High Alert Medication Learning Guides


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.

The leaflets are FREELY available for download and can be reproduced for free distribution to consumers. Or, if you are a facility or organization, you can order professional pre-printed leaflets shipped directly to you.

Learning Guides

Select a drug from the list below:

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
(used to treat HIV)

abacavir Combivir
atazanavir Atripla
deaviridine Epzicom
lamivudine Kaletra

Chemotherapy, oral
(used to treat cancer)

busulfan mercaptopurine
chlorambucil methotrexate
cyclophosphamide  procarbazine
lomustine  temozolomide
 Oral Medicine for diabetes Chlorpopamide glyburide
 flipizide  repaglinide
Anti-rejection medicine
(used after transplants)
azathioprine pimecrolimus
 cyclosporine  sirolimus
 daclizumab  tacrolimus
Insulin NPH/Regular glargine
aspart glulisine
detemir lispro
Powerful pain relievers
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)
midazolam liquid
(given to children before a procedure to make them sleepy)
(including Lovenox and Fragmin)
(used to treat arthritis)

Medication Safety Alerts

FDA Safety Alerts

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