Create New Custom Drug-Drug Interaction

Information entered in order to make a drug interaction request.

Fields

Sequence Number (required) The order in which the drug pair relate the two options are 1 or 2.
Request Assigned To (optional) Who the request is assigned.
Interaction Description (required) Description of the interaction. What the two pair of drugs causing the interaction.
Severity Level Code (required) The level of severity.
Monograph ID (optional) The Professional Monograph ID associated with the drug interaction pair.
Clinical Effect Code 1 (required) Clinical effect code
Clinical Effect Code 2 (optional) Clinical effect code
EDI Number (optional) The severity level from the Evaluations of Drug Interactions (EDI) system.
EDI Text (optional) The interaction text found in EDI.
DI Facts Number (optional) Severity number of interaction found in DI Facts.
DI Facts Onset (optional) The onset of the interaction as found in DI facts.
DI Facts Severity (optional) The severity level of the interaction found in DI facts.
DI Facts Documentation (optional) Documentation of the interaction found in the DI Facts.
DI Facts Text (optional) The text of the interaction from DI facts.
Micromedex Severity (optional) The severity found in Micromedex.
Micromedex Onset (optional) The onset of the interaction as found in MicoMedex.
Micromedex Substantiation (optional) Level of documentation of the interaction found in the Micromedex.
Micromedex Text (optional) If the interaction is found in Micromedex record the text. A summary is acceptable.
Medline Hits (optional) Is the interaction documented in the literature?
Medline Text (optional) Brief description of literature results.
Package Insert (optional) Is the interaction found in the package insert.
Package Insert Text (optional) Text information related to the package insert.
PBM Criteria (optional) Is the interaction documented in PBM criteria for use.
PBM Criteria Text (optional) Text information related to PBM criteria.
Aids Guidelines (optional) A dropdown list to select.
Aids Guidelines Text (optional) Text information for Aids guideline.
Interaction Source (optional) Source of the original request.
Interaction Type (optional) What type of interact Pharmacokinetic or Pharmacodynamic.
Highest Level of Evidence (optional) Highest evidence from which information was derived such as case report, clinical trial, normal volunteer or etc.
Group Discussion (optional) General comment from meeting.
Current Action Reason (optional) Reason for change