 years in a special register, with monthly quantitative reporting to the DSP.
• Yellow prescriptions (narcotics) — kept for at least 5 years, with daily quantitative records and a monthly report to the DSP. A mandatory annual audit by the DSP inspector.

These rules are set by Law 339/2005 and Government Decision 1915/2006 (Hotărârea 1915/2006). Non-compliance leads to suspension of the pharmacy's authorisation for psychotropics/narcotics and fines between 10,000 and 50,000 RON.

Who has the right to prescribe what

Not every doctor can prescribe every type of prescription. The limits are:

• The family doctor — white prescriptions, reimbursed SIPE prescriptions (standard sublists A, B, C3, and some C2), green prescriptions for stabilised psychiatric conditions that were already under specialist treatment. Does NOT issue yellow prescriptions (narcotics) except with a special DSP authorisation.
• The specialist — any type of prescription within their field (the psychiatrist: green ones for benzodiazepines; the oncologist: yellow ones for opioids; the neurologist: both types for epilepsy/neuropathic pain).
• The hospital doctor — prescriptions for discharge, valid for the duration of recovery (usually 30 days post-discharge). For chronic patients, the patient moves to the family doctor for renewals.
• The dentist — white prescriptions only for dental treatment (antibiotics, post-procedure anti-inflammatories, painkillers). Quantitative restrictions: max 7 days of treatment.

Special situations

Repeatable vs single-use

Chronic prescriptions (antihypertensives, etc.) can be marked „repeatable" — they are dispensed several times within the validity period (90 days, 3 cycles). Acute prescriptions are single-use — a single trip to the pharmacy.

Prescriptions for international travel

To legally transport psychotropic or narcotic substances across the border, you need a Schengen Article 75 certificate, issued by the pharmacy with the county DSP endorsement. Turnaround 5-10 working days. Details in our guide on the travel kit.

Telemedicine

Since 2020, doctors can issue SIPE prescriptions via teleconsultation. The patient receives the code by SMS or email. It applies only to non-restricted types — yellow prescriptions remain exclusively face-to-face.