SFGH Pharmacy Policies Rainbow Chart
Look Alike & Sound Alike Drugs
To prevent medication errors involving drugs that may look alike or sound alike, consider the following practices:
|Medication Ordering |Distinguishing Medications By: |Medication Administration/Storage: |
|PRINT clearly |Purchase DIFFERENT BRAND |DOUBLE CHECK against order and MAR before administration |
|DO NOT ABBREVIATE drug name |Store in SEPARATE areas |HIGH ALERT meds require independent double checks |
|Write both GENERIC and BRAND names |DISTINGUISH names |Physical separation in storage (with warning on shelf, different color |
|Write INDICATION for use |TALL MAN lettering |bins) |
| |Circle/highlight/underline differences | |
|Potentially Error-Prone |Potential Errors & Consequences |Error Prevention Measures |
|Drug Pairs /Groups of Drugs | | |
|Acetazolamide (DiaMOX®) |Similarity in generic and brand names may lead to errors |Physical separation in storage |
|Chlorothiazide (DiuRIL®) |Medications have the same indication | |
|AmiloRIDE (Midamor®) |Similarity in generic names, dosage strengths, and dosing may lead to |Physical separation in storage |
|AmlodiPINE (Norvasc®) |errors | |
| |Medications have some overlapping indications | |
|Amphotericin B (Fungizone®) |Confusion may occur between conventional and liposomal formulations; |Liposomal formulation requires ID approval |
|Amphotericin B – Liposomal (AmBisome®, Amphotec®) |products are NOT INTERCHANGEABLE | |
|BuPROPion Sustained Release (Wellbutrin SR®, Zyban®) |Similarity in generic names may lead to errors |Wellbutrin XL is on formulary, Wellbutrin SR is non-formulary |
|BuPROPion Extended Release (Wellbutrin XL®) |Both BuPROPions come in 150mg tablets but can be dosed either twice |Formulary status (bupreNORphine is non-formulary; bupreNORphine/naloxone |
|BupreNORphine (Subutex®) |daily (SR) or once daily (XL). |is formulary with restrictions) |
|BusPIRone (Buspar®) |These medications have different indications | |
|CARBOplatin (Paraplatin®) |Similarity in generic names may lead to errors |Double check process with chemotherapy audit tool for order review, |
|CISplatin (Platinol®) |Doses appropriate for CARBOplatin usually exceed the maximum safe dose |compounding, and administration |
| |of CISplatin |Tall Man lettering in pumps |
|CarBAMazepine (Tegretol®) |Similarity in generic and brand names may lead to errors |Physical separation in storage |
|OXcarbazepine (Trileptal®) |Medications have some overlapping indications | |
|Potentially Error-Prone |Potential Errors & Consequences |Error Prevention Measures |
|Drug Pairs /Groups of Drugs | | |
|CarVEDilol (Coreg®) |Similarity in generic names, indication and dosage strengths may lead |Physical separation in storage, with warning on shelf, different color |
|CapTOPril (Capoten®) |to errors |bins |
|CHLORpromazine (Thorazine®) |Similar generic names may lead to errors |Look-Alike alert decal on Omnicell lid |
|ProchlorPERazine (Compazine®) |Medications have some overlapping indications |Encourage written orders with both generic and brand names |
|ProMETHazine (Phenergan®) | | |
|EScitalopram (Lexapro®) |Similarity in generic names and indications may lead to errors |Look-Alike alert decal on Omnicell lid |
|CITalopram (CELexa®) | | |
|CloNIDine (Catapres®) |Similarity in generic names may lead to errors |Look-Alike alert decal on Omnicell lid |
|CloZAPine (Clozaril®, Fazaclo ODT®) |Medications have different indications |Preprinted order form for initial clozapine orders |
|ClonazePAM (KlonoPIN®) | |Formulary status (CloZAPine ODT is restricted) |
|Divalproex (Depakote®, Depakote Sprinkle®) |Confusion may occur between the regular release and extended release |Look-Alike alert decal on Omnicell lid |
|Divalproex Extended Release (Depakote ER®) |formulations, which may result in under/over-dosing |Pop-up in Siemens Rx system |
|Valproic Acid/Sodium Valproate (Depakene®) | |Bar code verification in all MAK units |
|DOPamine (Intropin®) |Similarity in names and strengths may lead to errors |Physical separation in storage, with warning on shelf, different colored |
|DOBUTamine (Dobutrex®) | |bins |
|DOCEtaxel (TaxoTERE®) |Similarity in generic and brand names may lead to errors |Double check process with chemotherapy audit tool for order review, |
|PACLItaxel (TaxOL®) |Interchanging these two drugs may result in serious dosing errors |compounding, and administration |
| | |Physical separation in storage, with warning on shelf, different colored |
| | |bins |
|FluPHENazine (ProLIXIN®) |Similarity in generic and brand names may lead to errors |Physical separation in storage, with warning on shelf, different colored |
|FluPHENazine Decanoate (LONG acting ProLIXIN®) |Medications have different indications |bins |
|FluOXETine (ProZAC®) | | |
|GlipiZIDE (Glucotrol®) |Similarity in names, strengths, and indications may lead to errors |Look-Alike alert decal on Omnicell lid |
|GlyBURide (Micronase®, Diabeta®,Glynase®) |GlipiZIDE = shorter acting; max dose 40 mg/day GlyBURide = longer | |
| |acting; max dose 20 mg/day | |
|Haloperidol Decanoate (LONG acting -- Haldol®) Haloperidol Lactate |Confusion may occur between the long acting and immediate release |Look-Alike alert decal on Omnicell lid |
|(SHORT acting -- Haldol®) |injectable formulation which may result in under/over-dosing | |
|Haemophilus B vaccine(Pedvax HIB®, ActHIB®, Hiberix®) |Similarities in names and reference to Haemophilus B vaccine as “HIB” |Physical separation in storage, with warning on shelf, different colored |
|Hepatitis B vaccine (Recombivax HB®, Engerix-B®) |and Hepatitis B Vaccine as “Hep B” may lead to errors |bins |
|Potentially Error-Prone |Potential Errors & Consequences |Error Prevention Measures |
|Drug Pairs /Groups of Drugs | | |
|HydrALAZINE (Apresoline®) |Similarity in generic names and strengths may lead to errors |Pop-up in Siemens Rx system |
|HydrOXYzine (Vistaril®) |Medications have different indications |Physical separation in storage, with warning on shelf, different colored |
| | |bins |
|IdaruCIZUMAB (Praxbind®) |Similarity in generic names may lead to errors |Formulary status (IDArubicin is non-formulary) |
|IDArubicin (Idamycin®) |Medications have different indications |InFLIXimab restricted to Rheumatology & GI use |
|InFLIXimab (Remicade®) | |Double check process with chemotherapy audit tool for order review, |
| | |compounding, and administration |
| | |Physical separation in storage |
|Insulin Glargine (Lantus®) long-acting basal |Similarity in names, strengths and concentration ratios may lead to |Look-Alike alert decal on Omnicell lid |
|Insulin Lispro (HumaLOG®) rapid-acting |errors |Formulary status (Insulin glargine and aspart are restricted, insulin |
|Insulin Aspart (NovoLOG®) rapid-acting | |lispro is non-formulary) |
|Insulin Regular (HumuLIN R®, NovoLIN R®) | |On High Alert Medication List, requiring two independent double checks |
|Insulin 70/30 products (NovoLIN 70/30®, NovoLOG Mix 70/30®) | | |
|KadCYLA® (ado-trastuzumab emtansine) |Similarity in brand names may lead to errors |Double check process with chemotherapy audit tool for order review, |
|KyPROLIS® (carfilzomib) |Interchanging these two drugs may result in serious dosing errors |compounding, and administration |
|LamiVUDine (Epivir®) |Similarity in generic and brand names and strengths may lead to errors |Look-Alike alert decal on Omnicell lid |
|LamoTRIgine (LaMICtal®) |Consequences of errors may include Stevens-Johnson syndrome | |
|Terbinafine (LamISIL®) |(lamotrigine) | |
| |Medications have different indications | |
|MetFORMIN (Glucophage®) |Similarity in names and strengths may lead to errors. |Look-Alike alert decal on Omnicell lid |
|MetroNIDAZOLE (Flagyl®) |Medications have different indications | |
|NiCARdipine (Cardene®) |Similarity in generic names may lead to errors |NiCARdipine is restricted to use by Anesthesia, Neurology, and |
|NiMODipine (Nymalize®) |Medications have some overlapping indications |Neurosurgery |
|NIFEdipine (Procardia®) | |Physical separation in storage |
|NORepinephrine (Levophed®) |Similar generic names and indications may lead to errors |Encourage written and verbal communication with both generic and brand |
|PHENYLephrine (Neosynephrine®) | |names |
|PredniSONE |Similar generic names may lead to errors |Physical separation in storage |
|PrednisoLONE |Medications have different indications | |
|Primidone | | |
|Potentially Error-Prone |Potential Errors & Consequences |Error Prevention Measures |
|Drug Pairs /Groups of Drugs | | |
|PHENobarbital (Luminal®) |Similarity in generic names and indications may lead to errors |PENTobarbital is restricted to use in the ICU and OR |
|PENTobarbital (Nembutal®) | |Physical separation in storage |
|RifAMPin (Rifadin®) |Similarity in generic names may lead to errors |Physical separation in storage |
|RifAXImin (Xifaxin®) |Medications have different indications | |
|RisperiDONE (RisperDAL®) |Similarity in generic and brand names may lead to errors |Physical separation in storage, with warning on shelf, different colored |
|ROPINIRole (Requip®) |Medications have different indications |bins |
|SulfaSALAzine (Azulfidine®, Sulfazine®) |Similarity in names may lead to errors |Encourage writing indications with medication orders |
|SulfaDIAzine |Medications have different indications | |
|Tdap (Boostrix®, Adacel®) |Similarity in names, strengths and concentration ratios may lead to |Product information posters showing which |
|DTaP (Infanrix®) |errors. |one is for which age group |
| |Tdap = adults; DTaP = children 6 weeks to ................
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