Risk Issues with Common Information Sources used by UKMi

This is not a comprehensive risk guide. It is a list of observations from experienced pharmacists that has been shared to help others appreciate that no information source is “perfect”.

General Risks

(1)No single source is totally comprehensive or completely up-to-date in all respects.

(2)Think about synonyms when searching books, databases or websites since cross-referencing is not always reliable (e.g. “hypericum” vs “St John’s Wort”; “alopecia” vs “hair loss”).

(3)In US texts remember that some generic names differ from the UK. There is a UKMi Q&A that addresses this issue:

(4)You should expect most books to be at least 1-2 years out-of-date at the point of publication.

(5)A webpage retrieved from a search engine such as Google may be an old version (a ‘cache’ page). For more information see: So ‘refresh’ web pages to be sure you get the current version. (If you want to find an old version of a webpage try )

(6)Some govermental websites can hold several versions of the same document.

(7)UKMi provides guidance to help you decide on the reliability of information on the web:

Risks with Specific Sources

Source / Risk Issues
BNF / (1)The introductory paragraphs to sections often contain important information which can be missed if users consult individual monographs only.
(2)Advice on missed pills differs from that provided by the FFPRHC
(3)The prices quoted for medicines are a general guide and may not be up-to-date.
(4)Do not rely on for information about current malaria prophylaxis & travel vaccines, use other more up to date sources such as Travax or MIMS.
(5)Lists of side effects do not indicate the frequency of occurrence.
(6)The interaction search function in e-BNF can be unreliable and may not retrieve interactions which are accessible via the interaction link next to individual drug names.
(7)Indications/ uses/ unlicensed uses etc sometimes reflect the views/ practice of experts and so may not be evidence-based or the same as in the SPC.
Department of Health website / The site’s search engine does not always function well. It is often better to use Google instead. Use Advanced Search and cut & paste into the box labelled “Search within a site or domain”. Then enter your search terms.
DrugDex / (1) This is a US database. Check that information reflects UK practice and SPCs.
(2) Check currency via the “last modified” date after the references list at the end.
eMC / (1)Individual SPCs may not list certain excipients if the medicine contains extremely small (“trace”) amounts. If it is vital to avoid all exposure to a given excipient it would be wise to ring the manufacturer and check.
(2)Not all SPCs for generic products are available through the eMC, see the Q&A on this topic.
Fridge Database / If you do not find what you are looking for, search using generic name and brandname.
Handbook on Injectable Drugs (”Trissel”) / Gives information mainly on American preparations. Note that formulations may differ between the US and UK and this can affect compatibility.
IV Guide on Medusa / Some monographs have not been updated recently. In June 2009, 24% monographs were more than 3 years old.
MHRA website / (1)Do not use the search engine on the MHRA home page to search Drug Safety Update. Go to the Drug Safety Update homepage and use the “section search” on the left-hand side. However, be aware that articles are not always appropriately keyworded.
(2)For a general search of the MHRA site, use Google Advanced Search and cut and paste into the box labelled “Search within a site or domain”. Then enter your search terms.
Natural Medicines Comprehensive Database / (1)Some natural medicines have very similar or identical names but contain different ingredients. Be careful to check names carefully.
(2)This is a US database, and European brandnames are not always included.
(3)Beware using the ‘interaction checker’ in isolation as this might miss pharmacodynamic interactions as well as drug/ disease interactions
NeLM / You must register and log in to find all information on this site.
NICE website / The site’s own search engine does not always function well. It is often better to use Google. Use Advanced Search and cut and paste into the box labelled “Search within a site or domain”. Then enter your search terms.
Renal Drug Handbook / (1)Not fully referenced making it difficult to determine if dose recommendations are based upon specialist anecdotal experience/ practice or are from published sources.
(2)Be careful about relying on as a sole source.
(3)The online version is a PDF of the book – if you have access to both a paper copy and the online copy check the versions are the same.
Stockley’s Drug Interactions / (1)This is not and was never intended to be a definitive guide to every possible drug interaction so should not be used as a sole source for “screening” patients’ medications for potential interactions.
(2)The search engine can be unreliable and may not retrieve interactions described in the main text (e.g. aminophylline and theophylline not always cross-referenced).

Dr Simon Wills. Wessex Drug & Medicines Information Centre, Southampton. July 2009