DUR: Drug Interaction Update
Drug-Drug Interaction System Updated
Medi-Cal supports a Drug-Drug interaction system that sends an online alert to
a pharmacist entering a certain drug that interacts with another drug on the
recipient’s profile. Currently, alerts are sent for only the most severe
interactions. Approximately 50,000 Drug-Drug interaction alerts are sent by
Medi-Cal each month. In November 1999, the Drug-Drug interaction system was
expanded to accommodate the growing number of drugs and Drug-Drug interaction
information. Not only were the system’s storage and computational ability
changed, but the severity level ratings of all current Drug-Drug interactions
were updated.
What This Means to You
The pharmacy and individual pharmacist will see fewer Drug-Drug interaction
alerts. Some of the expected alerts for certain interactions will no longer
appear, such as the alerts that occur due to multiple drug interactions with
warfarin. While many of these alerts are still significant, they are no longer
categorized as most severe and therefore will not appear in the alert field.
Severity Level Ratings
The severity level rating of Drug-Drug interactions creates a ranking and allows
Medi-Cal to generate an alert for only the most severe of these interactions.
Even if an interaction is determined to be severe, it is not certain that a
severe reaction will occur every time the two drugs are used together. In fact,
two interacting drugs may be combined in many different patients with no
interaction occurring. However, when this interaction does occur, severe illness
or death can result. For this reason, a pharmacist cannot justify ignoring a
Drug-Drug interaction alert simply because many people have taken it without
harm. The potential for serious harm is always present.
| Note: | The purpose of the online DUR alert process is to assist pharmacists in screening Medi-Cal prescriptions. The alerts are only an adjunct to the Board of Pharmacy and federal requirements on screening of all prescriptions for therapy problems before delivery to the patient. |