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UNC Health Medication Formulary

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UNC Health Medication Formulary

Change Request Form Chemical/SDS Search UNC Health.org

Black Box Warning

Please review each of these drugs carefully.

abacavir	Hypersensitivity
abacavir-dolutegravir-lamiVUDine	Hypersensitivity Reactions, Lactic Acidosis and Severe Hepatomegaly; Exacerbations of Hepatitis B
abacavir-lamiVUDine	Hypersensitivity Reactions And Exacerbations of Hepatitis B
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
adalimumab	Infection risk; malignancy in children and adolescents
adefovir	Exacerbation of Hepatitis; Nephrotoxicity; HIV Resistance; Lactic Acidosis, Severe Hepatomegaly
ado-trastuzumab emtansine	Hepatotoxicity, Cardiac Toxicity, Embryo-Fetal Toxicity
aldesleukin	Capillary Leak Syndrome
alemtuzumab	Hematological toxicity; opportunistic infections
alglucosidase alfa	Anaphylaxis; Cardiorespiratory Failure
aliskiren	Pregnancy risk
ALPRAZolam	Risks From Concomitant Use in Opioids
alprostadil	Apnea
alvimopan	Short-term hospital use only
ambrisentan	Hepatic Injury; pregnancy risk; restricted distribution
amikacin	Neurotoxicity; nephrotoxicity
amiloride	Hyperkalemia
amiodarone	Oral: Pneumonitis; Proarrhythmic Effects
amitriptyline	Suicidal ideation in children, adolescents
amphetamine-dextroamphetamine	Abuse/diversion potential; drug dependence
amphotericin B	Noninvasive fungal disease; avoid overdose
anti-thymocyte globulin (rabbit)	Used by Experienced Physicians in Immunosuppressive Therapy
apixaban	Discontinuation without anticoagulation
arformoterol	Asthma Related Death
aripiprazole	Elderly patients with dementia related psychosis
arsenic trioxide	Differentiation Syndrome, Cardiac Conduction Abnormalities and Encephalopathy Including Wernicke's
ascorbic acid-iron polysaccharide	Iron Overdose Risk
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 Susceptible Patients
azathioprine	Risk of neoplasia, infections
Bacillus Calmette-Guèrin (BCG)	Risk of infection; biohazard handling precautions
baclofen	Intrathecal: Abrupt discontinuation
baricitinib	Serious Infections, Mortality, Malignancy, Major Adverse Cardiovascular Events (MACE), and Thrombosis
basiliximab	Prior to initiation of therapy
belatacept	Post transplant lymphoproliferative disorder; serious infections
benzathine penicillin-procaine penicillin	Not for Intravenous Use
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
botulinum toxins	Distant spread of toxin effect
brentuximab vedotin	Progressive Multifocal Leukoencephalopathy (PML)
brexanolone	Excessive Sedation and Sudden Loss of Consciousness
brodalumab	Suicidal Ideation and Behavior
budesonide-formoterol	Asthma Related Death
bumetanide	Potent diuretic
bupivacaine	Intravascular injection risk; 0.75% strength caution
bupivacaine-EPINEPHrine	Bupivacaine: Intravascular injection risk; 0.75% strength caution
bupivacaine-fentaNYL	Intramuscular Injection Risk (0.75% strength caution)
bupivacaine-meloxicam	Risk of Serious Cardiovascular and Gastrointestinal Events
buprenorphine	Addiction, Abuse, And Misuse; Respiratory Depression; Neonatal Opioid Withdrawal Syndrome; Risks From Concomitant Use With Benzodiazepines
buprenorphine-naloxone	Implant: Implant Migration, Protrusion, Expulsion, and Nerve Damage Associated with Insertin and Removal
buPROPion	Suicidal Ideation
busulfan	Bone marrow suppression
butorphanol	Addiction, Abuse, And Misuse; Respiratory Depression; Neonatal Opioid Withdrawal Syndrome; and Risks From Concomitant Use With Benzodiazepines
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
capecitabine	Warfarin Interaction
captopril	Pregnancy risk
CAR t-cell immunotherapy (CAR-T)	Cytokine Release Syndrome and Neurological Toxicities
carBAMazepine	Hematological Risk; Serious Dermatologic Reactions
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
celecoxib	Cardiovascular, gastrointestinal risk
certolizumab	Serious infection risk
cetuximab	Infusion Reactions; Cardiopulmonary Arrest
chlordiazePOXIDE	Risks From Concomitant Use With Opioids
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	Diminished Effectiveness in Poor Metabolizers
clorazepate	Risks From Concomitant Use With Opioids
cloZAPine	Severe Neutropenia; Orthostatic Hypotension, Bradycardia, and Syncope; Seizure; Myocarditis and Cardiomyopathy; Increased Mortality in Elderly Patients with Dementia-Related Psychosis
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-elvitegravir-emtricitabine-tenofovir	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
collagenase clostridium histolyticum	Serious Penile Injury
conjugated estrogens	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
DACTINomycin	Handling precautions; extravasation risk
dalfopristin-quinupristin	Approved indication (Warning Removed)
dalteparin	Spinal/epidural hematoma risk
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
deferasirox	Renal Failure, Hepatic Failure and Gastrointestinal Hemorrhage
denosumab	Prolia - Severe Hypocalcemia in Patients with Advanced Kidney Disease
desipramine	Suicidal Ideation
desmopressin	Hyponatremia Hyponatremia (Nasal Spray)
deutetrabenazine	Depression and Suicidality in Patients with Huntington's Disease
dextroamphetamine	Abuse/diversion potential; drug dependence
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
dinutuximab	Serious Infusion Reactions and Neuropathy
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
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
duvelisib	Fatal and Serious Toxicities: Infections, Diarrhea or Colitis, Cutaneous Reactions, and Pneumonitis
eculizumab	Meningococcal Infection
edetate calcium disodium	Lead encephalopathy risk
elosulfase alfa	Risk of Anaphylaxis
eltrombopag	Risk for Hepatotoxicity, Restricted Distribution
emtricitabine	Lactic Acidosis, Severe Hepatomegaly
emtricitabine-tenofovir	Lactic acidosis; severe hepatomegaly; hepB co-infection
enalapril	Pregnancy risk
enasidenib	Differentiation Syndrome
enoxaparin	Spinal/epidural hematoma risk
entecavir	Lactic acidosis, severe hepatomegaly; hepB co-infection
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
escitalopram	Suicidal ideation
esketamine	Sedation; Dissociation; Abuse and Misuse; and Surcidal Thoughts and Behaviors
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
etanercept	Infection risk; tuberculosis
ethacrynic acid	Potent Diuretic
ethinyl estradiol-norethindrone	Cigarette smoking; risk of cardiovascular disease
etonogestrel	Bolded (not boxed): sexually transmitted disease risk
etoposide	Myelosuppression risk
everolimus	Malignancies and Serious Infections, Nephrotoxicity, Kidney Graft Thrombosis, Mortality in Heart Transplantation
fat emulsion, intravenous	Cautious use in infants Death in preterm infants
febuxostat	Cardiovascular Death
fedratinib	Encephalopathy Including Wernicke's
felbamate	Aplastic anemia; liver failure risk
fenfluramine	Valvular Heart Disease and Pulmonary Arterial Hypertension
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 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
FLUoxetine	Suicidal Ideation
fluPHENAZine	Mortality in elderly with dementia
flutamide	Hepatotoxicity
fluticasone-vilanterol	Vilanterol: Asthma-related death
fluvoxamine	Suicidal Ideation
fondaparinux	Spinal/epidural hematoma risk
foscarnet	Nephrotoxicity; seizure risk
fosphenytoin	Cardiovascular risk with rapid infusion
furosemide	Potent Diuretic
gadobenate dimeglumine	Nephrogenic Systemic Fibrosis
gadobutrol	Nephrogenic Systemic Fibrosis
gadopentetate dimeglumine	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
gilteritinib	Differentiation Syndrome
glasdegib	Embryo-Fetal Toxicity
glecaprevir-pibrentasvir	Risk of Hepatitis B Virus Reactivation in Patients Coninfected with HCV and HBV
glofitamab	Cytokine Release Syndrome
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-rituximab	Fatal Infusion Reaction; Mucocutaneous Reactions; Progressive Multifocal Leukoencephalopathy; Hep b Reactivation
hyaluronidase-trastuzumab	Cardiomyopathy, Embryo-Fetal Toxicity and Pulmonary Toxicity
hydroCHLOROthiazide-triamterene	Hyperkalemia
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
hydroxyethyl starch	Mortality and Renal Injury Requiring Renal Replacement Therapy
hydroxyurea	Myelosuppression and malignancies
ibuprofen	Cardiovascular; gastrointestinal risk
ibutilide	Potentially Fatal Arrhythmias
IDArubicin	Cardiotoxicity; myelosuppression; renal/hepatic impairment; avoid extravasation
idelalisib	Fatal and Serious Toxicities; Hepatic, Severe Diarrhea, Colitis, Pneumonitis, and Intestinal Perforation
ifosfamide	Urotoxicity; myelosuppressionm CNS toxicity
imipramine	Suicidal ideation
immune globulin	Renal dysfunction, acute renal failure
indomethacin	Cardiovascular; gastrointestinal risk
inFLIXimab	Serious infection risk; hepatosplenic t-cell lymphomas; malignancy
inotuzumab ozogamicin	Hepatotoxicity, Increased Risk of Post-Hematopoietic Stem Cell, Transplant Non-Relapse Mortality
interferon alfa-2b	Neuropsychiatric, autoimmune, ischemic and infectious disorders
intrauterine devices	Bolded (not boxed): Not Protective Against HIV
iodixanol	Not for intrathecal use
iopamidol	Not for intrathecal use
ioversol	Not for Intrathecal
ipilimumab	Immune-Mediated Adverse Reactions
irinotecan	Severe diarrhea
iron dextran	Injection: Anaphylactic reaction risk
iron polysaccharide	Iron overdose risk
iron sucrose	Iron overdose risk
isoniazid	Hepatitis
itraconazole	Congestive heart failure, drug interactions
ivosidenib	Differentiation Syndrome
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	Hematologic toxicity, Myopathy, Lactic acidosis and Severe Hepatomegaly with Steatosis, and Exacerbations of Hepatitis B
lamoTRIgine	Serious dermatological reactions
lapatinib	Hepatotoxicity
lecanemab	Amyloid Related Imaging Abnormalities
ledipasvir-sofosbuvir	Risk of Hepatitis B Virus Reactivation in Patients Coinfected with HCV and HBV
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
lifileucel	Treatment-related Mortality, Prolonged Severe Cytopenia, Severe Infection, Cardiopulmonary and Renal Impairment
linaclotide	Risk of Serious Dehydration in Pediatric Patients
lindane topical	Neurotoxicity
liothyronine	Treatment of obesity or weight loss
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, antithymocyte (equine)	Prior to initiation of therapy
macitentan	Embryo-Fetal Toxicity
mannitol	Severe bronchospasm risk
maraviroc	Hepatotoxicity
mechlorethamine	Prior to initiation of therapy
medroxyPROGESTERone	Oral: Cardiovascular and other risks Injection: Loss of Bone Mineral Density
meloxicam	Cardiovascular; gastrointestinal risk
melphalan	Bone marrow suppression; hypersensitivity reactions; pregnancy risk
meperidine	Addiction, Abuse, and Misuse; Life-Threatening Respiratory Depression; Accidental Exposure; Neonatal Opioid Withdrawal Syndrome
mercaptopurine	Bolded (not boxed): initiation of therapy
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
mifepristone	Serious and sometimes fatal infections and bleeding
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	Adrenal Crisis in the Setting of Shock, Severe Trauma or Infection
mitoxantrone	Cardiotoxicity; baseline neutrophil count; extravasation risk
molnupiravir	Mandatory requirements for administration of molnupiravir under emergency use authorization
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
mosunetuzumab	Cytokine Release Syndrome
moxifloxacin	Tendinitis, tendon rupture
multivitamin with iron	Iron overdose risk
multivitamin, prenatal	Iron Overdose Risk
mycophenolate	Prior to initiation of therapy
nalbuphine	Life-Threatening Respiratory Depression
naproxen	Cardiovascular; gastrointestinal risk
natalizumab	Progressive multifocal leukoencephalopathy (PML)
necitumumab	Cardiopulmonary Arrest and Hypomagnesemia
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
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
obeticholic acid	Hepatic Decompensation and Failure in Primary Biliary Cholangitis Patients with Cirrhosis
obinutuzumab	Hepatitis B Virus Reactivation and Progressive Multifocal Leukoencephalopathy
OLANZapine	Mortality in elderly with dementia related psychosis
olipudase alfa	Hypersensitivity Reactions Including Anaphylaxis
omalizumab	Anaphylaxis
onasemnogene abeparvovec	Acute Serious Liver Injury, Acute Liver Failure
oxaliplatin	Anaphylactic-like reactions
oxyCODONE	Oral solution: Risk of errors Controlled release: Abuse potential
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
panitumumab	Dermatologic toxicity; infusion reactions
PARoxetine	Suicidal ideation
pazopanib	Hepatotoxicity
pegcetacoplan	Serious Infections Caused By Encapsulated Bacteria
pegloticase	Anaphylaxis and Infusion Reactions
pemivibart	Anaphylaxis
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
pertuzumab-trastuzumab-hyaluronidase	Cardiomyopathy, Embryo-Fetal Toxicity, and Pulmonary Toxicity
phenelzine	Suicidal ideation
phenylephrine	Prior to initiation of therapy
phenytoin	Cardiovascular risk with rapid infusion
phytonadione	Severe reactions with IM and IV use
pimecrolimus topical	Long-term safety
pioglitazone	Congestive heart failure
polymyxin B sulfate	Parenteral use: nephrotoxicity, neurotoxicity, pregnancy risk
ponatinib	Arterial Occlusive Events, Venous Thromboembolic Events, Heart Failure, and Hepatotoxicity
potassium phosphate-sodium phosphate	Acute Phosphate Nephropathy
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	Arterial and venous thromboembolic complications
QUEtiapine	Elderly patients with dementia related psychosis
quizartinib	QT Prolongation, Torsades DE Pointes, and Cardia Arrest
raloxifene	Risk of VTE and death from stroke
ramucirumab	Increased Risk of Hemorrhage
rasburicase	Anaphylaxis; hemolysis; methemoglobinemia; uric acid measure interference
ravulizumab	Serious Meningococcal Infections
regorafenib	Hepatotoxicity
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
remimazolam	Personnel and Equipment for Monitoring and Resusciation and Risks From Concomitant Use with Opioid Analgesics
rho (D) immune globulin	Intravenous - Intravascular Hemolysis
ribavirin	Oral: Monotherapy; hemolytic anemia; teratogenicity Inhalation: Respiratory function deterioration
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
romosozumab	Potential Risk of Myocardial Infarction, Stroke and Cardiovascular Death
sacituzumab govitecan	Neutropenia and Diarrhea
sacubitril-valsartan	Valsartan: ACE inhibitor pregnancy risk
salsalate	Cardiovascular; gastrointestinal risk
saquinavir	Bioequivalency
sarilumab	Risk of Infections
selegiline	Suicidal ideation
sertraline	Suicidal ideation
sirolimus	Immunosuppression; liver or lung transplant patients
sodium nitrite-sodium thiosulfate	Life Threatening Hypotension and Methemoglobin Formation
sodium nitroprusside	Cyanide toxicity; hypotension risk; dilute
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
streptozocin	Nephrotoxicity; experienced physician; mutagen
succinylcholine	Hyperkalemic rhabdomyolysis in infants or children
SUFentanil	Addition, Abuse, and Misuse
sulfur hexafluoride	Serious Cardiopulmonary Reactions
sulindac	Cardiovascular; gastrointestinal risk
sunitinib	Hepatotoxicity
tacrolimus	Lymphoma risk; infection related to immunosuppression
tacrolimus topical	Long-term safety
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	Abuse potential; limitations of use
tarlatamab	Cytokine Release Syndrome and Neurologic Toxicity
teclistamab	Cytokine Release Syndrome & Neurologic Toxicity including Immune Effector Cell-associated Neurotoxicity Syndrome
temAZEpam	Risks From Concomitant Use With Opioids
tenofovir	Lactic acidosis, severe hepatomegaly; hepB co-infection
terbutaline	Preterm labor (injectable and oral)
teriflunomide	Hepatotoxicity & Embryo-Fetal Toxicity
teriparatide	Potential Risk of Osteosarcoma
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
tetrabenazine	Depression and Suicidality
thiothixene	Elderly patients with dementia related psychosis
thrombin topical	Bleeding, thrombosis risk
thyroid desiccated	Treatment of obesity or weight loss
ticagrelor	Bleeding Risk
tipranavir	Intracranial Hemorrhage; Hepatotoxicity
tisotumab vedotin	Ocular toxicity
tizanidine	Bolded (not boxed): bioequivalence between products
tobramycin	Ototoxicity, nephrotoxicity risk with IV use
tocilizumab	Serious infections risk
tofacitinib	Serious Infections, Mortality, Malignancy, Major Adverse Cardiovascular Events (MACE), and Thrombosis
tolvaptan	Initiation or re-initiation monitoring
topotecan	Bone marrow suppression
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	Experienced Physician, Acute Promyelocytic Leukemia : Increased Risk of ADRs
trifluoperazine	Elderly patients with dementia related psychosis
umeclidinium-vilanterol	Vilanterol: Asthma-related death
upadacitinib	Serious Infections, Malignancy, Major Adverse Cardiovascular Events, and Thrombosis
valbenazine	Depression and Suicidal Ideation and Behavior in Patients with Huntington’s Disease
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
Vigabatrin	Permanent Vision Loss
vinBLAStine	IV use only; granulocytopenia; avoid extravasation
vinCRIStine	IV use only; dose liposomal product differently
vinorelbine	IV use only; granulocytopenia; avoid extravasation
vismodegib	Embryo-Fetal Death and Severe Birth Defects
voclosporin	Malignancies and Serious Infections
vortioxetine	Suicidal Thoughts and Behaviors
warfarin	Bleeding Risk
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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