# Title 50 — North Dakota Board of Medicine

## Article 50-06 — Naturopathic Licensure

## Chapter 50-06-02 — Authority of Naturopaths

### § 50-06-02-01. Rights and privileges.

Unless otherwise limited by statute, naturopaths are entitled to all rights and privileges of
physicians in this state recognized under North Dakota Century Code section 43-58-09.
History: Effective April 1, 2024.
General Authority: NDCC 43-58-03.1
Law Implemented: NDCC 43-58-08, 43-58-09, 43-58-10
### § 50-06-02-02. Signing death certificates.

In case of the death of any patient, the naturopath shall fill out and sign such certificate of death as
is required by statute.
History: Effective April 1, 2024.
General Authority: NDCC 43-58-03.1
Law Implemented: NDCC 43-58-09
### § 50-06-02-03. Advertising.

Naturopaths may advertise their practice in any legitimate manner set forth in the code of ethics
adopted by the board, except as limited or prohibited by statute.
History: Effective April 1, 2024.
General Authority: NDCC 43-58-03.1
Law Implemented: NDCC 43-58-03.1
### § 50-06-02-04. Authority to administer, prescribe, and dispense.

The practice of naturopath medicine includes the administration, prescription, dispensing, ordering,
or performing of:
1. Food, vitamins, minerals, nutritional supplements, digestive enzymes, botanical medicine, and
homeopathic remedies.
2. Health care counseling, nutritional counseling and dietary therapy, hydrotherapy, and
naturopathic physical applications and therapeutic devices. Naturopathic physical application
does not include manipulation of the spine. Naturopathic physical application does include
osseous manipulation of the extremities, ribs, and pelvis.
3. Nondrug prescription devices.
4. Nonprescription topical drugs.
History: Effective April 1, 2024.

General Authority: NDCC 43-58-03.1
Law Implemented: NDCC 43-58-08
### § 50-06-02-05. Intradermal, intramuscular, intravenous, and subcutaneous administration.

1. A naturopath may not perform any intra-articular injection or intraspinal injection.
2. A naturopath may prepare and administer for immediate use vitamins, minerals, amino acids,
and homeopathic remedies in accordance with naturopathic medical training through
intradermal, intramuscular, or subcutaneous injection, or, if the naturopath holds the required
endorsement, through intravenous therapy. Any injectable therapies must be prepared in
accordance with USP 797 standards for immediate use. Substances administered by injection
or intravenous therapy must be manufactured and supplied by a manufacturer or outsourcing
facility required to register with the United States food and drug administration or compounded
pursuant to a prescription by a pharmacy licensed by the board of pharmacy.
3. A naturopath may use intravenous therapy only after the naturopath has obtained an
endorsement from the board to perform intravenous therapy by submitting a completed
application with an attestation of training to the board. The training must be at least sixteen
hours of instruction. At least eight hours of instruction must be from a graduate-level course
through an approved naturopathic medical school. Instruction must include:
a. Indications;
b. Contraindications;
c. Formularies;
d. Emergency protocols;
e. Osmolarity calculation;
f. Aseptic technique; and
g. Proper documentation.
4. A naturopath shall retain documentation of intravenous training for at least five years from
attestation date.
5. Intravenous chelation therapy is limited to use for heavy metal toxicity.
6. A naturopath who uses injection or intravenous therapy shall have a plan to manage adverse
events, including sensitivity, allergy, overdose, or other unintended reactions.
History: Effective April 1, 2024.
General Authority: NDCC 43-58-03.1
Law Implemented: NDCC 43-58-08
### § 50-06-02-06. Endorsement for prescriptive authority.

A licensed naturopath may not prescribe medications pursuant to the formulary adopted under
section 50-06-02-08 unless the licensed naturopath first obtains an endorsement under this section and
approval by the board.
1. Limited endorsement. To be eligible to prescribe, a licensed naturopath shall first obtain a
limited endorsement by submitting an application to the board and entering into a written
collaborative agreement with a supervising physician who meets the requirements of section
50-06-02-07.

2. Endorsement to practice independently. After completing the requirements of subsection 1,
the naturopath may submit an application to prescribe independently by showing successful
passage of the naturopathic physicians licensing examination (NPLEX) with the test results
sent directly to the board by the North American board of naturopathic examiners (NABNE).
The supervising physician shall provide proof and verification attesting to the naturopath's safe
prescribing practices sent directly to the board.
3. Waiver of limited endorsement. The requirements of subsections 1 and 2 may be waived if
the naturopath shows substantial experience in prescribing medications under the laws and
rules of another jurisdiction that has standards and qualifications for a licensed naturopath to
prescribe medications at least equal to those required under North Dakota Century Code
chapter 43-58. The naturopath shall apply for the waiver by submitting an application with the
board, providing a copy of the written collaborative agreement previously entered with a
supervising physician from the other jurisdiction, and providing a copy of the laws and rules of
the other jurisdiction showing equal requirements. The application will be reviewed by the
board at its next available regular meeting.
History: Effective April 1, 2024.
General Authority: NDCC 43-58-03.1
Law Implemented: NDCC 43-58-08.1
### § 50-06-02-07. Supervising physician for license endorsement for prescriptions.

The supervising physician for a naturopath's limited endorsement for prescriptive authority shall
possess an active, unencumbered physician license issued under North Dakota Century Code chapter
43-17 and must have been prescribing and administering prescription drugs without limitation for at
least five years immediately preceding the application. The supervising physician shall provide
objective and independent review of the naturopath's first one hundred prescriptions issued by the
naturopath or twelve months of prescribing, whichever occurs first. The supervising physician shall
evaluate the naturopath's ability to safely prescribe and administer prescription drugs within the
naturopath's scope of practice, education, training, and the naturopath's compliance with federal and
state laws and regulations. The naturopath shall keep a duplicate of all prescriptions written to be
reviewed at least monthly with the supervising physician.
The naturopath and supervising physician shall have a formal written agreement. The agreement
must address the requirements of this rule. A copy of the fully executed agreement must be filed with
the board along with the application for limited endorsement pursuant to North Dakota Century Code
section 43-58-08.1.
History: Effective April 1, 2024.
General Authority: NDCC 43-58-03.1
Law Implemented: NDCC 43-58-08.1
### § 50-06-02-08. Formulary.

1. A naturopath may only prescribe drugs pursuant to this formulary after obtaining an
endorsement for prescriptive authority under section 50-06-02-06.
2. A naturopath may not recommend altering or discontinuing a drug that is not within the
naturopath's scope of practice and prescriptive authority that may be prescribed under this
formulary. The naturopath instead shall refer the patient to their primary provider or prescribing
provider.
3. The formulary for naturopaths with an endorsement for prescriptive authority consists of
noncontrolled legend drugs and testosterone deemed appropriate for the primary health care
of patients within the scope of practice and training of each naturopath. Prescribing pursuant

to the formulary must be in accordance with the standard of care provided by the naturopath's
training, experience, and the degree of expertise.
4. The use of all drugs must be supported by FDA label, compendia, expert opinion, or clinical
practice guidelines. Compendia supported use is defined as recommended with evidence
favoring efficacy in the American Hospital Formulary Service Drug Information, United States
Pharmacopeia-Drug Information, or the DRUGDEX information system.
5. The following formulary references the United States Pharmacopeia (USP) drug classification
system.
6. Unless otherwise indicated in the formulary, drugs specified in the formulary that are allowed
to be prescribed include all forms of the drug including time release forms and other generic
forms.
7. A naturopath who obtains an endorsement for prescriptive authority under section
use within the corresponding category and indication:
Drugs or Classes of Drugs that May be Application and
Category/Indication Prescribed with Prescriptive Endorsement Other Limitations
Analgesics All drugs within the NSAID class may be
prescribed.
Anesthetics All drugs within the local anesthetics class
may be prescribed.
Antiaddiction/Substance Naltrexone
abuse treatment agents
Nicotine
Antibacterials Neomycin May not administer any
drugs in this category via
Gentamicin (topical only)
intravenous administration.
Tobramycin (topical only)
Amoxicillin
Amoxicillin/Clavulanate potassium
Penicillin G
Doxycycline
Clarithromycin
Clindamycin (topical only)
Nitrofurantoin
Metronidazole
Acetic acid
Polymyxin B sulfate
Rifaximin
Antiemetics Ondansetron

Diphenhydramine hydrochloride
Hydroxyzine hydrochloride
Meclizine hydrochloride
Metoclopramide hydrochloride
Scopolamine
Antifungals Terbinafine (topical only)
Miconazole nitrate (topical only)
Ketoconazole (topical only)
Terconazole (topical only)
Fluconazole
Nystatin
Antigout agents Probenecid
Allopurinol
Colchicine
Antimigraine agents Propranolol hydrochloride
Antineoplastics Anastrozole Topical only
All drugs may only be
Alitretinoin
prescribed for noncancer
purposes and uses.
Tretinoin
Antiobesity agents Orlistat
Antiparasitics Albendazole Topical only
Ivermectin
Mebendazole
Antispasticity agents Baclofen
Tizanidine hydrochloride
Antivirals Acyclovir
Valacyclovir
Oseltamivir
Anxiolytics Buspirone
Hydroxyzine
Blood glucoses All drugs within the antidiabetic agents and
regulators glycemic agents class may be prescribed.
All drugs within the biguanide and DPP 4
inhibitors group may be prescribed.
Blood products and Aspirin Not allowed to do blood
modifiers transfusions.

Heparin sodium (for nontherapeutic blood
thinning only)
Cardiovascular agents All drugs within the following classes may be Beta adrenergics
prescribed: medications are limited to
100 mg.
• Alpha-adrenergic agonists;
Nondihydropyridines
• Alpha-adrenergic blocking agents; medications are limited to
120 mg.
• Angiotensin II receptor antagonists;
• Angiotensin-converting enzyme
(ACE) inhibitors;
• Calcium channel blocking agents -
Dihydropyridines and
nondihydropyridines;
• Loop diuretics;
• Potassium-sparing diuretics;
• Thiazide diuretics;
• Dyslipidemics - Fibric acid derivatives,
HMG CoA reductase inhibitors, and
PCSK9 inhibitors.
Central nervous system Clonidine hydrochloride
agents
Contraceptives All drugs within the oral contraceptives May not prescribe any
combinations and oral progestins classes may drug within this category
be prescribed. that would require a
procedure such as
Citric acid/Lactic acid/Potassium bitartate
implantable
contraceptives.
Ethinyl estradiol/Etonogestrel
Ethyinyl estradiol/Norelgestromin
Levonorgestrel
Dental and oral agents Doxycycline hyclate
Minocycline hyclate
Prilocaine hydrochloride
Triamcinolone acetonide
Dermatological agents All drugs within this category may be Topical only except can
prescribed. allow triamcinolone
injection.
Electrolytes - Minerals - All drugs within this category may be
Metals - Vitamins prescribed.
Gastrointestinal agents All drugs within the following classes may be
prescribed:

• Anticonstipation agents;
• Antidiarrheal agents;
• Antispasmodics, gastrointestinal;
• Histamine receptor antagonists;
• Protectants;
• Proton pump inhibitors.
Metoclopramide hydrochloride
Rifaximin
Ursodiol
Cholic acid
Betaine
Betaine hydrochloride
Cromolyn sodium
Amoxicillin/Clarithromycin/Omeprazole
Genitourinary agents All drugs within this category may be
prescribed.
Hormonal agents: Hydrocortisone (dose limit: 30 mg daily)
stimulant, replacement,
Prednisone (dose limit: 5 mg daily)
modifying (adrenal)
Methylprednisolone acetate (burst dose pack -
dose limit of 1 pack per 60 days)
Triamcinolone acetonide
Hormonal agents: Testosterone Testosterone dosage
stimulant, replacement, limits:
All drugs within the androgens and progestins
modifying (sex Injectable - maximum
classes may be prescribed.
hormones, modifies) 400mg/28 days dosage
Topical - maximum
All drugs within the estrogens class may only
100mg/day dosage
be prescribed as topical and vaginal HRT.
Exception for oral estrogens prescribed for
purposes of contraception.
Estradiol/Levonorgestrel
Estradiol/Norethindrone acetate
Estradiol/Norgestimate
Estradiol/Progesterone
Hormonal agents: All drugs within this category may be
stimulant, replacement, prescribed.
modifying (thyroid)
Immunological agents All drugs within the vaccines class may be

prescribed.
All drugs within the other immunological
agents - Allergen specific immunotherapy
group may be prescribed.
Inflammatory bowel Hydrocortisone
disease agents
Prednisone
Metabolic bone disease Alendronate
agents
Ibandronate
Cholecalciferol
Calcitriol
Doxercalciferol
Paricalcitol
Ophthalmic agents All drugs within antiallergy agents class may
be prescribed.
All drugs within the anti-infectives class may
be prescribed (topical only).
Diclofenac sodium
Ketorolac tromethamine
Nepafenac
Bacitracin zinc/Hydrocortisone
acetate/Neomycin sulfate/Polymyxin B sulfate
Bacitracin zinc/Hydrocortisone
acetate/Polymyxin B sulfate
Hydrocortisone acetate/Neomycin
sulfate/Polymyxin B sulfate
Ciprofloxacin (topical only)
Otic agents All drugs within this category may be Topical use only
prescribed.
Respiratory tract/ All drugs within the following classes may be
Pulmonary agents prescribed:
• Antihistamines;
• Anti-inflammatories - Inhaled
corticosteroids;
• Antileukotrienes;
• Anticholinergic bronchodilators;
• Sympathomimetic bronchodilators;

• Combination bronchodilators;
• Cold-cough; and
• Mast cell stabilizers.
Acetylcysteine
Sexual disorder agents All drugs within the sexual disorder agents
(male) class may be prescribed.
Skeletal muscle relaxants Cyclobenzaprine hydrochloride
History: Effective April 1, 2024; amended effective January 1, 2026.
General Authority: NDCC 43-58-03.1
Law Implemented: NDCC 43-58-08(3)(c)
