Home Forums Discussions General Discussion Drug Interactions

I updated to 8.2.4 from 6.3.3 this weekend and noticed that the drug interactions in the rx module are super sensitive now.

So who do I believe in regards to the interactions? And is there a way to turn down the sensitivity of this feature?

Here's an example: Zithromax and Lipitor. I don't know what the interaction level reported was before but now it flags as "Severe" Interaction. So I checked ePocrates and no interaction was listed. I went back to the view the actual interaction in AC and it says there was a single case of rhabdo associated with lovastatin and zithromax (but not lipitor.) In fact it says that Lipitor had no pharmokinetic changes with Zithro. Does that really warrant a "Severe" rating? Can I disable this silly "interaction" forever for all patients?

I'm also seeing many things listed as "Contraindicated" (a big No, don't ever use this!) and in ePocrates it is listed only as a Caution/Monitor.

How are my PA/NP (and I) supposed to practice with such conflicting info? What do y'all do?

BTW, the upgrade otherwise was pretty smooth.

Thanks in advance for any advice or comments.

Dear Sean,

There is a way to change the interactions you see on the meds screen. Open the write scripts page then in the top right look for settings. Here you can edit the interactions you see. You can also right click an interaction per pt to hide the interaction.

Claire

I'm still not sure about these interactions...

Going through the fluff it looks like the drug interaction program that AC uses is Lexi-Comp.

I find the interactions listed to be nearly useless. In primary care we frequently have patients on many meds, and when that happens every one of them (almost) has "Severe" interactions listed. Prior to my update the "Severe" seemed fairly reasonable, but now it is ridiculous.

UpToDate uses Lexi-Comp, also. If you put in Lipitor and Zithromax there it returns a "C" rating which says "Monitor Therapy," hardly the severe rating issued through AC.

Here's another one: lisinopril and HCTZ yields a "Severe" interaction rating from AC. Yet the combined pill (zestoretic) is commonly used and it is not flagged by AC. The individuals plugged into UpToDate's gives a "Monitor therapy" rating. Such discrepancies.

I hate to turn off the interaction checker (that used to work well,) but right now it provides me nothing but anxiety. It reminds me of the boy who cried wolf story.