In the prescription: Hydrocodone/APAP 5 mg-325 mg, what indicates that it may have been altered?

The presence of "+1 RF" in the prescription indicates that it may have been altered. In pharmacy practice, any additional markings or notations that do not conform to standard prescription formatting can raise suspicion regarding the authenticity of the document. The notation "+1 RF" does not typically appear in standard prescription writing and could imply a modification intended to increase the quantity or strength of the medication, which is a common method of tampering.

When evaluating the other components of the prescription, APAP (acetaminophen) appears as the common abbreviation for the ingredient in the formulation, and its presence is completely normal. The notation “#60” refers to the quantity of pills to be dispensed, which is also standard practice in prescribing. The instruction “1-2 tabs” specifies the dosing regimen and is a legitimate way to indicate how many tablets the patient should take. None of these choices suggest alteration or tampering in the same way that the unusual "+1 RF" notation does.

Therefore, the indication of an alteration in the prescription is clearly marked by the presence of that specific notation, distinguishing it from standard pharmaceutical practice.