of the slow-release; chewed, cut, or crushed tablets A: ISMP no longer transposes the Oral Dosage Forms That Should Not Be Crushed into table form on the website. Developed to support hospitals, ambulatory surgery centers, and other procedural locations in addressing identified national gaps in perioperative and procedural medication safety. The Do Not Crush list from the Institute for Safe Medication Practices (ISMP) is referenced by thousands of health care professionals a day. A: ISMP encourages that organizations maintain, update, and periodically review a list of oral dosage forms that may require alteration through evaluation of package inserts, drug manufacturer inquiries, tertiary drug information resources, and primary literature. Drisdol (ergocalciferol) Capsule Liquid filled (d) Oxy CONTIN (oxy CODONE ) Tablet Slow-release (Note: tablet disruption may cause a The List of Oral Dosage Forms That Should Not Be Crushed , commonly referred to as the "Do Not Crush" list, contains 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. Unable to load your collection due to an error, Unable to load your delegates due to an error. official website and that any information you provide is encrypted Electronic Doxidan (bisacodyl) Tablet Enteric-coated (c) Table 1 provides a summary list of drug products based on nanocrystal or amorphous solid dispersion technologies that were approved by FDA as of December 31, 2019. Please select your preferred way to submit a case. Top 10 Medication Errors and Hazards that appeared in the ISMP Medication Safety Alert! potentially fatal overdose of oxy CODONE), Pancreaze (pancrelipase) Capsule Enteric-coated (a) : an American History (Eric Foner), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. To sign up for updates or to access your subscriber preferences, please enter your email address A white paper that serves as a call to action to nursing programs to change the way they are preparing students. Viokace (pancrelipase) Tablet Mucous membrane irritant Omtryg (omega-3-acid ethyl esters A) Capsule Note: contents of capsule may erode walls of (ISMP) Do Not Crush List and found that many presented no risk or low risk for crushing. The list is now maintained and updated by Thomas Land Publishers. Report an Error Medication Safety Highlights Featured Articles Note that even if you have an account, you can still choose to submit a case as a guest. The 2004 list was updated in 2010, 2012 and 2014. Enablex (darifenacin) Tablet Slow-release Professor Parsons, Lesson 8 Faults, Plate Boundaries, and Earthquakes, General Chemistry I - Chapter 1 and 2 Notes, Chapter 3 - Summary Give Me Liberty! Differences in medication reconciliation interventions between six hospitals: a mixed method study. Bisac-Evac (bisacodyl) Tablet Enteric-coated (c) Here is a list of non-crushable meds: http://www.ismp.org/Tools/DoNotCrush.pdf It's pretty extensive. Symax SR (hyoscyamine) Tablet Slow-release Filling the gaps on the Institute for Safe Medication Practices (ISMP) Do Not Crush List for Immediate-release Products. Please enable it to take advantage of the complete set of features! PRO zac Weekly ( FLU oxetine) Tablet Enteric-coated bioavailability of drug (b) Two summary tables along with the conditional recommendations are provided for pharmacists and other healthcare providers to aid in clinical decision making. An official website of Do Not Tube List for Pharmaceuticals (Revised September 2021) 1=Drug Alteration 2=Expense 3=Flammable 4= Product Foaming 5=Short Exp/Admin Time 6=ok to tube powder, but not the reconstituted product 7=Aerosol Containers over 2.5 ounces in volume 8=hazardous, antineoplastic 9=hazardous, non-antineoplastic, liquid and parenteral dosage forms (ok . Pancrecarb (pancrelipase) Capsule Enteric-coated (a) Query 2.5. Symax Duotab (hyoscyamine) Tablet Slow-release 1 Course Definition and Alignment Table Tania Woolfolk Capella University NURS-FPX6111 Prof Marylee Bressie February 8, This chart is an easily accessible list of medications that should not be crushed prior to or during administration. Manyare free. Such manipulations can compromise the integrity of the formulation and subsequently alter the oral bioavailability. using injection %%EOF Intelence (etravirine) Tablet Note: tablet should be swallowed whole and not However, evidence is weak or missing for a number of immediate-release products. Medication safety in the operating room: a survey of preparation methods and drug concentration consistencies in children's hospitals in the United States. The List of Oral Dosage Forms That Should Not Be Crushedwas originally compiled and updated by John Mitchell, PharmD. Cytoxan (cyclophosphamide) Tablet Note: drug may be crushed but company recommends Lenvima (lenvatinib) Capsule Note: may be dissolved in a small glass of liquid Tiazac (diltiazem) Capsule Slow-release (a) Strategy, Plain Dydyk AM, Sizemore DC, Fariba KA, Sanghavi D, Porter BR. (c) Antacids and/or milk may prematurely dissolve the coating of the tablet. Pertyze (pancrelipase) Capsule Slow-release (a) An analysis of vaccine error reports submitted to the ISMP National Vaccine Errors Reporting Program (ISMP VERP) during calendar years 2017 and 2018. Uniphyl (theophylline) Tablet Slow-release Keppra (lev ETIRA cetam) Tablet Taste (b) (Note: some extemporaneous formulas are Verapamil SR ------ Tablet Slow-release (h) government site. Filling the gaps on the Institute for Safe Medication Practices (ISMP) Do Not Crush List for Immediate-release Products. Epub 2017 Nov 10. Acticlate (doxycycline) Capsule; Tablet Film-coated (h) (Note: tablet scored in thirds rather should not handle crushed or broken tablets, Proquin XR (ciprofloxacin) Tablet Slow-release endstream endobj startxref Razadyne ER (galantamine) Capsule Slow-release Sites, Contact 91 0 obj <> endobj March 12, 2021. HHS Vulnerability Disclosure, Help ASHP guidelines on the safe use of automated dispensing devices. Collect critical information after a medication error or near-miss occurs. Altoprev (lovastatin) Tablet Slow-release Actiq (fenta NYL ) Lozenge Slow-release (Note: this lollipop delivery system 2021, Thomas Land Publishers, Inc. December 22, 2021. Viramune XR (nevirapine) Tablet Slow-release (b) Aplenzin (bu PROP ion) Tablet Slow-release Improving administration and documentation of enteral nutrition support therapy in a Veteran Affairs health care system: use of medication administration record and bar code scanning technology. [1] It is affiliated with the ECRI Institute. ASHP national survey of pharmacy practice in hospital settings: prescribing and transcribing-2019. Clinical dilemmas and a review of strategies to manage drug shortages. Disclaimer: This list is not meant to represent all products, either by generic or trade name. Ergomar (ergotamine) Tablet Sublingual form (g) during 2020. The authors provide recommendations for clinicians to aid in clinical decision-making regarding crushing, such as suitable personal protective equipment and prompt administration. 5600 Fishers Lane Purchase Wall Chart from Thomas Land Publishers, Look-Alike Drug Names with Recommended Tall Man (Mixed Case) Letters, High-Alert Medications in Community/Ambulatory Care Settings, High-Alert Medications in Long-Term Care (LTC) Settings, Medication Safety Officers Society (MSOS). Florida Controlled Substance Prescribing. inhalation or contact with the skin or mucous 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 . Medications not to be crushed solely because of poor palatability have been excluded. Strategy, Plain down at or above pH of 7) 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 . The authors provide recommendations for clinicians to aid in clinical decision-making regarding crushing, such as suitable personal protective equipment and prompt administration. zE:Y+SzlE;lVK_do,\ 8.kw_| B@FL7"1=9!J@60,!fXEX{sJxg . hbbd``b`@1$X BH$D b\ ma@`24 Resource Location: http://www.ismp.org/tools/donotcrush.pdf. capsules, especially leaking capsules, Azulfidine EN-Tabs (sulfa SALA zine) Tablet Slow-release (b) TEG retol-XR (car BAM azepine) 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. Erythromycin Stearate ------ Tablet Enteric-coated Disclaimer. Drug Product Active Ingredient(s) Dosage Form(s) Reasons/Comments Adderall XR (amphetamine salts) Capsule Slow-release (a) Adzenys XR-ODT (amphetamine) Tablet Slow-release; Sublingual form (g) Afeditab CR (NIFEdipine) Tablet Slow-release Afinitor (everolimus) Tablet . Ecotrin Maximum Strength (aspirin) Tablet Enteric-coated Its creator received a 2007 ISMP Cheers award. Levsinex Timecaps (hyoscyamine) Capsule Slow-release, Niaspan (nicotinic acid) Tablet Slow-release Ampyra (dalfampridine) Tablet Slow-release (Note: formerly fampridine-SR) Cotazym-S (pancrelipase) Capsule Enteric-coated (a) The https:// ensures that you are connecting to the ISMP offers a wide range of downloadableand easy to use resources. Over 30 drug products based on these technologies have been approved by the Food and Drug Administration, and more are in the development pipeline. Hysingla ER ( HYDRO codone) Tablet Slow-release (Note: crushing, chewing, or dissolving Fig 2.7 Medication discrepancies at various transitions of care. Please select your preferred way to submit a case. Medication administration, particularly when it involves drug formulation manipulation, is a complex process. Aggrenox (combination) Capsule Slow-release Reducing readmission at an academic medical center: results of a pharmacy-facilitated discharge counseling and medication reconciliation program. In: StatPearls [Internet]. should not handle crushed or broken tablets, Protonix (pantoprazole) Tablet Slow-release 2022 Nov 18;14(11):2508. doi: 10.3390/pharmaceutics14112508. Votrient (pazopanib) Tablet Note: crushing significantly increases the AUC and Kadian (morphine) Capsule Slow-release (a) (Note: do not give via NG tubes) This chart defines the stability and compatibility of medications that are routinely present in critical care, and intensive care settings. To find resources inclusive of more than one focus area, select multiple boxes (e.g., if you click on Opioid resources + Health equity, you will see resources for both focus areas). Afeditab CR (NIFEdipine) Tablet Slow-release 2021 Sep-Oct;25(5):364-371. 2018 Jan 15;535(1-2):379-392. doi: 10.1016/j.ijpharm.2017.10.051. Invega (paliperidone) Tablet Slow-release errors or omissions, or for any consequences that may arrise. administer Our error reporting program, education, and advocacy have helped protect millions of patients. Amitiza (lubiprostone) Capsule Slow-release Trilipix (fenofibric acid) Capsule Slow-release Xanax XR ( ALPRAZ olam) Tablet Slow-release 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. 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