Drug-to-Drug Checking

Check for interactions against existing medications in the patient's record.

Interaction checking is performed based on the generic names and generic grouping of the drugs in the database. Clinical also checks if the drug, or another drug in the same class, is already prescribed for the patient.

Prompts for drug-drug interactions are displayed only when a new drug is added to the patient's medication list. If you choose to prescribe the new item, you will not be prompted again when printing a repeat prescription for either of the two items.

There are a number of drug-to-drug interaction types checked by the Clinical program:
  • A simple reminder is given if a patient is prescribed a drug from the same group as a drug already on their current medication list. Confirm if you want to continue prescribing the medication. A similar reminder is given when an antibiotic is prescribed to a patient on the Oral Contraceptive pill.
  • Interactions between drugs that are of more significance and are divided into a number of categories. A warning message describing the general form of the interaction is displayed and the prescriber must choose whether to continue with the prescription of the new medication. For some interactions, the default option is to proceed. This occurs where caution should be observed in using the two drugs simultaneously, for example a benzodiazepine with an antihistamine.
  • Interaction checking occurs where the addition of the new drug may require adjustment of the dose of a drug that is already prescribed, or where the dose of the new drug may need to be monitored because of a drug that is already being taken, for example adding PHENYTOIN and THEOPHYLLINE.
  • For more serious interactions, the default option is to cancel the prescription of the new drug. These are interactions where it is best not to use the two drugs together without careful consideration of the potential consequences, for example WARFARIN and ASPIRIN, or TERFENADINE and KETOCONAZOLE.
  • For more information about a flagged interaction, click PI on the prompt to open the full Prescribing Information (PI) sheet for the item being prescribed.
  • As with allergy checking, it is almost always possible to override the default option. The decision on whether to prescribe a particular combination of drugs is left up to your clinical judgement.
  • As the new drug is checked against every drug on the patient's current list, so multiple warnings are possible. If you choose to continue at one warning, that does not stop the program from checking all items on the list, as there may be a more serious interaction with another medication on the list.
  • View the current list of interactions for any drug with each MDref drug update.