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FDA and ISMP Lists of Look-Alike Drug Names with ...

2016 FDA and ISMP Lists of Look-Alike Drug Names with Recommended Tall Man LettersInstitute for Safe Medication PracticesSince 2008, ISMP has maintained a list of drug name pairs and trios withrecommended, boldedtall man (uppercase) letters to help drawattention to the dissimilarities in Look-Alike drug Names . The list includesmostly generic-generic drug name pairs, although a few brand-brand orbrand-generic name pairs are included. The US Food and DrugAdministration (FDA) list of drug Names with recommended tall manletters was initiated in 2001 with the agency s Name DifferentiationProject ( ).

medication technology vendors. Any product label changes by manufac-turers require FDA approval. To promote standardization regarding which letters to present in uppercase, ISMP follows a tested methodology whenever possible called the CD3 rule.15 The methodology suggests working from the left of the drug name

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1 2016 FDA and ISMP Lists of Look-Alike Drug Names with Recommended Tall Man LettersInstitute for Safe Medication PracticesSince 2008, ISMP has maintained a list of drug name pairs and trios withrecommended, boldedtall man (uppercase) letters to help drawattention to the dissimilarities in Look-Alike drug Names . The list includesmostly generic-generic drug name pairs, although a few brand-brand orbrand-generic name pairs are included. The US Food and DrugAdministration (FDA) list of drug Names with recommended tall manletters was initiated in 2001 with the agency s Name DifferentiationProject ( ).

2 While numerous studies between 2000 and 2016 have demonstrated the ability of tallman letters alone or in conjunction with other text enhancements to improve the ac-curacy of drug name perception and reduce errors due to drug name similarity,1-9somestudies have suggested that the strategy is evidence is mixed duein large part to methodological differences and significant study , while gaps still exist in our full understanding of the role of tall manlettering in the clinical setting, there is sufficient evidence to suggest that thissimple and straightforward technique is worth implementing as one among nu-merous strategies to mitigate the risk of errors due to similar drug Names .

3 Toawait irrefutable, scientific proof of effectiveness minimizes and undervaluesthe study findings and anecdotal evidence available today13that support thisimportant risk-reduction strategy. As such, the use of tall man letters has beenendorsed by ISMP, The Joint Commission (recommended but not required), theUS Food and Drug Administration (as part of its Name Differentiation Project),as well as other national and international organizations, including the WorldHealth Organization and the International Medication Safety Network (IMSN).14 Table 1 provides an alphabetized list of FDA-approved established drugnames with recommended tall man letters.

4 Table 2 provides an alphabetized list of additional drug Names with recom-mendations from ISMP regarding the use and placement of tall manletters. This is not an official list approved by FDA. It is intended forvoluntary use by healthcare practitioners, drug information vendors, andmedication technology vendors. Any product label changes by manufac-turers require FDA approval. To promote standardization regarding which letters to present in uppercase,ISMP follows a tested methodology whenever possible called the methodology suggests working from the left of the drug namefirst by capitalizing all the characters to the right once 2 or more dissimilarletters are encountered, and then, working from the right, returning 2 ormore letters common to both words to lowercase letters.

5 When the rulecannot be applied because there are no common letters on the right sideof the name, the methodology suggests capitalizing the central part of theword only. When application of this rule fails to lead to the best tall manlettering option ( , makes Names appear too similar, makes Names hardto read based on pronunciation), an alternative option is considered. ISMP suggests that the bolded, tall man lettering scheme provided byFDA and ISMP for the drug name pairs listed in Tables 1 and 2befollowed to promote consistency. FDA and ISMPL ists of Look-Alike Drug Names with RecommendedTall Man Letterscontinued on next page >Table List of Generic Drug Names with Tall Man LettersDrug Name With Tall Man LettersConfused WithacetaZOLAMIDE acetoHEXAMIDE acetoHEXAMIDE acetaZOLAMIDEbuPROP ionbusPIRonebusPIRonebuPROP ionchlorproMAZINE chlorproPAMIDE chlorproPAMIDE chlorproMAZINE clomiPHENE clomiPRAMINE clomiPRAMINE clomiPHENE cycloSERINE cycloSPORINE cycloSPORINE cycloSERINEDAUNO rubicinDOXO rubicindimenhyDRINATE diphenhydrAMINE diphenhydrAMINE dimenhyDRINATEDOBUT

6 AmineDOPamineDOPamineDOBUT amineDOXO rubicinDAUNO rubicincontinued on next page > 2016 FDA and ISMP Lists of Look-Alike Drug Names with Recommended Tall Man LettersFDA and ISMPL ists of Look-Alike Drug Names with RecommendedTall Man LettersInstitute for Safe Medication PracticesTable 2. ISMP List of Additional Drug Names with Tall Man Letters**Drug Name With Tall Man LettersConfused WithALPRAZ olamLORazepam clonazePAMaMILorideamLODIP ineamLODIP ineaMILorideARIP iprazoleRABE prazoleAVINza*INVanz*azaCITID ineazaTHIO prineazaTHIO prineazaCITID inecarBAMazepineOXcarbazepineCARBO platinCISplatinceFAZolincefoTEtan cefOXitin cefTAZidime cefTRIAX onecefoTEtanceFAZolin cefOXitin cefTAZidime cefTRIAX onecefOXitinceFAZolin cefoTEtan cefTAZidime cefTRIAX onecefTAZidimeceFAZolin cefoTEtan cefOXitin cefTRIAX onecefTRIAX

7 OneceFAZolin - cefoTEtan cefOXitin cefTAZidime CeleBREX*CeleXA*CeleXA*CeleBREX*chlordia zePOXIDE chlorproMAZINE**Table Approved List of Generic Drug Names with Tall Man Letters(continued)Drug Name With Tall Man LettersConfused WithglipiZIDEglyBURIDEglyBURIDE glipiZIDE hydrALAZINE hydrOXYzine HYDRO morphoneHYDRO morphonehydrOXYzine hydrALAZINE hydrOXYzinehydrALAZINE HYDRO morphonemedroxyPROGESTER onemethylPREDNIS olone - methylTESTOSTER onemethylPREDNIS olonemedroxyPROGESTERone - methylTESTOSTER onemethylTESTOSTER onemedroxyPROGESTERone - methylPREDNIS olonemitoXANTRONENot specifiedniCARdipineNIFE dipineNIFE dipineniCARdipineprednisoLONE predniSONE predniSONE prednisoLONE risperiDONErOPINIR olerOPINIR olerisperiDONE sulfADIAZINE

8 SulfiSOXAZOLE sulfiSOXAZOLE sulfADIAZINETOLAZ amideTOLBUT amideTOLBUT amideTOLAZ amidevinBLAS tinevinCRIS tinevinCRIS tinevinBLAS tine* Brand Names always start with an uppercase letter. Some brand Names incorporate tall man letters in initial characters and may not be readily recognized as brand Names . An asterisk follows all brand Names on the ISMP list.** These drug Names are also on the FDA list.** The ISMP list is not an official list approved by FDA. It is intended for voluntary use by healthcare practitioners and drug information and technology vendors.

9 Any manufacturers product label changes require FDA approval. continued on next page > 2016 FDA and ISMP Lists of Look-Alike Drug Names with Recommended Tall Man LettersFDA and ISMPL ists of Look-Alike Drug Names with RecommendedTall Man LettersInstitute for Safe Medication PracticesTable 2. ISMP List of Additional Drug Names with Tall Man Letters** (continued)Drug Name With Tall Man LettersConfused WithchlorproMAZINE**chlordiazePOXIDECIS platinCARBO platincloBAZamclonazePAM clonazePAMcloNIDine cloZAPine cloBAZam LORazepamcloNIDineclonazePAM cloZAPine KlonoPIN*cloZAPineclonazePAM cloNIDineDACTIN omycinDAPTO mycinDAPTO mycinDACTIN omycinDEPO-Medrol* SOLU-Medrol*diazePAM dilTIAZ emdilTIAZ emdiazePAMDOCE taxelPACL itaxelDOXO rubicin**IDArubicinDULoxetineFLUoxetine PARoxetineePHED rineEPINEPH rineEPINEPH rineePHED rineepiRUBicineriBULin eriBULin epiRUBicinfentaNYLSUF

10 EntanilflavoxATEfluvoxaMINEFLU oxetineDULoxetine PARoxetinefluPHENAZ inefluvoxaMINE fluvoxaMINEfluPHENAZine - flavoxATEguaiFENesinguanFACINE guanFACINE guaiFENesinHumaLOG*HumuLIN*HumuLIN*HumaL OG*hydrALAZINE**hydroCHLORO thiazide hydrOXYzine** hydroCHLORO thiazidehydrOXYzine** hydrALAZINE**HYDRO codoneoxyCODONEHYDRO morphone**morphine oxyMORphoneHYDROXY progesteronemedroxyPROGESTERone**hydrOXY zine** hydrALAZINE** hydroCHLORO thiazide IDArubicinDOXO rubicin** idaruCIZUmab idaruCIZUmab IDArubicininFLIX imabriTUXimabINVanz*AVINza*ISOtretinoint retinoinKlonoPIN*cloNIDineLaMICtal*LamIS IL*LamISIL*LaMICtal*continued on next page >* Brand Names always start with an uppercase letter.


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