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Legacy Health

Approved Hospital Formulary

Pharmacy - Home (sharepoint.com) Contact Pharmacy

Black Box Warning

Please review each of these drugs carefully.

abacavir	Hypersensitivity reactions; lactic acidosis, hepatomegaly
abacavir-lamiVUDine	Hypersensitivity Reactions And Exacerbations Of Hepatitis B
abacavir/dolutegravir/lamivudine	Hypersensitivity Reactions, Lactic Acidosis and Severe Hepatomegaly; Exacerbations of Hepatitis B
abacavir/lamiVUDine/zidovudine	Abacavir: Hypersensitivity reactions; lactic acidosis, hepatomegaly Lamivudine: Lactic acidosis, hepatomegaly; exacerbations of hepatitis b; dosing formulation Zidovudine: Hematological adverse events; myopathy; lactic acidosis; hepatomegaly
acetaminophen	Hepatotoxicity
acetaminophen-codeine	Acetaminophen: Hepatotoxicity Codeine in children: death due to ultra-rapid metabolism
acetaminophen-HYDROcodone	Serious and Life-Threatening Risks from Use of Hydrocodone and Acetaminophen Products
acetaminophen-oxyCODONE	Addiction, Abuse, and Misuse
acetaminophen-traMADol	Serious and Life-Threatening Risks from Use of Tramadol Hcl and Acetaminophen Tablets
acetaminophen/butalbital/caffeine/codeine	Acetaminophen: Hepatotoxicity Codeine in children: death due to ultra-rapid metabolism Addiction, abuse, and misuse; risk evaluation and mitigation strategy (rems); life-threatening respiratory depression; accidental ingestion; risks from concomitant use with benzodiazepines or other cns depressants; ultra-rapid metabolism of codeine...
acetylcysteine	Inhalation solution: not for injection
acitretin	Contraindications and Warnings: Pregnancy/Teratogenecity
adalimumab	Infection risk; malignancy in children and adolescents
adefovir	Severe Acute Exacerbations of Hepatitis, Nephrotoxicity, HIV Resistance, Lactic Acidosis and Severe Hepatomegaly with Steatosis
ado-trastuzumab emtansine	Hepatotoxicity, Cardia Toxicity, Embryo-Fetal Toxicity
aldesleukin	Capillary Leak Syndrome
alemtuzumab	Hematological toxicity; opportunistic infections
alfentanil	Addiction, Abuse, and Misuse
alglucosidase alfa	Anaphylaxis; Cardiorespiratory Failure
aliskiren	Pregnancy risk
alosetron	Serious GI Reactions; indication; discontinuation
ALPRAZolam	Risks From Concomitant Use in Opioids
alprostadil	Apnea
altretamine	Experienced Physician; Peripheral Blood Counts; Neurological Examinations
alvimopan	Short-term hospital use only
ambrisentan	Hepatic Injury; pregnancy risk; restricted distribution
amikacin	Neurotoxicity; nephrotoxicity
aMILoride	Hyperkalemia
aMILoride-hydrochlorothiazide	Hyperkalemia
amiodarone	Oral: Pneumonitis; proarrhythmic effects
amitriptyline	Suicidal Ideation in children, adolescents
amitriptyline-perphenazine	Increased Mortality in Elderly Patients with Dementia-Related Psychosis
amLODIPine-benazepril	ACE inhibitor pregnancy risk
amLODIPine-olmesartan	Angiotensin II antagonist pregnancy risk
amLODIPine-valsartan	Angiotensin II antagonist pregnancy risk
amoxapine	Suicidal Ideation
amphetamine-dextroamphetamine	Abuse/diversion potential; drug dependence
amphotericin B	Noninvasive Fungal Disease; Avoid Overdose
amphotericin B lipid complex	Lipid Emulsions: Death in preterm infants
anti-thymocyte globulin (rabbit)	Used by experienced physicians in Immunosuppressive Therapy
antivenin latrodectus mactans	Severe liver injury, including fatal liver failure has been reported in patients treated with leflunomide, which is indicated for rheumatoid arthritis. A similar risk would be expected for teriflunomide.
apixaban	Discontinuation without anticoagulation
arformoterol	Asthma related death
ARIPiprazole	Elderly patients with dementia related psychosis
arsenic trioxide	Cardiac Toxicity
asenapine	Mortality in elderly patients with dementia related psychosis
asparaginase Escherichia coli	Anaphylaxis; Sudden death
aspirin-oxyCODONE	Addiction, Abuse, and Misuse
aspirin/butalbital/caffeine/codeine	Codeine in children: death due to ultra-rapid metabolism
atenolol	Avoid abrupt withdrawal
atenolol-chlorthalidone	Abrupt withdrawal of beta blockers
atomoxetine	Suicidal Ideation
auranofin	Gold toxicity
azaTHIOprine	Risk of neoplasia, infection
azilsartan	Pregnancy Risk
bacitracin	Injection: nephrotoxicity
baclofen	Intrathecal: abrupt discontinuation
balsalazide	Renal Impairment
bamlanivimab	Limitations of Authorized Use for COVID-19
baricitinib	Serious Infections, Malignancy, and Thrombosis
basiliximab	Prior to initiation of therapy
BCG vaccine	Risk of infection; biohazard handling precautions
bedaquiline	Increased Mortality; QT Prologation
belatacept	Post transplant lymphoproliferative disorder; serious infections
benazepril	Pregnancy risk
benazepril-hydrochlorothiazide	Pregnancy risk
bevacizumab	GI Perforation; wound healing complications
bexarotene	Birth Defects
bictegravir/emtricitabine/tenofovir	Post Treatment Acute Exacerbation of Hepatitis B
bleomycin	Pulmonary fibrosis; idiosyncratic reactions
Blinatumomab	Cytokine Release Syndrome and Neurological Toxicities
bosentan	Hepatotoxicity; teratogenecity
brentuximab vedotin	Progressive Multifocal Leukoencephalopathy (PML)
brexpiprazole	Elderly patients with dementia related psychosis; suicidal ideation
budesonide-formoterol inhaled	Asthma related death
bumetanide	Potent diuretic
bupivacaine	Intravascular injection risk; 0.75% strength caution
bupivacaine-clonidine	Bupivacaine Obstetrical anesthesia risk with 0.75% Clonidine epidural indication and restriction
bupivacaine-EPINEPHrine	Bupivacaine: Intravascular injection risk; 0.75% strength caution
bupivacaine-fentaNYL	Bupivacaine: Intravascular injection risk; 0.75% strength caution
bupivacaine-meloxicam	Risk of Serious Cardiovascular and Gastroinstestinal Events
buprenorphine	Transdermal: potential for Abuse ER Subcutaneous: Risk Of Serious Harm Or Death With Intravenous Administration; Sublocade Risk Evaluation And Mitigation Strategy
buprenorphine-naloxone	Addiction, Abuse, And Misuse
buPROPion	Suicidal Ideation
busulfan	Bone marrow supression
butorphanol	Addiction, Abuse, And Misuse
cabazitaxel	Neutropenia and Hypersensitivity Reactions
cabotegravir	Risk of Drug Resistance with Use of Cabotegravir for HIV-1 Pre-Exposure Prophylaxis (PrEP) in Undiagnosed HIV-1 Infection
caffeine-ergotamine	Drug interaction risk
candesartan	Pregnancy risk
capecitabine	Warfarin interaction
capreomycin	Nephrotoxicity, Ototoxicity
captopril	Pregnancy risk
captopril-hydrochlorothiazide	Pregnancy risk
carBAMazepine	Hematological risk; serious dermatologic reactions
carbidopa	Bolded (not boxed): initiation of therapy
carbidopa-levodopa	Bolded (not boxed): carbidopa dosing
CARBOplatin	Myelosuppression; Anaphylaxis risk
carfilzomib	Cardiac Toxicities; Tumor Lysis Syndrome; Pumonary Toxicity; Dyspnea; Hyprertension
Cariprazine	Increased Mortality in Elderly Patients with Dementia-Related Psychosis
carmustine	Bone marrow suppression; pulmonary toxicity
casirivimab-imdevimab	Limitations of Authroized Use for COVID-19
celecoxib	Cardiovascular; gastrointestinal risk
certolizumab	Serious infection risk
cetuximab	Infusion reactions; cardiopulmonary arrest
chlorambucil	Bone marrow suppression; teratogen
chloramphenicol	Fatal Blood Dyscrasias
chlordiazePOXIDE	Risk From Concomitant Use With Opioids
chlordiazePOXIDE-clidinium	Risk From Concomitant Use With Opioids
chloroquine	Prior to initiation of therapy
chlorpheniramine-HYDROcodone	Addiction, Abuse, and Misuse
chlorproMAZINE	Mortality in elderly with dementia
cidofovir	Nephrotoxicity; neutropenia
cilostazol	CHF patient contraindication
ciprofloxacin	Tendinitis; Tendon Rupture
CISplatin	Nephrotoxicity; myelosuppression
CISplatin-cyclophosphamide-etoposide	CISplatin: Nephrotoxicity; myelosuppression
citalopram	Suicidal Thoughts and Behaviors
cladribine	Bone Marrow Suppression; neurotoxicity; nephrotoxicity
clindamycin	Pseudomembranous colitis
clobazam	Risk From Concomitant Use with Opioids
clomiPRAMINE	Suicidal Ideation
clonazePAM	Risk From Concomitant Use With Opioids
cloNIDine	Epidural Clonidine
clonidine-baclofen	Clonidine epidural indication and restriction Baclofen Intrathecal: abrupt discontinuation
clopidogrel	Poor CYP2C19 metabolizers
clorazepate	Risk 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
cobicistat/darunavir/emtricitabine/tenof	Post Treatment Acture Exacerbation of Hepatitis B
cobicistat/elvitegravir/emtricitabine/tenofov	Tenofovir: lactic acidosis, severe hepatomegaly; hepB co-infection
codeine	Codeine in children: death due to ultra-rapid metabolism
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
collagenase clostridium histolyticum	Corporal Rupture [Penile Fracture] or Other Serious Penile Injury in the Treatment of Peyronie's Disease
conjugated estrogens	Endometrial cancer; cardiovascular; dementia risk
conjugated estrogens topical	Endometrial cancer; cardiovascular; dementia risk
conjugated estrogens-medroxyPROGESTERone	Cardiovascular and Other Risks
cycloSPORINE	Infection, neoplasm, nephrotoxicity risk
cytarabine	Prior to initiation of therapy
cytarabine liposomal	Chemical arachnoiditis
cytarabine liposomal-daunorubicin liposomal	Do Not Interchange with other Daunorubicin and/or Cytarabine Containing Products
cytarabine-etoposide	cytarabine: prior to initiation of therapy etoposide: Myelosuppression risk
dabigatran etexilate	Discontinuation without anticoagulation
dacarbazine	Hemopoietic depression; hepatic necrosis risk
daclizumab	Hepatic Injury Including Autoimmune Hepatitis and Other Immune-Medicated Disorders
DACTINomycin	Handling precautions; extravasation risk
dalfopristin-quinupristin	Approved indication
dalteparin	Spinal/epidural hematoma risk
danazol	Pregnancy contraindication; stroke risk; hepatic risk with long term use; benign intracranial hypertension
dantrolene	Hepatitis risk
darbepoetin alfa	Mortality, serious CV events, tumor progression or recurrence
dasabuvir/ombitasvir/paritaprev/ritonav	Ritonavir: Drug interaction risk
DAUNOrubicin	Cardiac, myelosuppression, extravasation risk
deferasirox	Renal Failure, Hepatic Failure, GI Hemorrhage
deferiprone	Agranulocytosis/Neutropenia
delafloxacin	Serious Adverse Reactions Including Tendinitis, Tendon Rupture, Peripheral Neuropathy, Cental Nervous System Effects, and Exacerbation of Myasthenia Gravis
denosumab	Severe Hypocalcemia in Patients with Advanced Kidney Disease
desipramine	Suicidal Ideation
desmopressin	Hyponatremia
desogestrel-ethinyl estradiol	Cigarette smoking; risk of cardiovascular disease
desvenlafaxine	Suicidal ideation
dexmethylphenidate	Caution in drug dependent patients; supervised withdrawal
dextroamphetamine	Abuse/diversion potential; drug dependence
dextromethorphan-promethazine	Promethazine: Contraindicated in patients < 2 years
diatrizoate	Not for intrathecal use
diazepam	Risk From Concomitant Use With Opioids
diclofenac	Cardiovascular; gastrointestinal risk
diclofenac-misoprostol	Diclofenac: Cardiovascular; gastrointestinal risk Misoprostol: pregnancy risk
didanosine	Pancreatitis, hepatotoxicity, lactic acidosis risk
diflunisal	Cardiovascular, gastrointestinal risk
dihydroergotamine	Drug interaction risk
dinoprostone	Suppository: use recommended dose
dinutuximab	Serious Infusion Reactions and Neurotoxicity
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); Emergence of Lamivudine-Resistant HBV & Exacerbations of HBV
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
DOXOrubicin-dacarbazine	doxorubicin: Cardiac, hepatic, myelosuppression, extravasation risk dacarbazine: Hemopoietic depression; hepatic necrosis risk
DOXOrubicin-etoposide-vinCRIStine	doxorubicin: Cardiac, hepatic, myelosuppression, extravasation risk etoposide: Myelosuppression risk Vincristine: IV use only (fatal intrathecally)
dronedarone	Contraindication in certain CHF conditions
droperidol	QT prolongation; cardiac risk
drospirenone-ethinyl estradiol	Cigarette smoking; risk of cardiovascular disease
DULoxetine	Suicidal Ideation
Ecallantide	Anaphylaxis
eculizumab	Meningococcal Infection
edetate calcium disodium	Lead encephalopathy risk
Edoxaban	Reduced efficacy; risk of ischemic events; spinal/epidural hematoma
efavirenz/emtricitabine/tenofovir	Emtricitabine: Lactic acidosis, severe hepatomegaly; hepB co-infection Tenofovir: lactic acidosis, severe hepatomegaly; hepB co-infection
efavirenz/lamivudine/tenofovir	Post Treatment Acute Exacerbations of Hepatitis B
elbasvir-grazoprevir	Risk of Hepatitis B Virus Reactivation in Patients Coninfected with HCV and HBV
elosulfase alfa	Risk of Anaphylaxis
emtricitabine	Lactic acidosis, severe hepatomegaly; hepB co-infection
emtricitabine-tenofovir	Emtricitabine: Lactic acidosis, severe hepatomegaly; hepB co-infection Tenofovir: lactic acidosis, severe hepatomegaly; hepB co-infection
emtricitabine/rilpivirine/tenofovir	Tenofovir: lactic acidosis, severe hepatomegaly; hepB co-infection
enalapril	Pregnancy risk
enalaprilat	Pregnancy risk
enoxaparin	Spinal/epidural hematoma risk
entecavir	Lactic acidosis, severe hepatomegaly; hepB co-infection
epirubicin	Myocardial toxicity; extravasation
epoetin alfa	Risk of mortality, tumor progression, cardiac events
eprosartan	Pregnancy risk
escitalopram	Suicidal ideation
esketamine	Sedation; Dissociation; Abuse and Misuse; and Surcidal Thoughts and Behaviors
estazolam	Risks From Concomitant Use with Opioids
esterified estrogens	Endometrial cancer; cardiovascular; dementia risk
esterified estrogens-methylTESTOSTERone	Endometrial cancer risk
estradiol	Transdermal: endometrial cancer; cardiovascular; dementia risk Vaginal cream/tab: endometrial cancer; cardiovascular; dementia risk
estradiol topical	Endometrial cancer; cardiovascular; dementia risk
estradiol-norethindrone	Cardiovascular and other risks; probable dementia
estropipate	Endometrial cancer; cardiovascular; dementia risk
eszopiclone	Serious psychiatric and behavioral reactions
etanercept	Infections, Tuberculosis
ethacrynic acid	Potent diuretic
ethinyl estradiol-ethynodiol	Cigarette smoking; risk of cardiovascular disease
ethinyl estradiol-levonorgestrel	Cigarette smoking; risk of cardiovascular disease
ethinyl estradiol-norelgestromin	Cigarette smoking; risk of cardiovascular disease
ethinyl estradiol-norethindrone	Cigarette smoking; risk of cardiovascular disease
ethinyl estradiol-norgestimate	Cigarette smoking; risk of cardiovascular disease
ethinyl estradiol-norgestrel	Cigarette smoking; risk of cardiovascular disease
etodolac	Cardiovascular; gastrointestinal risk
etonogestrel	Bolded (not boxed): sexually transmitted disease risk
etoposide	Myelosuppression risk
etoposide phosphate	Myelosuppression Risk
everolimus	Malignancies and Serious Infections; Kidney Graft Thrombosis; Nephrotoxicity
fam-trastuzumab deruxtecan	Interstitial Lung Disease and Embryo-Fetal Toxicity
fat emulsion, intravenous	Cautious use in infants
febuxostat	Cardiovascular Death
felbamate	Aplastic anemia; liver failure risk
fentaNYL	Use in chronic pain only
fentanyl-bupivacaine-clonidine	Bupivacaine Obstetrical anesthesia risk with 0.75% Clonidine epidural indication and restriction
fentanyl-ropivacaine-clonidine	Clonidine epidural indication and restriction
ferrous fumarate	Iron overdose risk
ferrous fumarate-folic acid	Iron overdose risk
ferrous gluconate	Iron overdose risk
ferrous sulfate	Iron overdose risk
ferumoxytol	Risk For Serious Hypersensitivity/Anaphylaxis Reactions
flecainide	Cardiovascular risk
floxuridine	Hematological risk
flucytosine	Hepatic, hematologic risks; caution in renal impairment
fludarabine	Neurotoxicity, hemolytic anemia risk
flumazenil	Seizure Risk
fluorouracil	Hematologic risk
fluorouracil topical	Hematologic risk
FLUoxetine	Suicidal Ideation
FLUoxetine-OLANZapine	Elderly patients with dementia related psychosis
fluPHENAZine	Mortality in elderly with dementia
flurazepam	Risk From Concomitant Use With Opioids
flurbiprofen	Cardiovascular; gastrointestinal risk
flutamide	Hepatotoxicity
fluticasone-salmeterol inhaled	Salmeterol: asthma related death; pediatric and adolescent patients
fluticasone-vilanterol inhaled	Vilanterol: Asthma-Related Death
fluticasone/umeclidinium/vilanterol	Asthma-Related Death
fluvoxaMINE	Suicidal Ideation
fondaparinux	Spinal/epidural hematoma risk
formoterol	Asthma related death
foscarnet	Nephrotoxicity; seizure risk
fosinopril	Pregnancy risk
fosphenytoin	Cardiovascular risk with rapid infusion
furosemide	Potent diuretic
gadobenate dimeglumine	Nephrogenic Systemic Fibrosis
gadobutrol	Nephrogenic Systemic Fibrosis
gadodiamide	Nephrogenic Systemic Fibrosis
gadofosveset trisodium	Nephrogenic Systemic Fibrosis
gadopentetate dimeglumine	Nephrogenic Systemic Fibrosis
gadoteridol	Nephrogenic Systemic Fibrosis
gadoxetate	Nephrogenic Systemic Fibrosis
ganciclovir	Hematological toxicity; IV and oral different indications
gemtuzumab ozogamicin	Hematological, Hepatotoxicity, Anaphlyaxis; use as single agent
gentamicin	Ototoxicity; nephrotoxocity
glecaprevir-pibrentasvir	Risk of Hepatitis B Virus Reactivation in Patients Coninfectd with HCV and HBV
glimepiride-pioglitazone	Pioglitazone: congestive heart failure
glyBURIDE-metFORMIN	Lactic Acidosis
gold sodium thiomalate	Toxic reaction risk
golimumab	Risk of Serious Infections; Maliganacy in Children
haloperidol	Mortality in elderly with dementia
hemin	Use only after alternate therapy failure
heparin	Spinal/Epidural Hematomas
hetastarch	Renal injury risk
hyaluronidase-rituximab	Fatal Infusion Reaction; Mucocutaneous Reactions; Progressive Multifocal Leukoencephalopathy; Hep b Reactivation
hyaluronidase/pertuzumab/trastuzumab	Cardiomyopathy, Embryo-Fetal Toxicity, and Pulmonary Toxicity
hydrochlorothiazide-lisinopril	Pregnancy risk
hydrochlorothiazide-losartan	Angiotensin II antagonist pregnancy risk
hydrochlorothiazide-spironolactone	Possible tumorigen
hydrochlorothiazide-triamterene	Hyperkalemia
hydrochlorothiazide-valsartan	Pregnancy risk
HYDROcodone-ibuprofen	Cardiovascular; gastrointestinal risk
HYDROmorphone	Respiratory depression risk; abuse potential
hydromorphone-bupivacaine	Hydromorphone: Respiratory Depression,Abuse and Medication Errors Bupivacaine Obstetrical anesthesia risk with 0.75%
hydromorphone-bupivacaine-clonidine	Hydromorphone: Respiratory Depression,Abuse and Medication Errors Bupivacaine Obstetrical anesthesia risk with 0.75% Clonidine epidural indication and restriction
hydromorphone-clonidine	Hydromorphone: Respiratory Depression,Abuse and Medication Errors Clonidine: epidural indication and restriction
hydromorphone-ropivacaine	Hydromorphone: Respiratory Depression,Abuse and Medication Errors
hydroxychloroquine	Prior to initiation of therapy
hydroxyurea	Prior to initiation of therapy
ibrexafungerp	Risk of Embryo Fetal Toxicity
ibritumomab tiuxetan	Fatal Infusion Reaction; Cytopenias; Dosing; Cutaneous Reactions
ibuprofen	Cardiovascular; gastrointestinal risk
ibutilide	Potentially Fatal Arrhythmias
IDArubicin	Cardiotoxicity; myelosuppression; renal/hepatic impairment; avoid extravasation
idursulfase	Anaphylaxis risk
ifosfamide	Urotoxicity; myelosuppressionm CNS toxicity
ifosfamide-mesna	ifosfamide: Urotoxicity; myelosuppressionm CNS toxicity
iloperidone	Mortality in elderly patients with dementia related psychosis
imipramine	Suicidal ideation
immune globulin intravenous	Renal dysfunction, acute renal failure
indomethacin	Cardiovascular; gastrointestinal risk
inFLIXimab	Serious infection risk; hepatosplenic t-cell lymphomas; malignancy
inFLIXimab dyyb	Risk Of Serious Infection and Malignancy
inotuzumab ozogamicin	Hepatotoxicity, Increased Risk of Post-Hematopoietic Stem Cell, Transplant Non-Relapse Mortality
interferon alfa-2b	Neuropsychiatric, autoimmune, ischemic and infectious disorders
iodixanol	Not for intrathecal use
iopamidol	Not for intrathecal use
ioversol	Not for Intrathecal Use
ipilimumab	Immune-Mediated Adverse Reactions
irbesartan	Pregnancy risk
irinotecan	Severe diarrhea
irinotecan liposomal	Severe Neutropenia and Severe Diarhhea
iron dextran	Injection: Anaphylactic reaction risk
iron polysaccharide	Iron overdose risk
iron sucrose	Iron overdose risk
isoniazid	Hepatitis
ISOtretinoin	Pregnancy contraindication
itraconazole	Congestive heart failure, drug interactions
ixabepilone	Toxicity in hepatic impariment
kanamycin	Neurotoxicity; nephrotoxicity; use in pregnancy
ketamine	Emergence reactions; psychological manifestations
ketoconazole	Oral: hepatoxicity, drug interactions
ketoprofen	Cardiovascular; gastrointestinal risk
ketorolac	Duration of therapy; max dose; GI, cardiovascular, bleeding, renal risk
lamiVUDine	Lactic acidosis, hepatomegaly; exacerbations of hepatitis b; dosing formulation
lamivudine-tenofovir	Post Treatment Acute Exacerbation of Hepatitis B
lamiVUDine-zidovudine	Lamivudine: Lactic acidosis, hepatomegaly; exacerbations of hepatitis b; dosing formulation Zidovudine: Hematological adverse events; myopathy; lactic acidosis; hepatomegaly
lamoTRIgine	Serious dermatological reactions
lapatinib	Hepatotoxicity
laronidase	Risk of Anaphylaxis
lecanemab	Amyloid Related Imaging Abnormalities
ledipasvir-sofosbuvir	Risk of Hepatitis B Virus Reactivation in Patients Coinfected with HCV and HBV
leflunomide	Pregnancy risk
lenalidomide	Embryo-Fetal Toxicity, Hematologic Toxicity, and Venous and Arterial Thromboembolism
levofloxacin	Tendinitis, tendon rupture
Levomilnacipran	Suicidal Thoughts and Behaviors
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
lidocaine-bupivacaine	Bupivacaine: Obstetrical anesthesia risk with 0.75%
linaclotide	Risk of Serious Dehydration in Pediatric Patients
lincomycin	Clostridium difficile associated diarrhea
lindane topical	Neurotoxicity
liothyronine	Treatment of obesity or weight loss
liotrix	Treatment of obesity or weight loss
liraglutide	Risk of Thyroid C-cell Tumors
lisdexamfetamine	High abuse/diversion potential; drug dependence
lisinopril	Pregnancy risk
lithium	Monitoring recommendations
lomustine	Bone marrow suppression
lopinavir-ritonavir	Ritonavir: Drug interactions
LORazepam	Risk From Concomitant Use With Opioids
losartan	Pregnancy risk
loxapine	Elderly patients with dementia related psychosis Aerosol: bronchospasm
lumateperone	Incresed Mortalilty In Elderly Patients With Dementia-Related Psychosis an Suicidal Thoughts & Behaviors
lurasidone	Mortality in elderly patients with dementia related psychosis
lymphocyte immune globulin, anti-thy (equine)	Prior to initiation of therapy
macitentan	Fetal Risk
mannitol	Severe bronchospasm risk
maprotiline	Suicidal ideation
maraviroc	Hepatotoxicity
mechlorethamine	Prior to initiation of therapy
meclofenamate	Cardiovascular, gastrointestinal risk
medroxyPROGESTERone	Cardiovascular and other risks
mefloquine	Neuropsychiatric events
meloxicam	Cardiovascular; gastrointestinal risk
melphalan	Bone marrow suppression; hypersensitivity reactions; pregnancy risk
meperidine	Addiction, Abuse, and Misuse
mercaptopurine	Bolded (not boxed): initiation of therapy
mestranol-norethindrone	Cigarette smoking; risk of cardiovascular disease
metFORMIN	Lactic Acidosis
methacholine	Diagnostic use only
methadone	Risk during initiation of or conversion to methadone
methamphetamine	Abuse/diversion potential
methohexital	Continuous monitoring of respiratory and cardiac function
methotrexate	Bone marrow, liver, lung and kidney toxicity risk
methotrexate-hydrocortisone-cytarabine	Methotrexate: Bone marrow, liver, lung and kidney toxicity risk Cytarabine: prior to initiation of therapy
methoxsalen	Methoxsalen injection: Used Only By Specialized Physicians Methoxsalen oral: Methoxsalen with UV radiation should be used only by physicians who have special competence in the diagnosis and treatment of psoriasis and who have special training and experience in photochemotherapy.
methyldopa	Fixed combination for initial hypertension management
methylene blue	Serotonin Syndrome with Concomitant Use of Serotonergic Drugs
methylphenidate	Tolerance and dependence
methylTESTOSTERone	Endometrial cancer risk (estrogens)
metoclopramide	Tardive Dyskinesia
metoclopramide-diphenhydrAMINE	Metoclopramide: Tardive Dyskinesia
metolazone	Bolded (not boxed): do not interchange
metoprolol	Avoid Abrupt Withdrawal (Oral) (Warning Removed 1/2022)
metroNIDAZOLE	Carcinogenicity
mexiletine	Mortality; Acute Liver Injury
midazolam	Individualize dose
midodrine	Supine blood pressure > 180 mmHg
miFEPRIStone	Termination of Pregnancy
milnacipran	Suicidal ideation
miltefosine	Embryo-Fetal Toxicity
minoxidil	Antihypertensive risk
mirtazapine	Suicidal ideation
mirvetuximab soravtansine	Ocular Toxicity
misoprostol	Pregnancy risk
mitoMYcin	Bone marrow suppression; hemolytic uremic syndrome
mitotane	Temporarily Stop Therapy After Shock or Severe Trauma
mitoXANTRONE	Cardiotoxicity; baseline neutrophil count; extravasation risk
moexipril	Pregnancy risk
molindone	Elderly patients with dementia related psychosis
molnupiravir	Mandatory requirements for administration of molnupiravir under emergency use authorization
mometasone-formoterol inhaled	Asthma related death
montelukast	Serious Neuropsychiatric Events
morphine	24-hour observation following epidural/intrathecal administration
morphine-bupivacaine	Morphine: observe for 24 hours after epidural/IT use Bupivacaine: Obstetrical anesthesia risk with 0.75%
morphine-bupivacaine-clonidine	Morphine: observe for 24 hours after epidural/IT use Bupivacaine: Obstetrical anesthesia risk with 0.75% Clonidine: epidural indication and restriction
morphine-ropivacaine-clonidine	Morphine: observe for 24 hours after epidural/IT use Clonidine: epidural indication and restriction
moxifloxacin	Tendinitis, tendon rupture
multivitamin with iron	Iron overdose risk
multivitamin with iron and fluoride	Iron overdose risk
muromonab-CD3	Prior to initiation of therapy
mycophenolate mofetil	Prior to initiation of therapy
mycophenolic acid	Embryofetal Toxicity, Malignancies, and Serious Infections
nabumetone	Cardiovascular; gastrointestinal risk
nadolol	Avoid abrupt withdrawal
nalbuphine	Life-Threatening Respiratory Depression and Risks From Concomitant Use With Benzodiazepines or Other CNS Depressants
naltrexone	Abuse Liability Hepatic injury with excessive dosing
naproxen	Cardiovascular; gastrointestinal risk
natalizumab	Progressive multifocal leukoencephalopathy (PML)
naxitamab	Serious Infusion Related Reactions and Neurotoxicity
necitumumab	Cardiopulmonary Arrest and Hypomagnesemia
nefazodone	Hepatotoxicity
nelarabine	Prior to initiation of therapy; neurologic events
neomycin	Neurotoxicity, nephrotoxicity, ototoxicity; general toxicity
nevirapine	Hepatotoxicity; dermal reactions; patient monitoring
NILOTinib	QT Prolongation and Sudden Death
nilutamide	Interstitial pneumonitis
niMODipine	Serious harm with IV administration of oral product
nirmatrelvir-ritonavir	Risk of Serious Adverse Reactions Due to Drug Interactions
nitroprusside	Cyanide toxicity; hypotension risk; dilute
norepinephrine	Extravasation risk
norethindrone	Cigarette smoking; risk of cardiovascular disease
norfloxacin	Tendinitis, tendon rupture
nortriptyline	Suicidal ideation
obinutuzumab	Hepatitis B Virus Reactivation and Progressive Multifocal Leukoencephalopathy
ofatumumab	Hepatitis B Virus (HBV) Reactivation; Progressive Multifocal Leukoencephalopathy
ofloxacin	Tendon Rupture, Tendinitis
OLANZapine	Mortality in elderly with dementia related psychosis
olanzapine-samidorphan	Increased mortality in elderly patients with dementia-related psychosis
olmesartan	Pregnancy risk
omalizumab	Anaphylaxis
onabotulinumtoxinA	Distant spread of toxin effect
oprelvekin	Allergic reactions, including anaphylaxis
oxaliplatin	Anaphylactic-like reactions
oxandrolone	Peliosis hepatitis; liver cell tumors; blood lipid changes
oxaprozin	Cardiovascular; gastrointestinal risk
oxazepam	Risks From Concomitant Use With Opioids
oxyCODONE	Oral solution: Risk of errors Controlled release: Abuse potential
oxymetholone	Peliosis hepatitis; liver cell tumors; blood lipid changes
oxymorphone	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
pancuronium	Bolded (not boxed): adequate training
panitumumab	Dermatologic toxicity; infusion reactions
PARoxetine	Suicidal ideation
patiromer	Binding to other oral medications
PAZOPanib	Hepatotoxicity
peginterferon alfa-2a	Neuropsychiatric, autoimmune, ischemic and infectious disorders
peginterferon alfa-2b	Neuropsychiatric, autoimmune, ischemic and infectious disorders
penicillAMINE	Toxicity risk
penicillin G benzathine	Not for Intravenous Use
pentazocine	Oral use only; lethal risk from misuse by injection
pentazocine-naloxone	Addiction, Abuse, And Misuse; Life-Threatening Respiratory Depression; Neonatal Opioid Withdrawal Syndrome Risks From Concomitant Use With Benzodiazepines or Other CNS Depressants
pentetate calcium trisodium	Asthma Exacerbation with Nebulization and Depletion of Trace Metals During Therapy
pentostatin	Prior to initiation of therapy
Perampanel	Serious Psychiatric and Behavioral Reactions
perflutren	Serious cardiopulmonary reactions
perindopril	Pregnancy risk
perphenazine	Elderly patients with dementia related psychosis
pertuzumab	Cardiomyopathy and Embryo-Fetal Toxicity
phenelzine	Suicidal ideation
phenylephrine	Prior to initiation of therapy
phenylephrine-promethazine	Promethazine: Patients < 2 years; respiratory depression
phenytoin	Cardiovascular risk with rapid infusion
phytonadione	Severe reactions with IV use
pimavanserin	Increased mortality in elderly patients with dementia-related psychosis
pimecrolimus topical	Long-term safety
pimozide	Elderly patients with dementia related psychosis
pioglitazone	Congestive heart failure
piroxicam	Cardiovascular; gastrointestinal risk
plasma protein fraction	Liver transplant, severe liver disease and coagulopathies
plazomicin	Nephrotoxicity, Ototoxicity, Neuromuscular Blockade and Fetal Harm
polymyxin B sulfate	Parenteral use: nephrotoxicity, neurotoxicity, pregnancy risk
prasugrel	Bleeding risk
primaquine	Prior to initiation of therapy
procainamide	Positive titers with chronic administration
procarbazine	Prior to initiation of therapy
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 concentrate	Arterial and venous thromboembolic complications
protriptyline	Suicidal ideation
QUEtiapine	Elderly patients with dementia related psychosis
quinapril	Pregnancy risk
quiNIDine	Active antiarrhythmic therapy may increase mortality
quiNINE	No benefit in leg cramps; hematologic risks
raloxifene	Risk of VTE and death from stroke
ramipril	Pregnancy risk
Ramucirumab	Hemorrhage, Gastrintestinal Perforation , and Impaired Wound Healing
ranibizumab ophthalmic	Endophthalmitis
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
ribavirin	Oral: Monotherapy; hemolytic anemia; teratogenicity Inhalation: Respiratory function deterioration
rimabotulinum toxin B	Distant Spread of Toxin Effect
riociguat	Embryo-Fetal Toxicity
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
sacituzumab govitecan	Neutropenia and Diarrhea
salmeterol	Asthma Related Deaths
salsalate	Cardiovascular; gastrointestinal risk
saquinavir	Bioequivalency
selegiline	Suicidal ideation
sertraline	Suicidal ideation
sirolimus	Immunosuppression; liver or lung transplant patients
sodium phosphate	Phosphate nephropathy
sofosbuvir	Risk of Hepatitis B Virus Reactivation in Patients Coinfected with HCV and HBV
sofosbuvir-velpatasvir	Risk of Hepatitis B Virus Reactivation in Patients Coinfected with HCV and HBV
sofosbuvir/velpatasvir/voxilaprevir	Risk of Hepatitis B Virus Reactivation in Patients Coinfected with HCV and HBV
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
sulindac	Cardiovascular; gastrointestinal risk
SUNItinib	Hepatotoxicity
tacrolimus	Lymphoma risk; infection related to immunosuppression
tacrolimus topical	Long-term safety
tamoxifen	Women at high risk for breast cancer; women with DCIS
tapentadol	Abuse potential; limitations of use
teclistamab	Cytokine Release Syndrome & Neurologic Toxicity including Immune Effector Cell-associated Neurotoxicity Syndrome
telavancin	Incresaed Mortality; Nephrotoxicity; Fetal Risk
telbivudine	Acute Exacerbation of Hepatitis B/Lactic Acidosis/Severe Hepatomegaly
telmisartan	Pregnancy risk
temazepam	Risk From Concomitant Use With Opioids
teniposide	Myelosuppression; hypersensitivity reactions
tenofovir	Lactic acidosis, severe hepatomegaly; hepB co-infection
terbutaline	Preterm labor (injectable and oral)
teriparatide	Potential Risk of Osteosarcoma
terlipressin	Serious or Fatal Respiratory Failure
testosterone	Secondary exposure to testosterone
thalidomide	Teratogen; informed consent required
thioridazine	QTc prolongation; elderly with dementia related psychosis
thiotepa	Severe Myelosuppression, Carcinogenicity
thiothixene	Elderly patients with dementia
thrombin topical	Bleeding, thrombosis risk
thyroid desiccated	Treatment of obesity or weight loss
ticagrelor	Bleeding Risk
ticlopidine	Severe hematological adverse events
tigecycline	All cause mortality
timolol	Avoid abrupt withdrawal
tinidazole	Potential Risk for Carcinogenicity
tiotropium-olodaterol	Asthma related death
tipranavir	Both fatal and nonfatal intracranial hemorrhage have been reported.
tiZANidine	Bolded (not boxed): bioequivalence between products
tobramycin	Ototoxicity, nephrotoxicity risk with IV use
tocilizumab	Serious infections risk
tolcapone	Hepatotoxicity
tolvaptan	Initiation or re-initiation monitoring
topotecan	Bone marrow suppression
toremifene	QT Prolongation; avoid CYP3A4 Inhibitors
traMADol	Addiction, Abuse, and Misuse
trandolapril	Pregnancy risk
tranylcypromine	Suicidal ideation
trastuzumab	Cardiomyopathy; infusion reactions, pulmonary toxicity; teratogenicity
traZODone	Suicidal ideation
tretinoin	Acute promyelocytic leukemia; experienced physician
triamterene	Hyperkalemia
triazolam	Risk From Concomitant Use With Opioids
trifluoperazine	Elderly patients with dementia related psychosis
trimipramine	Suicidal ideation
umeclidinium-vilanterol	Vilanterol: Asthma-Related Death
upadacitinib	Serious Infections, Malignancy, Major Adverse Cardiovascular Events, and Thrombosis
valGANciclovir	Granulocytopenia, anemia, thrombocytopenia
valproic acid	Risk to children exposed in utero
valsartan	Pregnancy risk
vancomycin	Risk of Embryo-Fetal Toxicity Due to Excipients
vandetanib	QT Prolongation, Torsades De Pointes, and Sudden Death
varenicline	Serious neuropsychiatric events, monitoring and patient counseling
venlafaxine	Suicidal ideation
vilazodone	Suicidal ideation
vinBLAStine	IV use only; granulocytopenia; avoid extravasation
vinCRIStine	IV use only; dose liposomal product differently
vinCRIStine-DOXOrubicin	Vincristine: IV use only (fatal intrathecally) Doxorubicin: Cardiac, hepatic, myelosuppression, extravasation risk
vinorelbine	IV use only; granulocytopenia; avoid extravasation
Vortioxetine	Suicidal Thoughts and Behaviors
warfarin	Serious bleeding risk
zaleplon	Risk of Serious Injuries With Certain Prescription Insomnia Medications
ziconotide	Severe psychiatric symptoms, neurological impairment
zidovudine	Hematological adverse events; myopathy; lactic acidosis; hepatomegaly
ziprasidone	Mortality in elderly with dementia related psychosis
zolpidem	Complex Sleep Behaviors

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