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Slidell Memorial Hospital

SMH Medication Formulary

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Slidell Memorial Hospital

SMH Medication Formulary

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Black Box Warning

Please review each of these drugs carefully.

abacavir	Hypersensitivity
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
acetylcysteine	Inhalation solution: not for injection
ALPRAZolam	Risks From Concomitant Use in Opioids
aMILoride	Hyperkalemia
amiodarone	Oral: Pneumonitis; Proarrhythmic Effects
amitriptyline	Suicidal ideation in children, adolescents
amitriptyline-chlordiazepoxide	Amitriptyline: Suicidal ideation in children, adolescents Chlordiazepoxide - Risk From Concomitant Use With Opioids
apixaban	Discontinuation without anticoagulation
arformoterol	Asthma Related Death
ARIPiprazole	Elderly patients with dementia related psychosis
aspirin/butalbital/caffeine/codeine	Codeine in children: death due to ultra-rapid metabolism
atenolol	Avoid abrupt withdrawal
azaTHIOprine	Risk of neoplasia, infections
bacitracin	Injection: Nephrotoxicity
baclofen	Intrathecal: Abrupt discontinuation
benazepril	ACE inhibitor pregnancy risk
benzathine penicillin-procaine penicillin	Not for Intravenous Use
bevacizumab	GI perforation; wound healing complications
bumetanide	Potent diuretic
bupivacaine	Intravascular injection risk; 0.75% strength caution
bupivacaine-epinephrine	Bupivacaine: Intravascular injection risk; 0.75% strength caution
buPROPion	Suicidal Ideation
butorphanol	Addiction, Abuse, And Misuse; Respiratory Depression; Neonatal Opioid Withdrawal Syndrome; and Risks From Concomitant Use With Benzodiazepines
candesartan	Pregnancy risk
captopril	Pregnancy risk
carBAMazepine	Hematological Risk; Serious Dermatologic Reactions
carbidopa-levodopa	Bolded (not boxed): Carbidopa dosing
CARBOplatin	Myelosuppression; Anaphylaxis risk
celecoxib	Cardiovascular, gastrointestinal risk
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
cilostazol	CHF patient contraindication
ciprofloxacin	Tendinitis; tendon rupture
CISplatin	Nephrotoxicity; Myelosuppression
citalopram	Suicidal Ideation
clindamycin	Pseudomembranous colitis
clonazePAM	Risk From Concomitant Use With Opioids
cloNIDine	Epidural Clonidine
clopidogrel	Poor CYP2C19 metabolizers
clorazepate	Risks From Concomitant Use With Opioids
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/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
dabigatran	Discontinuation without anticoagulation
dacarbazine	Hemopoietic depression; hepatic necrosis risk
dantrolene	Hepatotoxicity
diatrizoate	Not for intrathecal use
diazePAM	Risks From Concomitant Use With Opioids
diclofenac	Cardiovascular, gastrointestinal risk
dihydroergotamine	Drug interaction risk
dinoprostone topical	Suppository: use recommended dose
divalproex sodium	Hepatotoxicity; mitochondrial disease; fetal risk
DOCEtaxel	Hepatic dysfunction, hypersensitivity risk
dofetilide	Initiation or re-initiation monitoring
DOPamine	Peripheral ischemia risk
doxepin	Suicidal Ideation
DOXOrubicin	Cardiac, hepatic, myelosuppression, extravasation risk
dronedarone	Contraindication in certain CHF conditions
DULoxetine	Suicidal Ideation
emtricitabine-tenofovir	Lactic acidosis; severe hepatomegaly; hepB co-infection
enalapril	Pregnancy risk
enoxaparin	Spinal/epidural hematoma risk
epoetin alfa	Risk of mortality, tumor progression, cardiac events
escitalopram	Suicidal ideation
estradiol	Transdermal: endometrial cancer; cardiovascular; dementia risk Vaginal cream/tab: endometrial cancer; cardiovascular; dementia risk
estradiol topical	Endometrial cancer; cardiovascular; dementia risk
ethacrynic acid	Potent Diuretic
ethinyl estradiol-levonorgestrel	Cigarette smoking; risk of cardiovascular disease
etoposide	Myelosuppression risk
fat emulsion, intravenous	Cautious use in infants Death in preterm infants
fentaNYL	Buccal Tablet: 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 sulfate	Iron Overdose Risk
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
fluticasone-vilanterol	Vilanterol: Asthma-related death
fluvoxaMINE	Suicidal Ideation
fondaparinux	Spinal/epidural hematoma risk
fosinopril	Pregnancy risk
fosphenytoin	Cardiovascular risk with rapid infusion
furosemide	Potent Diuretic
gadobutrol	Nephrogenic Systemic Fibrosis
gadodiamide	Nephrogenic Systemic Fibrosis
gentamicin	Ototoxicity; Nephrotoxocity
haloperidol	Mortality in elderly with dementia
heparin	Spinal/Epidural Hematomas
homatropine-hydrocodone	Hycodan - Risks from Concomitant Use with Benzodiazepines or Other CNS Depressants
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
imipramine	Suicidal ideation
immune globulin intravenous	Renal dysfunction, acute renal failure
indomethacin	Cardiovascular; gastrointestinal risk
iodixanol	Not for intrathecal use
iopamidol	Not for intrathecal use
ipilimumab	Immune-Mediated Adverse Reactions
irbesartan	ACE inhibitor pregnancy risk
iron dextran	Injection: Anaphylactic reaction risk
iron polysaccharide	Iron overdose risk
isoniazid	Hepatitis
itraconazole	Congestive heart failure, drug interactions
ketamine	Emergence reactions; psychological manifestations
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
lamoTRIgine	Serious dermatological reactions
leflunomide	Pregnancy risk
levoFLOXacin	Tendinitis, tendon rupture; Pediatric Use
levothyroxine	Treatment of obesity or weight loss
lidocaine topical	Lidocaine, viscous: Do NOT use for teething pain
lincomycin	Clostridium difficile associated diarrhea
lindane topical	Neurotoxicity
liothyronine	Treatment of obesity or weight loss
lisinopril	ACE inhibitor pregnancy risk
lithium	Monitoring recommendations
lopinavir-ritonavir	Ritonavir: Drug interactions
LORazepam	Risks From Concomitant Use With Opioids
losartan	Pregnancy risk
loxapine	Elderly patients with dementia related psychosis Aerosol: Bronchospasm
LVP solution	Extraneal: Unrecognized Hypoglycemia Resulting From Drug-Device Interaction
mannitol	Severe bronchospasm risk
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
metFORMIN	Lactic Acidosis
methacholine	Diagnostic use only
methadone	Risk during initiation of or conversion to methadone
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
metoclopramide	Tardive Dyskinesia
metOLazone	Bolded (not boxed): do not interchange
metoprolol	Avoid abrupt withdrawal
metroNIDAZOLE	Carcinogenicity
mexiletine	Mortality; Acute Liver Injury
midazolam	Individualize dose
midodrine	Supine blood pressure > 180 mmHg
minoxidil	Antihypertensive risk
mirtazapine	Suicidal ideation
miSOPROStol	Pregnancy risk
moexipril	ACE inhibitor pregnancy 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
mycophenolate mofetil	Prior to initiation of therapy
nadolol	Avoid abrupt withdrawal
nalbuphine	Life-Threatening Respiratory Depression and Risks From Concomitant Use With Benzodiazepines or Other CNS Depressants
naproxen	Cardiovascular; gastrointestinal risk
neomycin	Neurotoxicity, nephrotoxicity, ototoxicity; general toxicity
norepinephrine	Extravasation risk
nortriptyline	Suicidal ideation
OLANZapine	Mortality in elderly with dementia related psychosis
olmesartan	ACE inhibitor pregnancy risk
onabotulinumtoxinA	Distant spread of toxin effect
oxaliplatin	Anaphylactic-like reactions
oxandrolone	Peliosis hepatitis; Liver Cell Tumors; Blood Lipid Changes
oxyCODONE	Oral solution: Risk of errors Controlled release: Abuse potential
oxytocin	Elective induction of labor
PACLitaxel	Prior to initiation of therapy
PACLitaxel protein-bound	Prior to initiation of therapy
PARoxetine	Suicidal ideation
patiromer	Binding to Other Oral Medications
phenylephrine	Prior to initiation of therapy
phenytoin	Cardiovascular risk with rapid infusion
phytonadione	Severe reactions with IM and IV use
pioglitazone	Congestive heart failure
prasugrel	Bleeding risk
procainamide	Positive titers with chronic administration
prochlorperazine	Elderly patients with dementia related psychosis
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
quinapril	ACE inhibitor pregnancy risk
raloxifene	Risk of VTE and death from stroke
ramipril	Olmesartan: ACE inhibitor pregnancy risk
rasburicase	Anaphylaxis; hemolysis; methemoglobinemia; uric acid measure interference
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
sacubitril-valsartan	Valsartan: ACE inhibitor pregnancy risk
salsalate	Cardiovascular; gastrointestinal risk
sertraline	Suicidal ideation
sodium nitroprusside	Cyanide toxicity; hypotension risk; dilute
sodium phosphate	Phosphate nephropathy
sotalol	Therapy initiation; renal impairment caution; product selection
spironolactone	Possible tumorigen
tacrolimus	Lymphoma risk; infection related to immunosuppression
tamoxifen	Women at high risk for breast cancer; women with DCIS
telavancin	Increased Mortality/Nephrotoxicity/Fetal Risk
telmisartan	ACE inhibitor pregnancy risk
temazepam	Risks From Concomitant Use With Opioids
terbutaline	Preterm labor (injectable and oral)
testosterone	Secondary exposure to testosterone Testosterone undecanoate, injection: POME reactions and anaphylaxis
thioridazine	QTc prolongation; elderly with dementia related psychosis
thrombin topical	Bleeding, thrombosis risk
thyroid desiccated	Treatment of obesity or weight loss
ticagrelor	Bleeding Risk
tigecycline	All cause mortality
tiZANidine	Bolded (not boxed): bioequivalence between products
tobramycin	Ototoxicity, nephrotoxicity risk with IV use
tocilizumab	Serious infections risk
tolvaptan	Initiation or re-initiation monitoring
traMADol	Addiction, Abuse, and Misuse; Life-Threatening Depression; Accidental Exposure; Neonatal Opioid Withdrawal Syndrome; and Hepatotoxicity
trandolapril	ACE inhibitor pregnancy risk
trastuzumab	Cardiomyopathy; infusion reactions, pulmonary toxicity; teratogenicity
traZODone	Suicidal ideation
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
varenicline	Serious neuropsychiatric events, monitoring and patient counseling
venlafaxine	Suicidal ideation
vinBLAStine	IV use only; granulocytopenia; avoid extravasation
vinCRIStine	IV use only; dose liposomal product differently
warfarin	Serious bleeding risk
zidovudine	Hematological adverse events; myopathy; lactic acidosis; hepatomegaly
ziprasidone	Mortality in elderly with dementia related psychosis
zolpidem	Complex Sleep Behaviors

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