Franciscan Missionaries of Our Lady Health System
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Franciscan Missionaries of Our Lady Health System
Questions or Suggestions
Drug Information Questions
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High Alert
Black Box Warning
Hazardous Drugs
Do Not Crush
Therapeutic Interchange
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Do Not Tube-LACH
Restricted
CMS Self-Administered Drug Exclusion List
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Black Box Warning
Please review each of these drugs carefully.
abacavir
Hypersensitivity
abacavir-lamivudine
Abacavir: hypersensitivity reactions; lactic acidosis, hepatomegaly
abacavir/dolutegravir/lamivudine
Hypersensitivity Reactions, Lactic Acidosis and Severe Hepatomegaly; Exacerbations of Hepatitis B
abacavir/lamivudine/zidovudine
Hypersensitivity Reactions, Lactic Acidosis and Severe Hepatomegaly; Exacerbations of Hepatitis B
abobotulinumtoxinA
Distant spread of toxin effect
acetaminophen
Hepatotoxicity
acetaminophen-codeine
Addiction, Abuse, And Misuse; Life-Threatening Respiratory Depression; Risks From Concomitant Use With Benzodiazepines
acetaminophen-hydrocodone
Acetaminophen - Hepatotoxicity
Hydrocodone - Risks from Concomitant Use with Benzodiazepines or Other CNS Depressants
acetaminophen-oxycodone
Addiction, Abuse, and Misuse; Life-Threatening Depression; Accidental Exposure; Neonatal Opioid Withdrawal Syndrome; and Hepatotoxicity
acetaminophen-tramadol
Addiction, Abuse, and Misuse; Life-Threatening Depression; Accidental Exposure; Neonatal Opioid Withdrawal Syndrome; and Hepatotoxicity
acetylcysteine
Inhalation solution: not for injection
acitretin
Pregnancy/Teratogenecity
adalimumab
Infection risk; malignancy in children and adolescents
ado-trastuzumab emtansine
Hepatotoxicity, Cardiac Toxicity, Embryo-Fetal Toxicity
alemtuzumab
Autoimmunity, Infusion Reactions, and Malignacies; Autoimmune Hepatitis - LEMTRADA; Cytopenias, Infusion-Related Reactions, and Infections - CAMPATH
alglucosidase alfa
Anaphylaxis; Cardiorespiratory Failure
aliskiren
Pregnancy risk
ALPRAZolam
Risks From Concomitant Use in Opioids
alprostadil
Apnea
alvimopan
Short-term hospital use only
amikacin
Neurotoxicity; nephrotoxicity
aMILoride
Hyperkalemia
amiodarone
Oral: Pneumonitis; Proarrhythmic Effects
amitriptyline
Suicidal ideation in children, adolescents
amitriptyline-perphenazine
Increased Mortality in Elderly Patients with Dementia-Related Psychosis
amoxapine
Suicidal Ideation
amphetamine-dextroamphetamine
Abuse/diversion potential; drug dependence
amphotericin B
Noninvasive fungal disease; avoid overdose
apixaban
Discontinuation without anticoagulation
arformoterol
Asthma Related Death
ARIPiprazole
Elderly patients with dementia related psychosis
arsenic trioxide
Cardiac toxicity
ascorbic acid-carbonyl iron
Iron Overdose Risk
ascorbic acid-iron polysaccharide
Iron Overdose Risk
asenapine
Mortality in elderly patients with dementia related psychosis
asparaginase Erwinia chrysanthemi
Note: Latest labeling (3/2007) does not include prior boxed warning.
atenolol
Avoid abrupt withdrawal
atomoxetine
Suicidal Ideation
avalglucosidase alfa
Severe Hypersensitivity Reactions, Infusion-Associated Reactions, and Risk of Acute Cardiorespiratory Failure in Susceptable Patients
azaTHIOprine
Risk of neoplasia, infections
azilsartan (non-formulary)
Pregnancy risk
bacitracin
Injection: Nephrotoxicity
baclofen
Intrathecal: Abrupt discontinuation
balsalazide
Renal Impairment - Giazo
baricitinib (non-formulary)
Serious Infections, Malignancy, and Thrombosis
BCG
Risk of infection; biohazard handling precautions
belantamab mafodotin
Ocular Toxicity
belatacept
Post transplant lymphoproliferative disorder; serious infections
benzathine penicillin-procaine penicillin
Not for Intravenous Use
bevacizumab
GI perforation; wound healing complications
bictegravir/emtricitabine/tenofovir
Post Treatment Acute Exacerbation of Hepatitis B
bleomycin
Pulmonary Fibrosis; Idiosyncratic Reactions
blinatumomab
Cytokine Release Syndrome and Neurological Toxicities
bosentan
Risks of Hepatotoxicity and Embryo-Fetal Toxicity
brentuximab vedotin
Progressive Multifocal Leukoencephalopathy (PML)
budesonide-formoterol
Asthma Related Death
bumetanide
Potent diuretic
bupivacaine
Intravascular injection risk; 0.75% strength caution; Risk of Use in Obstetrical Anesthesia
bupivacaine-epinephrine
Bupivacaine: Intravascular injection risk; 0.75% strength caution; Risk of Use in Obstetrical Anesthesia
bupivacaine-meloxicam
Risk of Serious Cardiovascular and Gastroinstestinal Events
buprenorphine
Addiction, Abuse, And Misuse; Respiratory Depression; Neonatal Opioid Withdrawal Syndrome; Risks From Concomitant Use With Benzodiazepines
buprenorphine-naloxone (non-formulary)
Implant: Implant Migration, Protrusion, Expulsion, and Nerve Damage Associated with Insertin and Removal
buPROPion
Suicidal Ideation
butorphanol
Addiction, Abuse, And Misuse; Respiratory Depression; Neonatal Opioid Withdrawal Syndrome; and Risks From Concomitant Use With Benzodiazepines
cabazitaxel
Hemtalogical & Hypersensitivity Reactions
candesartan (non-formulary)
Pregnancy risk
capecitabine
Warfarin Interaction
captopril (non-formulary)
Pregnancy risk
captopril-hydrochlorothiazide (non-formulary)
Captopril: Pregnancy risk
carBAMazepine
Hematological Risk; Serious Dermatologic Reactions
carbidopa
Bolded (not boxed): Carbidopa dosing
carbidopa-levodopa
Bolded (not boxed): Carbidopa dosing
carbidopa/entacapone/levodopa
Bolded (not boxed): Carbidopa dosing
CARBOplatin
Myelosuppression; Anaphylaxis risk
carfilzomib
Cardiac Toxicities; Tumor Lysis Syndrome; Pumonary Toxicity; Dyspnea; Hyprertension
cariprazine (non-formulary)
Increased Mortality in Elderly Patients with Dementia-Related Psychosis
carmustine
Bone Marrow Suppression; Pulmonary Toxicity
celecoxib
Cardiovascular, gastrointestinal risk
certolizumab
Risk of Serious Infections and Malignancy
cetuximab
Infusion Reactions; Cardiopulmonary Arrest
chlorambucil
Bone marrow suppression; teratogen
chlordiazePOXIDE
Risks From Concomitant Use With Opioids
chlordiazepoxide-clidinium
Risks From Concomitant Use With Opioids
chlorpheniramine-hydrocodone
Tussionex Pennkinetic and Vituz - Risks from Concomitant Use with Benzodiazepines or Other CNS Depressants
chlorproMAZINE
Mortality in elderly with dementia
cidofovir
Nephrotoxicity; neutropenia
cilostazol
CHF patient contraindication
ciprofloxacin
Tendinitis; tendon rupture
CISplatin
Nephrotoxicity; Myelosuppression
citalopram
Suicidal Thoughts and Behaviors
cladribine
Bone Marrow Suppression; Neurotoxicity; Nephrotoxicity
clindamycin
Pseudomembranous colitis
cloBAZam
Risk From Concomitant Use with Opiods
clomiPRAMINE
Suicidal Ideation
clonazePAM
Risk From Concomitant Use With Opioids
cloNIDine
Epidural Clonidine
clopidogrel
Poor CYP2C19 metabolizers
clorazepate
Risks From Concomitant Use With Opioids
cloZAPine
Agranulocytosis, myocarditis, seizure risk
coagulation factor VIIa
Serious Thrombotic Adverse Events Associated with Recombinant Coagulation Factor VIIa Outside Label Indicatons
coagulation factor Xa
Thromboembolic Risks, Ischemic Risks, Cardiac Arrest, and Sudden Deaths
cobicistat/darunavir/emtricitabine/tenof
Post Treatment Acture Exacerbation of Hepatitis B
cobicistat/elvitegravir/emtricitabine/tenofov
Lactic acidosis, severe hepatomegaly; hepB co-infection
cocaine topical
Topical: Not for injection or ophthalmic use.
codeine
Addiction, Abuse, And Misuse; Respiratory Depression; Neonatal Opioid Withdrawal Syndrome; and Risks From Concomitant Use With Benzodiazepines
codeine-guaifenesin
Codeine in children: death due to ultra-rapid metabolism
codeine-promethazine
Codeine in children: death due to ultra-rapid metabolism
Promethazine: contraindicated in patients < 2 years
codeine/guaifenesin/pseudoephedrine
Codeine in children: death due to ultra-rapid metabolism
codeine/phenylephrine/promethazine
Codeine in children: death due to ultra-rapid metabolism
Promethazine: contraindicated in patients < 2 years
conjugated estrogens
Endometrial cancer; cardiovascular; dementia risk
conjugated estrogens topical
Endometrial cancer; cardiovascular; dementia risk
cycloSPORINE
Infection, neoplasm, nephrotoxicity risk
cytarabine
Prior to initiation of therapy
cytarabine liposomal-daunorubicin liposomal
Do Not Interchange with other Daunorubicin and/or Cytarabine Containing Products
dabigatran
Discontinuation without anticoagulation
dacarbazine
Hemopoietic depression; hepatic necrosis risk
DACTINomycin
Handling precautions; extravasation risk
dalfopristin-quinupristin
Approved indication (Warning Removed)
danazol
Pregnancy contraindication; stroke risk; hepatic risk with long term use; benign intracranial hypertension
dantrolene
Hepatotoxicity
darbepoetin alfa
Mortality, serious CV events, tumor progression or recurrence
DAUNOrubicin
Cardiac, myelosuppression, extravasation risk
denosumab
Prolia - Severe Hypocalcemia in Patients with Advanced Kidney Disease
desipramine
Suicidal Ideation
desmopressin
Hyponatremia
Hyponatremia (Nasal Spray)
desvenlafaxine
Suicidal ideation
dexmethylphenidate
Caution in drug dependent patients; supervised withdrawal
dextromethorphan-promethazine
Promethazine: Contraindicated in patients < 2 years
dextromethorphan-quinidine
Quinidine: Active antiarrhythmic therapy may increase mortality
diatrizoate
Not for intrathecal use
diazePAM
Risks From Concomitant Use With Opioids
diclofenac
Cardiovascular, gastrointestinal risk
diclofenac topical
Cardiovascular, gastrointestinal risk
diclofenac-misoprostol
Risk of Uterine Rupture, Abortion, Premature Birth, Birth Defects; and Serious Cardiovascular and Gastrointestinal Events
dihydroergotamine
Drug interaction risk
dinoprostone topical
Suppository: use recommended dose
disopyramide
Mortality Risk
disulfiram
Administer with patient consent
divalproex sodium
Hepatotoxicity; mitochondrial disease; fetal risk
DOCEtaxel
Hepatic dysfunction, hypersensitivity risk
dofetilide
Initiation or re-initiation monitoring
dolutegravir-lamivudine
Patients Co-Infected with Hepatitis B Virus (HBV) & Human Immunodeficiency Virus (HIV-1)
DOPamine
Peripheral ischemia risk
doravirine/lamivudine/tenofovir
Post-Treatment Acute Exacerbation of Hepatitis B
doxepin
Suicidal Ideation
DOXOrubicin
Cardiac, hepatic, myelosuppression, extravasation risk
DOXOrubicin liposomal
Cardiac, acute infusion reaction, myelosuppresssion risk
dronedarone
Contraindication in certain CHF conditions
droperidol
QT prolongation; cardiac risk
droxidopa
Supine Hypertension
DULoxetine
Suicidal Ideation
ecallantide
Anaphylaxis
eculizumab
Meningococcal Infection
efavirenz/emtricitabine/tenofovir
Lactic Acidosis; Severe Hepatomegaly with Steatosis and Post Treatment Exacerbation of Hepatitis B
elbasvir-grazoprevir
Risk of Hepatitis B Virus Reactivation in Patients Coninfected with HCV and HBV
elranatamab
Cytokine Release Syndrome and Neurologic Toxicity, including Immune Effector Cell-Associated Neurotoxicity Syndrome
emicizumab
Thrombotic Microangiopathy and Thromboembolism
emtricitabine
Lactic Acidosis, Severe Hepatomegaly
emtricitabine-tenofovir
Lactic acidosis; severe hepatomegaly; hepB co-infection
emtricitabine/rilpivirine/tenofovir
Lactic acidosis, severe hepatomegaly; hepB co-infection
enalapril
Pregnancy risk
enfortumab vedotin
Serious Skin Reactions
enoxaparin
Spinal/epidural hematoma risk
epcoritamab
Cytokine release syndrome (CRS) and Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS)
epiRUBicin
Cardiac Toxicity, Secondary Malignancies, Extravasation & Tissue Necrosis, and Severe Myelosuppression
epoetin alfa
Risk of mortality, tumor progression, cardiac events
eprosartan (non-formulary)
Pregnancy risk
escitalopram
Suicidal ideation
estazolam (non-formulary)
Risks From Concomitant Use With Opioids
esterified estrogens
Endometrial cancer; cardiovascular; dementia risk
esterified estrogens-methyltestosterone
Endometrial cancer; cardiovascular; dementia risk
estradiol
Transdermal: endometrial cancer; cardiovascular; dementia risk
Vaginal cream/tab: endometrial cancer; cardiovascular; dementia risk
Oral: ndometrial cancer; cardiovascular; dementia risk
estradiol topical
Endometrial cancer; cardiovascular; dementia risk
eszopiclone (non-formulary)
Risk of Serious Injuries With Certain Prescription Insomnia Medications
etanercept
Infection Risk; Tuberculosis; Malignancy in Children and Adolescents
ethacrynic acid
Potent Diuretic
ethinyl estradiol-norethindrone
Cigarette smoking; risk of cardiovascular disease
etodolac
Cardiovascular; gastrointestinal risk
etoposide
Myelosuppression risk
etoposide phosphate
Myelosuppression risk
exenatide
Extended Release Injection: Risk of thyroid c-cell tumors
fam-trastuzumab deruxtecan
Interstitial Lung Disease and Embryo-Fetal Toxocity
fat emulsion, intravenous
Cautious use in infants
Death in preterm infants
febuxostat
Cardiovascular Death
felbamate
Aplastic anemia; liver failure risk
fentaNYL
Buccal Table & Injection: Serious adverse events, deaths; abuse potential
Nasal Spray: Schedule II Controlled Substance: Abuse potential
Sublingual Spray: Risk of respiratory depression, medication errors, abuse potential
Transdermal: High concentration of Schedule II opioid agonist
ferrous gluconate
Iron Overdose Risk
ferrous sulfate
Iron Overdose Risk
ferumoxytol
Risk For Serious Hypersensitivity/Anaphylaxis Reactions
flecainide
Cardiovascular risk
flucytosine
Hepatic, hematologic risks; caution in renal impairment
fludarabine
Neurotoxicity, hemolytic anemia risk
flumazenil
Seizure Risk
fluorouracil
Hematologic risk
FLUoxetine
Suicidal Ideation
fluPHENAZine
Mortality in elderly with dementia
flurazepam (non-formulary)
Risks From Concomitant Use With Opioids
flutamide
Hepatotoxicity
fluticasone-salmeterol
Salmeterol: asthma related death; pediatric and adolescent patients
fluticasone-vilanterol
Vilanterol: Asthma-related death
fluvoxaMINE
Suicidal Ideation
fondaparinux
Spinal/epidural hematoma risk
formoterol fumarate (non-formulary)
Asthma Related Death
formoterol-mometasone (non-formulary)
Asthma Related Death
foscarnet
Nephrotoxicity; seizure risk
fosphenytoin
Cardiovascular risk with rapid infusion
furosemide
Potent Diuretic
gadobenate dimeglumine
Nephrogenic Systemic Fibrosis
gadobutrol
Nephrogenic Systemic Fibrosis
gadodiamide
Nephrogenic Systemic Fibrosis
gadoterate meglumine
Nephrogenic Systemic Fibrosis
gadoteridol
Nephrogenic Systemic Fibrosis
gadoxetate
Nephrogenic Systemic Fibrosis
ganciclovir
Hematological toxicity; IV and oral different indications
gemtuzumab ozogamicin
Hepatotoxicity
gentamicin
Ototoxicity; Nephrotoxocity
glecaprevir-pibrentasvir
Risk of Hepatitis B Virus Reactivation in Patients Coninfectd with HCV and HBV
golimumab
Risk of Serious Infections, Malignancy in Children and Adolescents
haloperidol
Mortality in elderly with dementia
heparin
Spinal/Epidural Hematomas
hetastarch
Renal injury risk
homatropine-hydrocodone
Hycodan - Risks from Concomitant Use with Benzodiazepines or Other CNS Depressants
hyaluronidase-immune globulin
Renal dysfunction, acute renal failure
hyaluronidase-rituximab
Fatal Infusion Reaction; Mucocutaneous Reactions; Progressive Multifocal Leukoencephalopathy; Hep b Reactivation
hyaluronidase-trastuzumab
Cardiomyopathy, Embryo-Fetal Toxicity and Pulmonary Toxicity
hyaluronidase/pertuzumab/trastuzumab
Cardiomyopathy, Embryo-Fetal Toxicity, and Pulmonary Toxicity
hydrochlorothiazide-triamterene
Hyperkalemia
hydrocodone-ibuprofen
NSAIDS - Cardiovascular; gastrointestinal risk
Hydrocodone - Addiction, Abuse, and Misuse
HYDROmorphone
Injection: Respiratory depression risk; abuse potential
Injection, High Potency: Opioid-tolerant patients only; Respiratory depression risk; abuse potential
Oral, extended release: Opioid-tolerant patients only; overdose risk; abuse potential
Oral, liquid & tablets: Abuse potential; respiratory depression; neonatal withdrawal; alcohol interaction
hydroxychloroquine
Prior to initiation of therapy
hydroxyurea
Prior to initiation of therapy
ibuprofen
Cardiovascular; gastrointestinal risk
ibutilide
Potentially Fatal Arrhythmias
IDArubicin
Cardiotoxicity; myelosuppression; renal/hepatic impairment; avoid extravasation
ifosfamide
Urotoxicity; myelosuppressionm CNS toxicity
imipramine
Suicidal ideation
immune globulin intramuscular
Renal dysfunction, acute renal failure
immune globulin intravenous
Renal dysfunction, acute renal failure
immune globulin intravenous and subcutaneous
Renal dysfunction, acute renal failure
incobotulinumtoxinA
Distant Spread of Toxin Effect
indacaterol (non-formulary)
Asthma Related Death
indomethacin
Cardiovascular; gastrointestinal risk
inFLIXimab
Serious infection risk; hepatosplenic t-cell lymphomas; malignancy
inotuzumab ozogamicin
Hepatotoxicity, Including Hepatic Veno-Occlusive Disease (VOD - also known as Sinusoidal Obstruction Syndrome) and Increased Risk of Post-Hematopoietic Stem Cell Transplant (HSCT) Non-Relapse Mortality
iodixanol
Not for intrathecal use
iopamidol
Not for intrathecal use
ioversol
Not for Intrathecal
ipilimumab
Immune-Mediated Adverse Reactions
irbesartan (non-formulary)
ACE inhibitor pregnancy risk
irinotecan
Severe diarrhea
irinotecan liposomal
Severe diarrhea
iron dextran
Injection: Anaphylactic reaction risk
iron sucrose
Iron overdose risk
isoniazid
Hepatitis
itraconazole
Congestive heart failure, drug interactions
ixabepilone
Toxicity in hepatic impariment
ketamine
Emergence reactions; psychological manifestations
ketoconazole
Oral: hepatoxicity, drug interactions
ketorolac
Duration of therapy; max dose; GI, cardiovascular, bleeding, renal risk
Nasal Spray - Risk of Serious Cardiovascular and Gastrointestinal Events
lamiVUDine
Lactic acidosis, hepatomegaly; exacerbations of hepatitis b; dosing formulation
lamivudine-zidovudine
Lamivudine: Lactic acidosis, hepatomegaly; exacerbations of hepatitis b; dosing formulation
Zidovudine: Hematological adverse events; myopathy; lactic acidosis; hepatomegaly
lamoTRIgine
Serious dermatological reactions
lecanemab
Amyloid Related Imaging Abnormalities
leflunomide
Pregnancy risk
levoFLOXacin
Tendinitis, tendon rupture; Pediatric Use
levonorgestrel
Bolded (not boxed): Not Protective Against HIV
levothyroxine
Treatment of obesity or weight loss
lidocaine topical
Lidocaine, viscous: Do NOT use for teething pain
linaclotide
Risk of Serious Dehydration in Pediatric Patients
lincomycin
Clostridium difficile associated diarrhea
lindane topical
Neurotoxicity
liothyronine
Treatment of obesity or weight loss
liraglutide
Risk of Thyroid C-cell Tumors
lisdexamfetamine
High abuse/diversion potential; drug dependence
lisinopril
ACE inhibitor pregnancy risk
lithium
Monitoring recommendations
lomustine
Bone marrow suppression
lopinavir-ritonavir
Ritonavir: Drug interactions
LORazepam
Risks From Concomitant Use With Opioids
losartan
Pregnancy risk
loxapine
Elderly patients with dementia related psychosis
Aerosol: Bronchospasm
lurasidone
Mortality in elderly patients with dementia related psychosis
LVP solution
Extraneal: Unrecognized Hypoglycemia Resulting From Drug-Device Interaction
lymphocyte immune globulin, anti-thy (equine)
Prior to initiation of therapy
mannitol
Severe bronchospasm risk
maraviroc
Hepatotoxicity
margetuximab
Left Ventricular Dysfunction and Embryo-Fetal Toxicity
medroxyPROGESTERone
Oral: Cardiovascular and other risks
Injection: Loss of Bone Mineral Density
meloxicam
Cardiovascular; gastrointestinal risk
meperidine
Addiction, Abuse, and Misuse; Life-Threatening Respiratory Depression; Accidental Exposure; Neonatal Opioid Withdrawal Syndrome
mercaptopurine
Bolded (not boxed): initiation of therapy
mestranol-norethindrone
Cigarette smoking; risk of cardiovascular disease
metFORMIN
Lactic Acidosis
methacholine
Diagnostic Use Only; Severe Bronchoconstriction
methadone
Risk during initiation of or conversion to methadone
methohexital
Continuous monitoring of respiratory and cardiac function
methotrexate
Bone marrow, liver, lung and kidney toxicity risk
methyldopa
Fixed combination for initial hypertension management
methylene blue
Serotonin Syndrome with Concomitant Use of Serotonergic Drugs
methylphenidate
Tolerance and dependence
metoclopramide
Tardive Dyskinesia
metOLazone
Bolded (not boxed): do not interchange
metroNIDAZOLE
Carcinogenicity
mexiletine
Mortality; Acute Liver Injury
midazolam
Risk From Concomitant Use With Opiods; Individualize dose
midodrine
Supine blood pressure > 180 mmHg
milnacipran (non-formulary)
Suicidal ideation
minoxidil
Antihypertensive risk
mirtazapine
Suicidal ideation
mirvetuximab soravtansine
Ocular Toxicity
miSOPROStol
Pregnancy risk
mitoMYcin
Bone marrow suppression; hemolytic uremic syndrome
mitoXANTRONE
Cardiotoxicity; baseline neutrophil count; extravasation risk
montelukast
Serious Neuropsychiatric Events
morphine
Injection PreserveFree: 24-hour observation following epidural/intrathecal administration
Controlled/Extended Release: Addiction, Abuse, and Misuse; Life-Threatening Respiratory Depression; Accidental Exposure; Neonatal Opioid Withdrawal Syndrome
moxifloxacin
Tendinitis, tendon rupture
multivitamin with iron
Iron overdose risk
multivitamin with iron and fluoride
Iron overdose risk
multivitamin, prenatal
Iron Overdose Risk
mycophenolate mofetil
Prior to initiation of therapy
mycophenolic acid
Embryofetal Toxicity, Malignancies, and Serious Infections
nabumetone
Cardiovascular; gastrointestinal risk
nadolol (non-formulary)
Avoid abrupt withdrawal
nalbuphine
Life-Threatening Respiratory Depression
naloxone-pentazocine
Addiction, Abuse, and Misuse; Life-Threatening Depression; Accidental Exposure; Neonatal Opioid Withdrawal Syndrome
naproxen
Cardiovascular; gastrointestinal risk
natalizumab
Progressive multifocal leukoencephalopathy (PML)
nefazodone (non-formulary)
Hepatotoxicity
nelarabine
Prior to initiation of therapy; neurologic events
neomycin
Neurotoxicity, nephrotoxicity, ototoxicity; general toxicity
nevirapine
Hepatotoxicity; dermal reactions; patient monitoring
niMODipine
Serious harm with IV administration of oral product
nirmatrelvir-ritonavir
Risk of Serious Adverse Reactions Due to Drug Interactions
norepinephrine
Extravasation risk
norethindrone
Risk of Cardiovascular Disease; Visual Abnormalities
nortriptyline
Suicidal ideation
obinutuzumab
Hepatitis B Virus Reactivation and Progressive Multifocal Leukoencephalopathy
ofatumumab
Hepatitis B Virus (HBV) Reactivation/Progressive Multifocal Leukoencephalopathy
OLANZapine
Mortality in elderly with dementia related psychosis
olmesartan (non-formulary)
ACE inhibitor pregnancy risk
olodaterol (non-formulary)
Asthma-Related Death
olodaterol-tiotropium (non-formulary)
Asthma-Related Death
omalizumab
Anaphylaxis
onabotulinumtoxinA
Distant spread of toxin effect
oxaliplatin
Anaphylactic-like reactions
oxandrolone
Peliosis hepatitis; Liver Cell Tumors; Blood Lipid Changes
oxazepam
Risks From Concomitant Use With Opioids
oxyCODONE
Oral solution: Risk of errors
Controlled release: Abuse potential
oxyMORphone (non-formulary)
Abuse/diversion potential; drug dependence
oxytocin
Elective induction of labor
PACLitaxel
Prior to initiation of therapy
PACLitaxel protein-bound
Prior to initiation of therapy
paliperidone
Mortality in elderly patients with dementia related psychosis
panitumumab
Dermatologic toxicity; infusion reactions
PARoxetine
Suicidal ideation
patiromer
Binding to Other Oral Medications
pegcetacoplan
Serious Infections Caused By Encapsulated Bacteria
peginterferon alfa-2a
RISK OF SERIOUS DISORDERS
pegloticase
Anaphylaxis and Infusion Reactions
penicillAMINE
Toxicity risk
pentostatin
Prior to initiation of therapy
perampanel
Serious psychiatric and behavioral reactions
perflutren
Serious cardiopulmonary reactions
perphenazine
Elderly patients with dementia related psychosis
pertuzumab
Cardiomyopathy and Embryo-Fetal Toxicity
phenylephrine
Prior to initiation of therapy
phenytoin
Cardiovascular risk with rapid infusion
phytonadione
Severe reactions with IM and IV use
pimecrolimus topical (non-formulary)
Long-term safety
pimozide
Elderly patients with dementia related psychosis
pioglitazone
Congestive heart failure
piroxicam
Cardiovascular; gastrointestinal risk
polymyxin B sulfate
Parenteral use: nephrotoxicity, neurotoxicity, pregnancy risk
potassium phosphate-sodium phosphate
Acute Phosphate Nephropathy
pozelimab
Serious Meningococcal Infections
prasugrel
Bleeding risk
prazosin
Combination Not Used for Initial Therapy
primaquine
Prior to initiation of therapy
procainamide
Positive titers with chronic administration
prochlorperazine
Elderly patients with dementia related psychosis
progesterone
Cardiovascular disorders; breast cancer; probable dementia
promethazine
Patients < 2 years; severe tissue injury
propafenone
Mortality (CAST trial results)
propranolol
Avoid abrupt withdrawal
propylthiouracil
Severe liver injury; acute liver failure
protamine
Hypotension, pulmonary hypertension; risk factors described
prothrombin complex
Arterial and venous thromboembolic complications
QUEtiapine
Elderly patients with dementia related psychosis
quiNIDine
Active antiarrhythmic therapy may increase mortality
quiNINE (non-formulary)
No benefit in leg cramps; hematologic risks
raloxifene
Risk of VTE and death from stroke
ramipril (non-formulary)
Use in Pregnancy, Fetal Toxicity
ramucirumab
Increased Risk of Hemorrhage
rasburicase
Anaphylaxis; hemolysis; methemoglobinemia; uric acid measure interference
Ravulizumab
Serious Meningococcal Infections
remdesivir
Black Box Warning is for Use of Remdesivir to Treat COVID-19. Remdesivir Must Be Administered by Intravenous (IV) Infusion.
remifentanil
Addiction, Abuse, and Misuse
reslizumab
Anaphylaxis
RHo (D) immune globulin
Intravenous - Intravascular Hemolysis
ribavirin
Oral: Monotherapy; hemolytic anemia; teratogenicity
Inhalation: Respiratory function deterioration
risperiDONE
Elderly patients with dementia related psychosis
ritonavir
Drug interaction risk
riTUXimab
Fatal infusion reaction; mucocutaneous reactions; progressive multifocal leukoencephalopathy; hep b reactivation
rivaroxaban
Premature discontinuation; spinal/epidural hematomas
rocuronium
Prior to initiation of therapy
romosozumab
Potential Risk of Myocardial Infarction, Stroke and Cardiovascular Death
sacituzumab govitecan
Neutropenia and Diarrhea
sacubitril-valsartan
Valsartan: ACE inhibitor pregnancy risk
salmeterol
Asthma Related Deaths
salsalate
Cardiovascular; gastrointestinal risk
saquinavir
Bioequivalency
selegiline
Suicidal ideation
sertraline
Suicidal ideation
sirolimus
Immunosuppression; liver or lung transplant patients
sodium nitroprusside
Cyanide toxicity; hypotension risk; dilute
sodium phosphate
Phosphate nephropathy
sotalol
Therapy initiation; renal impairment caution; product selection
spironolactone
Possible tumorigen
stavudine
Pancreatitis, lactic acidosis, hepatomegaly
streptomycin
Neurotoxicity; nephrotoxicity
streptozocin
Nephrotoxicity; experienced physician; mutagen
succinylcholine
Hyperkalemic rhabdomyolysis in infants or children
SUFentanil
Addiction, Abuse, and Misuse
tacrolimus
Lymphoma risk; infection related to immunosuppression
tacrolimus topical
Long-term safety
tagraxofusp
Capillary Leak Syndrome
talquetamab
Cytokine Release Syndrome and Neurologic Toxicity, including Immune Effector Cell-Associated Neurotoxicity Syndrome
tamoxifen
Women at high risk for breast cancer; women with DCIS
tapentadol (non-formulary)
Abuse potential; limitations of use
tarlatamab-dlle
Cytokine Release Syndrome and Neurologic Toxicity, including Immune Effector Cell-Associated Neurotoxicity Syndrome
teclistamab
Cytokine Release Syndrome and Neurologic Toxicity including Immune Effector Cell-associated Neurotoxicity Syndrome
telmisartan (non-formulary)
ACE inhibitor pregnancy risk
temazepam
Risks From Concomitant Use With Opioids
tenofovir
Lactic acidosis, severe hepatomegaly; hepB co-infection
terbutaline
Preterm labor (injectable and oral)
teriparatide
Boxed Warning removed 11/16/2020
terlipressin
Serious or fatal respiratory failure
testosterone
Secondary exposure to testosterone
Testosterone undecanoate injection: POME reactions and anaphylaxis
Testosterone enanthate: Blood Pressure Increases
Testosterone undecanoate Capsule: Increase in Blood Pressure
thioridazine
QTc prolongation; elderly with dementia related psychosis
thiothixene
Elderly patients with dementia related psychosis
thrombin topical
Bleeding, thrombosis risk
thyroid desiccated
Treatment of obesity or weight loss
ticagrelor
Bleeding Risk
tigecycline
All cause mortality
tipranavir
Both fatal and nonfatal intracranial hemorrhage have been reported.
tisotumab vedotin
Ocular toxicity
tiZANidine
Bolded (not boxed): bioequivalence between products
tobramycin
Ototoxicity, nephrotoxicity risk with IV use
tocilizumab
Serious infections risk
tolvaptan
Initiation or re-initiation monitoring
topotecan
Bone marrow suppression
toremifene
QT Prolongation; avoid CYP3A4 Inhibitors
traMADol
Addiction, Abuse, and Misuse; Life-Threatening Depression; Accidental Exposure; Neonatal Opioid Withdrawal Syndrome; and Hepatotoxicity
trastuzumab
Cardiomyopathy; infusion reactions, pulmonary toxicity; teratogenicity
traZODone
Suicidal ideation
tretinoin
Acute promyelocytic leukemia; experienced physician
triazolam (non-formulary)
Risks From Concomitant Use With Opioids
trifluoperazine
Elderly patients with dementia related psychosis
umeclidinium-vilanterol
Vilanterol: Asthma-related death
valGANciclovir
Hematologic Toxicity; Impairment of Fertility; Fetal Toxocity; Mutagenesis & Carcinogenesis
valproic acid
Risk to children exposed in utero
valsartan
ACE inhibitor pregnancy risk
vancomycin
Risk of Embryo-Fetal Toxicity Due to Excipient Containing Products
varenicline
Serious neuropsychiatric events, monitoring and patient counseling
venetoclax
Tumor Lysis Syndrome
venlafaxine
Suicidal ideation
vilazodone
Suicidal ideation
vinBLAStine
IV use only; granulocytopenia; avoid extravasation
vinCRIStine
IV use only; dose liposomal product differently
vinorelbine
IV use only; granulocytopenia; avoid extravasation
vortioxetine
Suicidal Thoughts and Behaviors
warfarin
Serious bleeding risk
zidovudine
Hematological adverse events; myopathy; lactic acidosis; hepatomegaly
ziprasidone
Mortality in elderly with dementia related psychosis
zolpidem
Complex Sleep Behaviors