
Educating Consumers About High-Alert Medications Dispensed From Community Pharmacies
Just a handful of drugs are considered high-alert medicines. These medicines have been proven to be safe and effective when taken properly. But they can cause injury or death if a mistake happens while taking them. This means that it is vitally important for you to know about this medicine and take it exactly as intended.
During a study on medication safety in community pharmacies, the Institute for Safe Medication Practices (ISMP) identified which medications should be included on this list of high-alert medications. For some of these medications, the Institute created safety pamphlets for consumers. By clicking on the medications listed below, you can access these pamphlets, which can help keep you safe while taking these medications.
- Warfarin (Coumadin)
- Lovenox (enoxaparin)
- Methotrexate (Rheumatrex, Trexal)
- Fentanyl patch (Duragesic)
- Hydrocodone with acetaminophen (Vicoden, Lorcet)
- Oxycodone with acetaminophen (Percocet, Roxicet)
- Humalog (insulin lispro)
- NovoLog (insulin aspart)
- Lantus (insulin glargine)
- Apidra (insulin glulisine)
- Levemir (insulin detemir)
View Hydrocodone with acetaminophen Resource
Download Teaching Sheet:
Hydrocodone with acetaminophen

The full list of high-alert medications dispensed from community pharmacies can be found below. Please be sure to talk to your pharmacist when picking up these high-alert medications. As resources become available for these medications, we will add them to our website.
Types of Medicine | Examples | Combination of products |
Antiretroviral Agents |
abacavir | Combivir |
atazanavir | Atripla | |
deaviridine | Epzicom | |
lamivudine | Kaletra | |
ritonavir | ||
zidovudine | ||
Chemotherapy, oral |
busulfan | mercaptopurine |
chlorambucil | methotrexate | |
cyclophosphamide | procarbazine | |
lomustine | temozolomide | |
melphalan | ||
Oral Medicine for diabetes | Chlorpopamide | glyburide |
flipizide | repaglinide | |
Anti-rejection medicine (used after transplants) |
azathioprine | pimecrolimus |
cyclosporine | sirolimus | |
daclizumab | tacrolimus | |
mycophenolate | ||
Insulin | NPH/Regular | glargine |
aspart | glulisine | |
detemir | lispro | |
Powerful pain relievers (narcotics |
butorphanol | methadone |
fentanyl | morphine | |
hydromorphone | opium tincture | |
meperidine | oxycodone | |
Drugs that cause birth defects when taken during pregnancy | atorvastatin | isotretinoin |
bosentan | simvastatin | |
estazolam | temazepam | |
Pediatric liquid medications that require measurement | carbamazepine | |
chloral hydrate liquid (given to children before a procedure to make them sleepy) |
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midazolam liquid (given to children before a procedure to make them sleepy) |
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heparin (including Lovenox and Fragmin) |
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Metformin | ||
methotrexate (used to treat arthritis) |
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propylthiouracil | ||
warfarin |