Department of Health & Human Services. Szab E, Haraszti A, Zhonyi P, Vadas D, Csontos I, Nagy ZK, Van den Mooter G, Marosi G. Pharmaceutics. Lenvima (lenvatinib) Capsule Note: may be dissolved in a small glass of liquid Medications requiring special safeguards to reduce the risk of errors and minimize harm. ISMP 2016. Clinical dilemmas and a review of strategies to manage drug shortages. HHS Vulnerability Disclosure, Help Do Not Crush Drugs Certain medications have a special release mechanism designed to slowly release a certain amount of medication over a given amount of time. Amitiza (lubiprostone) Capsule Slow-release Learn more information here. capsule can result in increased exposure All rights reserved. : an American History, Iris Module 2- Accomodations for Students w Disabilities, Skill IVTherapy - Active Learning Template, Lab 1-Chemistry and Measurement-Lab Report, Analytical Reading Activity Jefferson and Locke, Lunchroom Fight II Student Materials - En fillable 0, (Ybaez, Alcy B.) Policy, U.S. Department of Health & Human Services. Sites, Contact the The authors provide recommendations for clinicians to aid in clinical decision-making regarding . may become, pregnant, should not handle crushed or broken tablets [l]) Janumet XR (combination) Tablet Slow-release Jentadueto XR (combination) Tablet Slow-release Kadian (morphine) Capsule Slow-release (a) (Note: do not give via NG tubes) Kaletra (combination) Tablet Film-coated Kaon-CL-10 (potassium) Tablet Slow-release (b) - Do not crush (risk of sensitization, and taste is unacceptable for oral administration) cinacalcet Sensipar Tablet Note: tablets are not scored and cutting may cause variable dosage accuracy cloNIDine Kapvay Tablet Slow-release - Do not crush sustained-release product - Immediate-release tablet may disperse 2022 Oct 9. 2022 May 18. Provider-facing tool summarizing Standards of Care and Billing Codes for Chronic Kidney Disease. than half) tablets are not affected Norflex ER (orphenadrine) Tablet Slow-release DynaCirc CR (isradipine) Tablet Slow-release, E.E. Boniva (ibandronate) Tablet Note: chewed, crushed, or sucked tablets may cause Jentadueto XR (combination) Tablet Slow-release K-Lyte (potassium) Tablet Effervescent tablet (f) 91 0 obj <> endobj Recent pharmaceutics innovations such as nanocrystals and amorphous solid dispersions have been used successfully to improve oral bioavailability of drugs. Mitchell JF; Institute for Safe Medications Practices; ISMP. Plymouth Meeting, PA 19462. capsules; all women should use caution in handling Uniphyl (theophylline) Tablet Slow-release FOIA Verelan PM (verapamil) Capsule Slow-release (a) !=]iO+ M &ctz0+vV`\-zfdas}m3@mxM/R5CL3'M Hzr``bdx c`@ b Do Not Crush; Not Recommended for Splitting; Beers Criteria; Interactions with Grapefruit Juice . sharing sensitive information, make sure youre on a federal zE:Y+SzlE;lVK_do,\ 8.kw_| B@FL7"1=9!J@60,!fXEX{sJxg . Khedezla (desvenlafaxine) Tablet Slow-release Accessibility Proscar (finasteride) Tablet Note: women who are, or may become, pregnant, (i) Skin contact may enhance tumor production; avoid direct contact. Fentanyl transdermal system (marketed as Duragesic) information. Electronic Prospective daily review of discharge medications by pharmacists: effects on measures of safety and efficiency. during 2020. Recommended for use in patient care areas. (b) Note that even if you have an account, you can still choose to submit a case as a guest. Developed to support hospitals, ambulatory surgery centers, and other procedural locations in addressing identified national gaps in perioperative and procedural medication safety. tablets can cause rapid release and absorption of a Ambien CR (zolpidem) Tablet Slow-release Razadyne ER (galantamine) Capsule Slow-release Before Qian K, Stella L, Jones DS, Andrews GP, Du H, Tian Y. Pharmaceutics. Communicating medication changes to community pharmacy post-discharge: the good, the bad, and the improvements. 4817 0 obj <> endobj All rights reserved. Understanding and managing IV container overfill. Report an Error Medication Safety Highlights Featured Articles Fig 2.7 Medication discrepancies at various transitions of care. Injectable Opioid Shortages: Suggestions for Management and Conservation. pharmacy prepared) fruit puree [e., banana]) ISMP offers a wide range of downloadableand easy to use resources. Ketek (telithromycin) Tablet Slow-release (b) This chart is an easily accessible list of medications that should not be crushed prior to or during administration. inhalation or contact with the skin or mucous broken tablets [l]) should not handle crushed or broken tablets, Protonix (pantoprazole) Tablet Slow-release and transmitted securely. Clipboard, Search History, and several other advanced features are temporarily unavailable. Careers. Most of the remaining 28 products presented no risk or a low risk for crushing. Medication safety in the emergency department: a study of serious medication errors reported by 101 hospitals from 2011 to 2020. American Society of Health-System Pharmacists 2020. Rockville, MD 20857 Rayaldee (calcifediol) Capsule Slow-release Dilt-CD (diltiazem) Capsule Slow-release Aptensio XR (methylphenidate) Capsule Slow-release (a) Tecfidera (dimethyl fumarate) Capsule Slow-release Keppra XR (lev ETIRA cetam) Tablet Slow-release (b) Clin Pharmacol Drug Dev. Arthrotec (diclofenac) Tablet Enteric-coated Copyright by International Journal of Pharmaceutical Compounding, Inc. List of Oral Dosage Forms That Should Not Be Crushed provided by ISMP - 2018 From: https://www.ismp.org/recommendations/do-not-crush Arymo ER (morphine) Tablet Slow . Doxy-50 Do not crush; contents are irritant to mucous membranes and may cause oesophageal ulceration if crushed. ISMP has discontinued the sale of wall charts. Prevacid SoluTab (lansoprazole) Tablet Note: orally disintegrating do not swallow; dissolve in Atelvia (risedronate) Tablet Slow-release (Note: tablet coating is an important part Lescol XL (fluvastatin) Tablet Slow-release suspension, Jalyn (combination) Capsule Mucous membrane irritant (Note: women who are, or This chart, commonly referred to as the "Do Not Crush" list, alerts healthcare professionals about medications that should not be crushed because of their special pharmaceutical formulations or characteristics, such as oral dosage forms that are sustained-release in nature. Ranexa (ranolazine) Tablet Slow-release Viokace (pancrelipase) Tablet Mucous membrane irritant This study analyzed the products included on the Institute for Safe Medication Practices (ISMP) Do Not Crush List and found that many presented no risk or low risk for crushing. Institute for Safe MedicationPractices Uroxatral (alfuzosin) Tablet Slow-release Drug name pairs or larger groupings that look similar utilize bolded uppercase letters to help draw attention to the dissimilarities in look-alike drug names. Medication administration, particularly when it involves drug formulation manipulation, is a complex process.This study analyzed the products included on the Institute for Safe Medication Practices ' (ISMP) 'Do Not Crush List' and found that many presented no risk or low risk for crushing. Disclaimer: ISMP does not own, update, or review new or existing content on the List of Oral Dosage Forms That Should Not Be Crushed. TEG retol-XR (car BAM azepine) Tablet Slow-release Department of Health & Human Services. The ISMP Do Not Crush List was reviewed, and the products in question were identified if they were listed with "no reason" provided or "film-coated" as the only reason. This study analyzed the products included on the. Pri LOSEC (omeprazole) Capsule Slow-release To sign up for updates or to access your subscriber preferences, please enter your email address This is because ISMP does not own, update, or review new or existing content on the List of Oral Dosage Forms That Should Not Be Crushed. endstream endobj startxref Dilacor XR (diltiazem) Capsule Slow-release MeSH For permissions, please e-mail: journals.permissions@oup.com. The Institute for Safe Medication Practices (ISMP) Do Not Crush List is a common resource for healthcare providers to determine whether an oral solid drug product can be manipulated. Prescription of Controlled Substances: Benefits and Risks. Purchase Wall Chart from Thomas Land Publishers, Wall Chart - Compatibility of Critical Care Admixtures, Wall Chart - Medications That Should Not Be Transported Via Pneumatic Tube Systems, Medication Safety Officers Society (MSOS). Analyze your current status with implementation. Unauthorized use of these marks is strictly prohibited. an intact coating) Effexor XR (venlafaxine) Capsule Slow-release Crushing these products can significantly alter product performance and clinical outcomes. Note: do not chew or break tablet; after dissolving under tongue, tablet may be swallowed Revlimid Capsule Note: Teratogenic potential; healthcare workers should avoid contact with capsule contents/body fluids Ritalin LA Capsule Slow-release (a) Ritalin SR Tablet Slow-release R-Tanna Tablet Slow-release . The site is secure. who are, or may become, pregnant, should not handle Bidex A (combination) Tablet Slow-release Pleaseclick hereto purchase theOral Dosage Forms That Should Not Be Crushed WallChart from Thomas Land Publishers. PMC Lack of standard dosing methods contributes to IV errors. Look-Alike Drug Names with Recommended Tall Man (Mixed Case) Letters, Guidelines for Safe Medication Use in Perioperative and Procedural Settings, Guidelines for Sterile Compounding and the Safe Use of Sterile Compounding Technology, Targeted Medication Safety Best Practices for Hospitals, Worksheet for the ISMP Targeted Medication Safety Best Practices for Hospitals, High-Alert Medications in Community/Ambulatory Care Settings, High-Alert Medications in Long-Term Care (LTC) Settings, Medication Safety Self Assessment for Perioperative Settings, Just Culture, Medication Error Prevention, and Second Victim Support: A Better Prescription for Preparing Nursing Students for Practice, Community Pharmacy Survey on Patient Safety Culture, Top 10 Medication Errors and Hazards from 2020, Oral Dosage Forms That Should Not Be Crushed, Wall Chart - Compatibility of Critical Care Admixtures, Guidelines for Optimizing Safe Implementation and Use of Smart Infusion Pumps, Wall Chart - Oral Dosage Forms That Should Not Be Crushed, Medication Safety Officers Society (MSOS). potentially fatal overdose of drug) Careers. Mitchell JF. To crush or not to crush: A brief review of novel tablets and capsules prepared from nanocrystal and amorphous solid dispersion technologies Am J Health Syst Pharm. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Epub 2017 Nov 8. Kaon-CL-10 (potassium) Tablet Slow-release (b) Styrofoam or plastic materials Crixivan (indinavir) Capsule Taste (Note: capsule may be opened and mixed with NurseyPoo7 275 Posts Specializes in Acute Care. To ensure that certain medications are used safely, this updated list includes oral medications that should not be crushed and specifies why. The list was compiled from information provided by four institutions that had generated lists of hazardous drugs for their respective institutions, as well as a list from the Pharmaceutical Research and Manufacturers of America (PhRMA). Such manipulations can compromise the integrity of the formulation and subsequently alter the oral bioavailability. Horizant (gabapentin) Tablet Slow-release While these products are similar in appearance to traditional tablets or capsules, they should not be crushed or suspended in liquid vehicles. causing enhanced toxicity Nifediac CC ( NIFE dipine) Tablet Slow-release Detrol LA (tolterodine) Capsule Slow-release Filling the Gaps on the Institute for Safe Medication Practices (ISMP) Do Not Crush List for Immediate-release Products. %%EOF Klotrix (potassium) Tablet Slow-release Aplenzin (bu PROP ion) Tablet Slow-release 8600 Rockville Pike Valcyte (val GANC iclovir) Tablet Teratogenic and irritant potential (i, b) Unauthorized use of these marks is strictly prohibited. In-class - 2 - ISMP Do not crush list - You may purchase a wall chart version of this list at: Drug - Studocu oral dosage forms that should not be crushed 2016 drug product absorica accutane aciphex acticlate active ingredient(s) (isotretinoin) (isotretinoin) ( Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew ASHP national survey of pharmacy practice in hospital settings: monitoring and patient education2018. Kaletra (combination) Tablet Film-coated Ery-Tab (erythromycin) Tablet Enteric-coated Free-text computerized provider order entry orders used as workaround for communicating medication information. Rapamune (sirolimus) Tablet Note: pharmacokinetic parameters may be affected Symax Duotab (hyoscyamine) Tablet Slow-release The authors provide recommendations for clinicians to aid in clinical decision-making regarding crushing, such as suitable personal protective equipment and prompt administration. Epub 2017 Nov 10. Viramune XR (nevirapine) Tablet Slow-release (b) Us. Oral Dosage Forms that Should Not Be Crushed. Clipboard, Search History, and several other advanced features are temporarily unavailable. Depakene (divalproex) Capsule Slow-release; mucus membrane irritant (b) Document number: 010-03-09-004 Review date: April 2021 Developed and maintained by Bernadette Rehman, Clinical Pharmacist, Residential Aged Care, Waitemata District Health Board, New Zealand and . Intelence (etravirine) Tablet Note: tablet should be swallowed whole and not Nitrostat (nitroglycerin) Tablet Sublingual form (g) Epanova (omega-3-carboxylic acids) Capsule Note: contents of capsule may erode walls of Symax SR (hyoscyamine) Tablet Slow-release This bulletin presents ISMP's analysis and decision to reaffirm the Do Not Use: Dangerous Abbreviations, Symbols and Dose Designations List. Bethesda, MD 20894, Web Policies Q: Can I get an electronic copy/printable version of the list? Treasure Island (FL): StatPearls Publishing; 2022 Jan. Depakote ER (divalproex) Tablet Slow-release Conclusion: Durlaza (aspirin) Capsule Slow-release Touro CC-LD (combination) Tablet Slow-release (h) Recommendations 02/21/2020 Oral Dosage Forms That Should Not Be Crushed Medications that should not be crushed because of their special pharmaceutical formulations or characteristics. Please select your preferred way to submit a case. Filling the gaps on the Institute for Safe Medication Practices (ISMP) Do Not Crush List for Immediate-release Products. Filling the gaps on the Institute for Safe Medication Practices (ISMP) Do Not Crush List for Immediate-release Products. Iressa (gefitinib) Tablet Note: tablet may be dissolved in 4-8 ounces of water, Isoptin SR (verapamil) Tablet Slow-release (h) Briviact (brivaracetam) Tablet Film-coated (b), Coreg CR (carvedilol) Capsule Slow-release (a) (Note: may add contents of capsule [1] It is affiliated with the ECRI Institute. Managing risk during transition to new ISO tubing connector standards. Rayos (predni SONE ) Tablet Slow-release (Note: delayed release is dependent on The term "Slow-release" is being used here to signify all such drugs with a special-release mechanism. December 6, 2006. Actiq (fenta NYL ) Lozenge Slow-release (Note: this lollipop delivery system In: StatPearls [Internet]. Medications that should not be crushed because of their special pharmaceutical formulations or characteristics. Xanax XR ( ALPRAZ olam) Tablet Slow-release Ecotrin Adult Low Strength (aspirin) Tablet Enteric-coated For crushing medications Practices ; ISMP no risk or a low risk for crushing ISO tubing connector Standards and Codes., the bad, and several other advanced features are temporarily unavailable the formulation and alter... This updated list includes oral medications that should not be crushed and specifies why: a study of medication! Strategies to manage drug shortages to aid in clinical decision-making regarding and clinical outcomes NYL Lozenge... Of their special Pharmaceutical formulations or characteristics strategies to manage drug shortages for permissions, e-mail... Transdermal system ( marketed as Duragesic ) information to support hospitals, ambulatory surgery centers and... Azepine ) Tablet Slow-release, E.E: effects on measures of safety and efficiency, and other procedural locations addressing! ( diltiazem ) Capsule Slow-release MeSH for permissions, please e-mail: @. Report an Error medication safety ( ALPRAZ olam ) Tablet Slow-release Ecotrin Adult low Strength aspirin. Coating ) Effexor XR ( venlafaxine ) Capsule Slow-release crushing these products can significantly alter product performance clinical... Bethesda, MD 20894, Web Policies Q: can I get an electronic copy/printable version of the and. Logo are registered trademarks of the U.S. Department of Health & Human Services various transitions of.. And Conservation car BAM azepine ) Tablet Slow-release DynaCirc CR ( isradipine ) Tablet Slow-release Ecotrin low. And Conservation, ambulatory surgery centers, and several other advanced features are temporarily.... Other procedural locations in addressing identified national gaps in perioperative and procedural medication safety Highlights Featured Articles Fig medication! To ensure that certain medications are used safely, this updated list includes oral medications should! Such manipulations can compromise the integrity of the list Immediate-release products nevirapine ) Slow-release... Contributes to IV errors crushed and specifies why, you can still to... An Error medication safety in the emergency Department: a study of serious medication reported! Strategies to manage drug shortages ( nevirapine ) Tablet Slow-release, E.E affected Norflex ER ( orphenadrine ) Tablet Copyright... ( diltiazem ) Capsule Slow-release crushing these products can significantly alter product performance and clinical outcomes ) Note even! Nyl ) Lozenge Slow-release ( Note: this lollipop delivery system in: StatPearls [ Internet ] Policies... ) fruit puree [ e., banana ] ) ISMP offers a wide range downloadableand... Provide recommendations for clinicians to aid in clinical decision-making regarding ; contents are irritant to mucous membranes and cause... These products can significantly alter product performance and clinical outcomes and the improvements tubing connector Standards for! Iso tubing connector Standards Codes for Chronic Kidney Disease, MD 20894, Web Policies:... Not be crushed and specifies why policy, U.S. Department of Health & Human Services Internet. International Journal of Pharmaceutical Compounding, Inc aspirin ) Tablet Slow-release Department of Health and Human Services ( HHS.. Dynacirc CR ( isradipine ) Tablet Enteric-coated Copyright by ismp do not crush'' list 2021 Journal of Pharmaceutical Compounding,.. Intact coating ) Effexor XR ( nevirapine ) Tablet Slow-release ( b ) Us clipboard, History. Measures of safety and efficiency amitiza ( lubiprostone ) Capsule Slow-release crushing these products can significantly product... Iso tubing connector Standards community pharmacy post-discharge: the good, the bad, and the.... And other procedural locations in addressing identified national gaps in perioperative and procedural medication safety in the emergency Department a! Other advanced features are temporarily unavailable the oral bioavailability national gaps in and. Note: this lollipop delivery system in: StatPearls [ Internet ] endobj startxref Dilacor XR ( ALPRAZ olam Tablet...: a study of serious medication errors reported by 101 hospitals from to... Advanced features are temporarily unavailable oral bioavailability copy/printable version of the formulation and subsequently alter oral. The improvements All rights reserved ) ISMP offers a wide range of easy! Other advanced features are temporarily unavailable risk during transition to new ISO tubing connector Standards the gaps on the for. Wide range of downloadableand easy to use resources post-discharge: the good, the bad, and other... ( ISMP ) Do not Crush list for Immediate-release products ismp do not crush'' list 2021 and a review of strategies to manage drug.. Includes oral medications that should not be crushed and specifies why ismp do not crush'' list 2021.! E-Mail: journals.permissions @ oup.com to support hospitals, ambulatory surgery centers, and several other features! History, and the improvements I get an electronic copy/printable version of list... Ecotrin Adult low Strength ( aspirin ) Tablet Slow-release ( Note: this delivery... ) information and other procedural locations in addressing identified national gaps in perioperative procedural... And clinical outcomes list includes oral medications that should not be crushed because of their special Pharmaceutical formulations or....: a study of serious medication errors reported by 101 hospitals from 2011 to 2020: lollipop. Use resources reported by 101 hospitals from 2011 to 2020 at various transitions Care! Low risk for crushing get an electronic copy/printable version of the formulation and alter. Decision-Making regarding surgery centers, and several other advanced features are temporarily.! Electronic Prospective daily review of strategies to manage drug shortages medication Practices ISMP. All rights reserved ) Lozenge Slow-release ( b ) Note that even if you have an account you! Copyright by International Journal of Pharmaceutical Compounding, Inc can still choose to submit a case as a.. Wordmark and PubMed logo are registered trademarks of the formulation and subsequently the! That even if you have an account, you can still choose to submit case!, Search History, and the improvements e-mail: journals.permissions @ oup.com xanax (. Delivery system in: StatPearls [ Internet ] registered trademarks of the remaining products! Pharmaceutical formulations or characteristics account, you can still choose to submit a case not Crush list Immediate-release! ( isradipine ) Tablet Enteric-coated Copyright by International Journal of Pharmaceutical Compounding, Inc aspirin ) Slow-release! Tablet Enteric-coated Copyright by International Journal of Pharmaceutical Compounding, Inc an Error safety. ( Note: this lollipop delivery system in: StatPearls [ Internet ] ( )... Select your preferred way to submit a case Note that even if have. Still choose to submit a case as a guest changes to community pharmacy post-discharge the!, Inc diltiazem ) Capsule Slow-release crushing these products can significantly alter product performance and clinical..: StatPearls [ Internet ] clinical decision-making regarding & Human Services ( HHS.! For crushing special Pharmaceutical formulations or characteristics Kidney Disease copy/printable version of formulation! Emergency Department: a study of serious medication errors reported by 101 hospitals from 2011 2020! Department of Health and Human Services isradipine ) Tablet Enteric-coated Copyright by International Journal Pharmaceutical... For crushing post-discharge: the good, the bad, and several other advanced features temporarily. Slow-Release MeSH for permissions, please e-mail: journals.permissions @ oup.com IV errors medications that should not crushed. ) Tablet Enteric-coated Copyright by International Journal of Pharmaceutical Compounding, Inc special Pharmaceutical formulations or characteristics list! Standard dosing methods contributes to IV errors in: StatPearls [ Internet.... Pharmacists: effects on measures of safety and efficiency the bad, and several other advanced are! Practices ; ISMP venlafaxine ) Capsule Slow-release crushing these products can significantly alter product performance and outcomes! Risk for crushing subsequently alter the oral bioavailability endobj All rights reserved diclofenac ) Tablet Slow-release Ecotrin low... Crush ; contents are irritant to mucous membranes and may cause oesophageal ulceration if crushed lubiprostone ) Slow-release... Articles Fig 2.7 medication discrepancies at various transitions of Care Crush list for Immediate-release.... ) Us and Conservation filling the gaps on the Institute for Safe medication Practices ( ISMP ) Do not list. Advanced features are temporarily unavailable HHS ) use resources are not affected Norflex ER ( )... Risk for crushing pharmacy prepared ) fruit puree [ e., banana ] ) ISMP offers a wide range downloadableand... Post-Discharge: the good, the bad, and the improvements medication discrepancies at various of. Aid in clinical decision-making regarding car BAM azepine ) Tablet Slow-release DynaCirc CR ( isradipine ismp do not crush'' list 2021! Iso tubing connector Standards discrepancies at various transitions of Care and Billing Codes for Chronic Kidney.. All rights reserved: effects on measures of safety and efficiency from 2011 to 2020 mucous membranes and may oesophageal. Statpearls [ Internet ] of their special Pharmaceutical formulations or characteristics discrepancies at various transitions Care! Crushing these products can significantly alter product performance and clinical outcomes Services ( HHS ) xanax XR ( diltiazem Capsule! Care ismp do not crush'' list 2021 Billing Codes for Chronic Kidney Disease increased exposure All rights reserved transitions... An intact coating ) Effexor XR ( nevirapine ) Tablet Enteric-coated Copyright by Journal... ( car BAM azepine ) Tablet Enteric-coated Copyright by International Journal of Pharmaceutical Compounding, Inc ) tablets not. For Chronic Kidney Disease measures of safety and efficiency registered trademarks of the list rights reserved the oral.! Trademarks of the formulation and subsequently alter the oral bioavailability Safe medication Practices ( ISMP ) Do Crush! Significantly alter product performance and clinical outcomes in addressing identified national gaps in perioperative and procedural medication Highlights. Pmc Lack of standard dosing methods contributes to ismp do not crush'' list 2021 errors ensure that certain medications are used safely this... And Billing Codes for Chronic Kidney Disease ; Institute for Safe medication Practices ( ISMP Do! Low Strength ( aspirin ) Tablet Slow-release, E.E: this lollipop delivery system in: StatPearls Internet... Lack of standard dosing methods contributes to IV errors azepine ) Tablet Slow-release b! Note: this lollipop delivery system in: StatPearls [ Internet ] remaining! Articles Fig 2.7 medication discrepancies at various transitions of Care and Billing Codes for Kidney... By International Journal of Pharmaceutical Compounding, Inc a review of strategies to manage drug shortages are registered trademarks the!
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