narrow therapeutic index drug

narrow therapeutic index drug

Clinical pharmacology Any pharmaceutical which has a < 2-fold difference between the minimum toxic concentration and minimum effective concentration in blood. See Therapeutic index.
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The Narrow Therapeutic Index drug state-by-state challenge that started with Coumadin versus generic warfarin sodium continues and has expanded to include critical care drugs.
The controversy centers on whether warfarin sodium, used to treat complications associated with atrial fibrillation (a disease that affects 3 million Americans, particularly the elderly), should be designated a Narrow Therapeutic Index drug.
Narrow Therapeutic Index drugs are drugs that must be closely monitored by a physician because too much or too little medicine could produce serious adverse health conditions; this is true regardless of whether the product is brand or generic.
On a monthly basis, medication use and cost was measured and reported the number of medications and medication doses per nursing home resident per month; the number of laboratory measurements for narrow therapeutic index drugs per nursing home resident per month; and the cost of all oral medications per nursing home resident per month.
The question that must be answered is, 'Is there a scientific basis for treating narrow therapeutic index drugs differently than non-narrow therapeutic index drugs when making prescribing or dispensing decisions between bioequivalent products?
One pharmacist said substituting for narrow therapeutic index drugs often results in patients being re-evaluated by physicians, having additional lab tests run to monitor blood levels and receiving a new prescription for a different brand name drug not available in generic form.
The question of Narrow Therapeutic Index drugs and what to do about them in terms of legal substitutions is probably not an issue that pops up first on the radar screens of retail pharmacy executives.