Frequently Asked Questions

When does Epocrates add new drug products?

The medical information editors generally add most new drugs approved by the FDA for use in humans around the time the drug becomes commercially available. In order to avoid confusion about what is actually available for clinicians to prescribe, we do not add drugs to the database immediately upon FDA approval. After the FDA approves a product, it typically takes several weeks to months (or even in rare circumstances, years) for the manufacturer to actually release the product to the market. During this time, we remain in contact with pharmaceutical manufacturers regarding their expected launch dates for new products, and then time the addition of a new monograph around this. Because new content is pushed out to users weekly, you can expect to see a new monograph in Epocrates Rx either shortly before or after the time of launch.

What does Epocrates do when brand name drug products are removed from the market?

Often, many clinicians are unaware that a brand product has actually been off the market. This is because people continue to refer to the drug by the brand name and prescribers continue to order it that way. Pharmacists will generally just switch the order to the available generic without providing feedback to the prescriber that the brand name product is actually not available any longer, thus perpetuating the myth that the brand name product is still available.

The Epocrates Rx database differs from that of many other compendia in that it is actually product-specific. Rather than providing a single generic monograph with a listing of several synonyms for different brand name products, we build a distinct monograph for each brand name product and the generic (if available), based on product-specific information, such as available formulations, dosing, indications, manufacturer, and pricing, which often differ between specific products containing the same active ingredient.

When a brand name product is discontinued or phased out by its manufacturer, we typically make the following note in the Dosing sections of the Epocrates Rx monograph.

Brand Discontinued in US [see generic]

Periodically, some of these obsolete brand name monographs (generally those with less recognized names) are removed from Epocrates Rx to consolidate the space of the application on handheld devices and because we have found removal of obsolete information to be most consistent with our ideals of providing accurate, product-specific, up-to-date content. However, in response to user feedback, we have also left many higher-profile and higher-use brand name medication names in Epocrates Rx longer than usual and restored some others, though they are truly discontinued.

When you are on a brand name monograph for which a generic and/or other brand versions are available, you can simply click/tap on the generic name at the top of the monograph to quickly navigate to these alternatives.

From what sources does Epocrates develop its clinical drug content?

The Epocrates Rx and Epocrates Online drug database is a proprietary database developed by our editorial team of pharmacists and physicians from academic backgrounds and institutions. To provide our customers with the most accurate, comprehensive, and clinically relevant drug information, these editors review information sources ranging from product labeling (package inserts) and the FDA to standard medical and pharmacotherapy texts, specialty references, clinical guidelines and consensus documents, high-quality review articles, and primary literature. We also maintain a board of clinical practitioners whom the medical editors may consult regarding specific clinical practices or controversies. To learn more about the sources of all of our products, visit our content sources page.

What is in the Adult and Peds Dosing sections of Epocrates standard drug monographs?

The Adult and Peds Dosing sections of Epocrates Rx standard monographs include dosage forms and dosing for both FDA-approved indications and off-label uses. Off-label uses and populations are denoted by a preceding asterisk (*). Available dosage forms are listed at the tops of these sections. By convention, when the unit strength for dosage forms is mg, Epocrates does not specifically include this for conservation of space.

For products that are systemically absorbed to a clinically significant extent, dosing for patients with renal and hepatic dysfunction is also provided. Renal dosing also includes dose adjustments and supplement dose information for patients receiving hemodialysis (HD) or chronic ambulatory peritoneal dialysis (CAPD), when available.

When brand products or formulations have been discontinued by the manufacturer, this is noted. Clicking on the generic name will direct you to other products with the same active ingredient(s), when available.

What is in the Dosing section of Epocrates OTC monographs?

The Dosing section of Epocrates OTC monographs includes dosing for each formulation and all appropriate age ranges. (Uses for each of the product's ingredient and formulations available are contained in other sections.) The dosing included corresponds to the uses listed in the Uses section. Off-label populations are denoted by a preceding asterisk (*). Off-label or prescription-strength uses and dosing can often be found by navigating to the individual generic monographs via the links provided.

For products that are systemically absorbed to a clinically significant extent, dosing or considerations for patients with renal and hepatic dysfunction are also provided, with links to individual ingredient monographs, where appropriate.

What is in the Uses section of Epocrates OTC monographs?

The Uses section of Epocrates OTC monographs includes FDA-approved indications for each ingredient when used in OTC products. Off-label or prescription-strength uses and dosing can often be found by navigating to the individual generic monographs via the links provided.

What is in the Formulations section of Epocrates OTC monographs?

The Formulations section of Epocrates OTC monographs includes available formulations for the drug and the amount of each active ingredient in each formulation. For soft oral formulations (e.g., oral liquids, chewables, dissolvables, etc.), flavors and the presence or absence of inactive ingredients of note (alcohol, dye, phenylalanine, saccharin, sucralose, and sugar) are also listed.

What is in the Contraindications/Cautions section of Epocrates drug monographs?

The Contraindications/Cautions section of Epocrates Rx monographs includes diseases, conditions, and other circumstances with which the monograph's subject drug should not generally be used or should be used with caution. Epocrates does not differentiate between relative and absolute contraindications and commonly interprets such phrases as "should not be used" or "is not recommended" appearing in prescribing information as contraindication language. Contraindications are listed first followed by cautions (which always begin with the term "caution"). Otherwise, the order of items listed within the contraindications and cautions is not necessarily an indication of severity or clinical relevance. For most oral combination over-the-counter (OTC) products, the individual ingredient(s) responsible for the contraindication or caution are identified.

What is in the Drug Interactions section of Epocrates drug monographs?

The Drug Interactions section of Epocrates Rx monographs includes identified and evidence-based theoretical interactions that are both pharmacokinetic and pharmacodynamic in nature, with the exception of those based primarily on intended therapeutic effects (e.g., using multiple antihypertensive agents in combination). Epocrates medical information editors go far beyond the prescribing information when researching drug interactions, often extrapolating broad statements involving mechanisms, such as cytochrome P-450 (CYP), P-glycoprotein (P-gp), and pharmacodynamic activity, and extending them to carefully researched lists that are maintained to help us track metabolic and clinical effects, taking into account such attributes as inhibition potency, substrate exclusivity, and therapeutic index when determining clinical significance.

Drug Interactions are organized according to clinical management (action required by the clinician) and utilize such categories as "Contraindicated", "Avoid/Use Alternative", "Monitor/Modify Tx", and "Caution Advised". Each interaction lists the action necessary for clinical management, the expected or possible effects of the drug combination, and the proposed mechanism of interaction. If the interaction is with a group of drugs (e.g., "SSRIs, all"), the drugs included in that group are listed along with the interaction statement.

What is in the Adverse Reactions section of Epocrates drug monographs?

The Adverse Reactions section of Epocrates Rx monographs includes Serious Reactions and Common Reactions. Serious Reactions are included regardless of incidence and are not listed in order of frequency. We typically group these effects by organ system or severity, but may sometimes list them in other ways, such as alphabetically. The decision to include an effect as a Serious Reaction is based on its potential to cause death, result in significant morbidity or dependence/abuse, or require acute medical intervention.

Common Reactions include all effects reported in at least 2% of patients at any recommended dose and as occurring more frequently in the treatment group than the placebo group. Common Reactions also include any adverse effects referred to as "frequent", "common", or "most common" in the product labeling or primary literature. However, this may vary with some products for which such information is not available or reported differently (e.g., grouped by >1% or >5% in the product labeling). Common Reactions are generally listed in descending order of frequency (if available). Occasionally, similar or related effects are listed together for ease of use (e.g., nausea/vomiting). For most oral combination over-the-counter (OTC) products, we list the Common Reactions in alphabetical order because adverse reaction frequency data is seldom available or reliable for these agents. Also for these products, the individual ingredient(s) responsible for the adverse reaction are usually identified.

What is in the Safety/Monitoring section of Epocrates standard drug monographs?

The Safety/Monitoring section of Epocrates Rx standard monographs includes special content directly related to the safe use and safety monitoring of the drug. This section includes pregnancy risk category, lactation safety rating, and laboratory and objective safety monitoring parameters. Additional content included only when applicable are therapeutic monitoring parameters, special considerations, and look/sound-alike content (including "tallman" lettering).

What is in the Pharmacology section of Epocrates standard drug monographs?

The Pharmacology section of Epocrates Rx standard monographs contains information on the drug's metabolism, excretion, and mechanism of action. For products that are systemically absorbed to a clinically significant extent, specific cytochrome P-450 (CYP450) and other metabolic pathways and effects can be found under the Metabolism header, while the drug's terminal elimination half-life can be found under the Excretion header. The known or proposed mechanism of therapeutic action is also given in this section.

In addition, the Pharmacology section lists the Epocrates subclasses to which the drug belongs. Epocrates' class/subclass structure is a combination of both functional (therapeutic) and pharmacologic classes, a structure that we have discovered increases speed of access when browsing by class. For example, the "Gastrointestinal" class includes both functional subclasses (e.g., "Nausea/Vomiting") and pharmacologic subclasses (e.g., "H2 Blockers", "PPIs"). Additional information about the pharmacologic class can often be found in the mechanism of action statement, where appropriate.

What is in the Safety/Pharmacology section of Epocrates OTC monographs?

The Safety/Pharmacology section of Epocrates OTC monographs includes content related to use in pregnancy and lactation, as well as information about the drug's metabolism, excretion, and mechanism of action. For most oral combination OTC products, pregnancy risk categories and lactation safety ratings are listed for individual ingredients.

For products that are systemically absorbed to a clinically significant extent, specific cytochrome P-450 (CYP450) and other metabolic pathways and effects can be found under the Metabolism header, while the drug's terminal elimination half-life can be found under the Excretion header. The known or proposed mechanism of therapeutic action is also given in this section. (Most oral combination OTC products refer to the individual standard ingredient monographs for this information, which can be accessed by clicking on their respective links.)

In addition, the Safety/Pharmacology section lists the Epocrates subclasses to which the drug belongs. Epocrates' class/subclass structure is a combination of both functional (therapeutic) and pharmacologic classes, a structure that we have discovered increases speed of access when browsing by class. For example, the "Gastrointestinal" class includes both functional subclasses (e.g., "Nausea/Vomiting") and pharmacologic subclasses (e.g., "H2 Blockers", "PPIs"). Additional information about the pharmacologic class can often be found in the mechanism of action statement, where appropriate.

What is in the Manufacturer/Pricing section of Epocrates drug monographs?

The Manufacturer/Pricing section of Epocrates Rx monographs includes content about the manufacturer of the drug or identifies it as a generic product, identifies the legal status of the product (e.g., OTC, Rx, or controlled substance), and gives retail pricing. Epocrates considers the manufacturer to be the company a health care professional would contact for information about the drug, even if another company physically manufactures or distributes the drug.

Epocrates' pricing partner, Good Rx, provides retail prices for the most frequently dispensed quantities of each medication. At this time, we are unable to provide pricing information for products that are not sold via Good Rx's prescription pharmacy division because this information is not included in the Good Rx data we receive.

What is in the Alternatives section of Epocrates OTC monographs?

The Alternatives section of Epocrates OTC monographs includes various links to similar products to allow for easy and fast alternative product selection. First, other OTC products with the same active ingredients, but which may be available in other formulations that are more appropriate for a given patient, are listed, if available. Below that are links to search for other products (Rx and OTC) in the same subclass and in related subclasses. The related subclass links often allow you to quickly exclude an ingredient that is inappropriate, unsafe, or otherwise undesired for a given patient, or to add another ingredient that he or she needs.

From where is Epocrates' Black Box Warnings content derived?

The Black Box Warnings section of Epocrates Rx monographs includes content adapted from boxed warnings appearing in the US prescribing information. Epocrates may add content to this section before it is published in the US prescribing information, if the FDA has released proposed language for a new boxed warning that will be required.

Does Epocrates list generic equivalency (AB) ratings for drug products?

Due to the number of therapeutically equivalent generic products available for each drug that no longer holds patent exclusivity, and the constant approval and removal from the market of these drugs from multiple manufacturers, we are unable to provide FDA equivalency ratings for all products.

When looking up a drug by its generic name, you will be directed to a screen with both the generic and brand names, providing the product is available in both forms in the US and both forms are in the Epocrates drug database. If the product is not available generically in the US or is not yet in Epocrates, selecting the generic name takes you directly to the brand name monograph or a listing of multiple brand names, if more than one is available.

Does Epocrates have intravenous (IV) administration information?

At present, Epocrates does not include intravenous (IV) administration information. As time and resources allow, we are continuing to explore this matter further.

In the meantime, we encourage you to use the “Notes” section of a drug monograph to record IV administration information for the drugs you administer frequently. We developed the Notes functionality so that individual users could customize Epocrates Rx for their own needs and practice settings.

How can pharmaceutical manufacturers make clinical requests?

Our medical information editors take all content addition, update, and correction requests very seriously, and carefully investigate all concerns regarding such. Due consideration is given to each individual request. We always appreciate diligent, clinically focused scrutiny, as we are constantly working to update our applications and content.

Our users rely on Epocrates Rx to provide them the most relevant, unbiased information on the drugs they prescribe, presented in the most concise manner possible. Our processes for researching and developing our drug information content were established to meet the demands of the more than 1,000,000 healthcare professionals constituting our large user base, who consistently rate accuracy, clinical relevance, utility, and conciseness amongst the most valuable aspects of our references. In this context, it is neither our goal to include every product available, nor to exactly reproduce product labeling; our drug monographs do not contain all information provided in the prescribing information and often provide information beyond that contained in the prescribing information.

In order to expedite content addition, update, and correction requests from pharmaceutical manufacturers, the Epocrates clinical team requests all such inquiries:

  1. Are sent directly to clinical@epocrates.com ,
  2. Are addressed directly from a clinical representative within the pharmaceutical manufacturer’s medical information department or equivalent business unit, and
  3. At a minimum contain specific information, as indicated below.

New Monograph Requests

  • name of product
  • date of FDA approval
  • date of product launch to the market
  • name and contact information of clinical representative
  • current FDA-approved product labeling (prescribing information)
  • supportive scientific literature, as desired

Product Labeling Updates

  • name of product
  • name and contact information of clinical representative
  • description of all changes made from previous product labeling
  • current FDA-approved product labeling (prescribing information)
  • supportive scientific literature, as desired

Content Correction Requests

  • name of product
  • name and contact information of clinical representative
  • description of specific changes requested and clinical rationale for each
  • current FDA-approved product labeling (prescribing information)
  • supportive scientific literature

After submitting correspondence, inquirers can expect to receive an automated e-mail confirming receipt of the submission. (Absence of this may indicate a lost transmission.) Our medical information editors address each request personally and strive to provide a personal written response to all requests within ten business days.