What is the NAPLEX Exam?

Once you’ve earned your Doctor of Pharmacy degree, or PharmD, you’re one step closer to becoming a practicing pharmacist.

You’ve successfully navigated the challenging journey of a rigorous pharmacy school education. This is certainly a time to celebrate your accomplishments and efforts. Only about 2% of the US population holds a doctoral degree, so you are already in an elite company.

After you walk across the stage, accept your degree, and participate in the hooding ceremony surrounded by friends, family, and doctors, only one major obstacle remains in your way: passing the national pharmacy licensure exam.

The NAPLEX (North American Pharmacist Licensure Examination) is a standardized examination developed by the National Association of Boards of Pharmacy (NABP) to assess the competency of new pharmacy graduates. This comprehensive test evaluates your knowledge and ability to apply pharmaceutical care concepts in real-world scenarios. Successful completion of the NAPLEX is a prerequisite for obtaining a pharmacist license in the United States and its territories.

The NAPLEX is a 6-hour exam with 225 questions delivered in a computerized, fixed form. The exam results are reported as PASS or FAIL, and candidates are allowed 5 attempts to pass the examination. While the exam consists of 225 questions, only 200 will be used to calculate your exam score. The remaining 25 questions are experimental and may be included in future examinations.

A test taker can expect the total appointment time to be up to 6 hours and 40 minutes to allow time to read and agree to the non-disclosure agreement for NABP examinations, read the tutorial, take the examination, take the two optional breaks, and take the post-exam survey. Unfortunately, any bathroom break or unscheduled break will not result in additional time given. There is a process for ADA testing accommodations.

The NAPLEX competency statements outline the knowledge, skills, and abilities evaluated during the examination. A strong familiarity with the competency statements will greatly benefit you as you prepare to take this examination. 

The six competency areas, according to the NABP are:

Develop or Manage Treatment Plans (~35% of exam)

1. Triage or medical referral

2. Therapeutic goals or outcomes and clinical endpoints

3. Medication reconciliation; indication or therapeutic uses; lack of indication; inappropriate indication; duplication of therapy; omissions

4. Drug dosing or dosing adjustments; duration of therapy

5. Drug route of administration, dosage forms, or delivery systems

6. Drug contraindications, allergies, or precautions

7. Adverse drug effects, toxicology, or overdose

8. Drug interactions

9. Therapeutic monitoring parameters, monitoring techniques, monitoring tools, or monitoring frequency

10. Drug pharmacokinetics or pharmacodynamics

11. Evidence-based practice

12. Non-drug therapy: lifestyle, self-care, first-aid, complementary and alternative medicine, or medical equipment

Obtain, Interpret, or Assess Data, Medical, or Patient Information (~18% of exam)

1. From instruments, screening tools, laboratory, genomic or genetic information, or diagnostic findings

2. From patients: treatment adherence, or medication-taking behavior; chief complaint, medication history, medical history, family history, social history, lifestyle habits, socioeconomic background

3. From practitioners: treatment adherence, or medication-taking behavior; chief complaint, medication history, medical history, family history, social history, lifestyle habits, socioeconomic background

4. From medical records: treatment adherence, or medication-taking behavior; chief complaint, medication history, medical history, family history, social history, lifestyle habits, socioeconomic background

5. Signs or symptoms of medical conditions, healthy physiology, etiology of diseases, or pathophysiology

6. Risk factors or maintenance of health and wellness

7. Evidence-based literature or studies using primary, secondary, and tertiary references

Identify Drug Characteristics (~14% of exam)

1. Pharmacology, mechanism of action, or therapeutic class

2. Commercial availability; prescription or non-prescription status; brand, generic, or biosimilar names; physical descriptions; or how supplied

3. Boxed warnings or REMS

4. Pregnancy or lactation

Perform Calculations (~14% of exam) 

1. Patient parameters or laboratory measures

2. Quantities of drugs to be dispensed or administered

3. Rates of administration

4. Dose conversions

5. Drug concentrations, ratio strengths, osmolarity, osmolality, or extent of ionization

6. Quantities of drugs or ingredients to be compounded

7. Nutritional needs and the content of nutrient sources

8. Biostatistics, epidemiological, or pharmacoeconomic measures

9. Pharmacokinetic parameters

Compound, Dispense, or Administer Drugs, or Manage Delivery Systems (~11% of exam)

1. Physicochemical properties of drug products affecting compatibility, stability, delivery, absorption, onset, duration, distribution, metabolism, or elimination

2. Techniques, procedures, or equipment for hazardous or non-hazardous sterile products

3. Techniques, procedures, or equipment for hazardous or non-hazardous non-sterile products

4. Equipment or delivery systems

5. Instructions or techniques for drug administration

6. Packaging, storage, handling, or disposal

Develop or Manage Practice or Medication-Use Systems to Ensure Safety and Quality (~7% of exam)

1. Interdisciplinary practice, collaborative practice, or expanded practice responsibilities

2. Continuity of care or transitions of care

3. Disease prevention or screening programs; or stewardship

4. Vulnerable populations, special populations, or risk prevention programs

5. Pharmacy informatics

Not only does a recent pharmacy school graduate need to study for the NAPLEX, but a newly minted PharmD needs to prepare for the Multistate Pharmacy Jurisprudence (i.e. MPJE exam). While the NAPLEX is a comprehensive examination designed to evaluate a pharmacist’s readiness to practice in a clinical setting, the MPJE focuses on assessing a pharmacist’s understanding of pharmacy law and regulatory practices.

Each state has its version of the MPJE as different states have their own unique set of laws and regulations. Regardless of what state you intend to practice in, all examinations contain the following key elements:

1. State-Specific Pharmacy Laws such as controlled substance schedules, licensing requirements, and dispensing regulations

2. Federal Pharmacy Laws such as the Controlled Substances Act and the Food, Drug, and Cosmetic Act

3. Ethical and Professional Behaviors such as understanding ethical and professional conduct to best serve the patients and the community

4. Patient Privacy and Confidentiality such as knowledge of the Health Insurance Portability and Accountability Act (HIPAA) as well as other measures to safeguard patient privacy

Eligibility requirements may differ depending on which state (jurisdiction) you intend to practice in. The first step is to check your state’s Board of Pharmacy Website (may want to have a link to all the BOP websites here-creating something similar to this) for state-specific eligibility requirements.

Prior to applying to take the NAPLEX or MPJE, at a minimum, you must have graduated from an ACPE-accredited pharmacy school or have received a foreign pharmacy graduate examination committee certification if you were educated outside the United States.

Applying for the NAPLEX and MPJE

To apply for either examination, you must log in to your NABP e-profile and follow the instructions. There is a nonrefundable eligibility application fee of $100 for the NAPLEX and $100 per jurisdiction for the MPJE. The exam fee is separate and may only be purchased once eligibility is established and after your official transcript is received from your college of pharmacy.

Once your eligibility has been granted, the purchase link for the desired examination will become available in your e-profile. The examination fees are:

• NAPLEX: $475

• MPJE: $150, per jurisdiction

Eligibility typically lasts 1 year. After payment is received, you will receive your Authorization to Test (ATT) via email.

Once you receive your ATT, you can schedule your appointment with Pearson VUE. First-time test takers must create a Pearson VUE web account. When creating that account and scheduling your test, you’ll need your NABP ID number from the ATT letter. The ATT letter includes the dates during which you are eligible to take the examination.

There are various testing centers throughout the US, but if you live in a rural area, you may need to travel an hour or more to find a site. It is best to start the eligibility process as soon as possible, as testing centers will fill up very quickly in early Summer. While the test is available on a rolling basis throughout the year, many employers require that you pass these examinations within the first several months of employment. If you wait too long to schedule your test, your test date may be delayed, or you may need to travel farther to take an earlier test.

To retake the NAPLEX, you must start the eligibility application process again, including the $100 application fee. Once eligibility is granted by a Board of Pharmacy, the $475 exam fee must again be paid. There is a mandatory waiting period of at least 45 days from the previous attempt. Some states or jurisdictions may have a longer waiting period.

You are allowed 3 attempts to take the NAPLEX during a 12-month period. If you fail 3 times, you will need to wait at least 12 months from the date of the first attempt to reapply prior to the 4^th attempt. You have a maximum of 5 attempts to pass the NAPLEX, unless a jurisdiction’s Board of Pharmacy determines otherwise. Similarly, the MPJE has a minimum waiting period of 30 days with a maximum of 5 attempts per jurisdiction. Some jurisdictions may require a longer waiting period.

Creating a solid NAPLE and MPJE study schedule is crucial for success. This is no time to be overconfident as a failed exam may jeopardize your employment or residency standing. While everyone’s learning style and preferences are different, the key to success is starting early, staying consistent, and covering all the necessary competency areas.