Prescribing After Orofacial Harmonization: What the Rules Say

"Can I take medication after the filler?" and "do I need a corticosteroid after the lip?" are among the most common aftercare questions. Behind them are two layers: the clinical one (is any medication needed?) and the regulatory one (who can prescribe what, and on which prescription?). This guide organizes the second layer and shows how to document the first.

It does not recommend any drug, dose, or regimen and does not state which professional may prescribe what. It reports what the general rules in Brazil say and where to check. Each council's rules change and some are being contested in court; read the current rule before deciding. General care instructions, without medication, are in post-procedure instructions.

What determines who can prescribe?

The right to prescribe comes from the law that governs each profession and from the rules of the respective council. In HOF this matters because professionals with different training perform similar procedures but do not have the same legal basis for prescribing.

The regulatory landscape of HOF by council is in HOF regulation at the CFO, facial harmonization in biomedicine, aesthetics in nursing, aesthetic pharmacy, and facial harmonization and the CFM.

Which Anvisa rules apply to any prescriber?

Besides professional competence, the prescription must follow the health rules for the type of drug:

• Over-the-counter drugs can be recommended, but the guidance should still be recorded in the patient record.
• Prescription-only drugs require a prescription with the minimum elements (identification of the prescriber and the patient, drug, directions for use, date, and signature).
• Antimicrobials follow Anvisa RDC No. 471/2021, as amended: the prescription is retained by the pharmacy and, per the text of the rule, is valid for 10 days from issue.
• Specially controlled substances follow SVS/MS Ordinance No. 344/1998, with a prescription notification or special-control prescription depending on the substance's list.

A digital prescription needs a valid electronic signature under the law, and some categories require a qualified signature. Check the rule for the type of prescription before issuing it.

What tends to come up in HOF aftercare?

Without recommending any approach, these are the situations in which the medication question tends to arise. In all of them, the decision is clinical, individual, and documented.

What about the medications the patient already takes?

Much of the question "can I take medication?" is about what the patient already takes. The practical rule is not to stop an ongoing medication because of the aesthetic procedure. Anticoagulants, antiplatelets, and other drugs prescribed by a physician are only adjusted by whoever prescribed them, and postponing the procedure is usually safer than asking the patient to stop the drug.

Also ask about supplements and herbal products, which the patient does not usually think of as "medication", and about drugs with a relevant interaction for the plan, such as isotretinoin (isotretinoin and injectable procedures).

What to record in the patient record?

Every prescription, including a verbal recommendation of an over-the-counter drug, should be in the patient record:

1. Drug, form, dosage, and duration, as prescribed.
2. Clinical reason for the prescription.
3. Allergies and current medications checked beforehand.
4. Copy or record of the prescription delivered.
5. Guidance given on warning signs and when to seek care.
6. Progress at the follow-up.

What to record at each visit is detailed in patient record and documentation in HOF.

When to refer instead of prescribing?

In some situations the safest answer is not a prescription but a referral. This applies when the picture goes beyond what you assess and follow in the office, or when the prescription needed is outside your legal competence:

• Systemic signs: fever, malaise, shortness of breath, swelling in other parts of the body, or generalized hives.
• Patient with decompensated chronic disease, such as diabetes, hypertension, or kidney disease, which changes the choice of any drug.
• Pregnancy or breastfeeding discovered after the procedure, which change the safety of almost any drug.
• Use of several medications, with an interaction risk you cannot safely assess.
• Visual, neurological, or ischemia symptoms, which are an emergency and follow their own protocol. See safety and complications.

Referring is not failing: it is documenting that you recognized the limit. Note in the record the reason, whom you referred to, and the guidance given until the visit.

How to answer the patient?

Giving instructions in writing reduces self-medication. There are templates for aftercare instructions for hyaluronic acid filler and botulinum toxin aftercare instructions, which you adapt to what your rule allows.

And in Harmy?

HOF aftercare prescribing checklist

1. Prescribing competence checked against the profession's law and the council's current rule.
2. Individual clinical indication, with no routine prescription for everyone.
3. Allergies, ongoing medications, and supplements asked about.
4. Prescription type suited to the drug's category.
5. Prescription and guidance recorded in the patient record.
6. Written instructions given to the patient, with warning signs.
7. Ongoing medication never stopped without the original prescriber.