“A pharmacist’s mandate includes dispensing the correct drug for the patient’s disease, and the pharmacist is both ethically and legally liable if a drug is dispensed for an inappropriate indication.”
It is legal in all 50 states to prescribe drugs for “off-label” indications.
These indications are usually supported by medical research of which the pharmacist may often be unaware.
An example is beta blockers, originally approved for treatment of hypertension, but widely used to control tachycardia in atrial fibrillation and hyperthyroidism for many years before that indication was approved my the FDA.
Thus, it is not up to a pharmacist to pass judgement on the indication.
There is a difference between “off-label” and “inappropriate.” If a drug is prescribed that seems inappropriate to the stated indication, or could endanger a patient, it is the pharmacist’s duty to check, and indeed refuse the prescription if his or her concerns are not satisfied. Pharmacists can and have been held liable when they failed to do so and the patient was harmed.