High risk medicines: Victorian Medicines Advisory Committee (VMAC) - Victorian Government Health Information, Australia

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High risk medicines

Page contents: High risk medicine alert system | Publications and links | Guidelines

High risk medicines (HRM) can be defined as a those which have a heightened risk of causing significant or catastrophic harm when used in error.

This includes:

medicines with a low therapeutic index
medicines that present a high risk when administered via the wrong route or when other systems errors occur.

The VMAC HRM working party are focusing on the development of initiatives for the following drugs and categories:

P - potassium
I - insulin
N - narcotics
C - chemotherapy
H - heparin
S - systems

High risk medicine alert system

The aim of this alert system is to:

warn healthcare professionals about serious known medication risks
outline the action required to minimise risks
provide tools to facilitate risk minimisation

Note: Audit tools are provided to assist organisations in evaluating local practice. The Department of Human Services does not require data to be submitted.

High Risk Medicine	Alert and location
Potassium	Potassium – Australian Commission on Safety and Quality in Healthcare (ACSQHC), South Australia (SA), Victoria (VIC), Western Australia (WA), UK
Insulin	Subcutaneous insulin Subcutaneous Insulin - Alert (51kb, pdf) Subcutaneous Insulin - Audit tool (338kb, word)
Narcotics	Fentanyl patches – New South Wales (NSW) National Patient Safety Agency (NPSA) alerts National Health Service (NHS) to risks with high dose morphine and diamorphine injections Oxycodone alert regarding the range, strength and variable rates of release of oxycodone products available - New South Wales (NSW)
Chemotherapy	Vincristine – ACSQHC - VIC, Improving compliance with oral methotrexate guidelines - UK Update on producing patient information on methotrexate usage – UK Methotrexate - UK
Heparin (and other anticoagulants)	Enoxaparin – Queensland (QLD) Warfarin - NSW Actions that can make anticoagulant therapy safer - UK Unfractionated Heparin – Alert (89kb, pdf) Unfractionated Heparin – Audit Tool (79kb, pdf)
Systems	Promoting safer measurement and administration of liquid medicines via oral and other enteral routes - UK Wrong route administration of oral liquid medicines Wrong Route Administration of Oral Liquid Medicines - Alert (as at July 2008) (61kb, pdf) Wrong route administration of oral liquid medicines - Audit tool (as at July 2008) (387kb, MS Word)

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Provide us with your feedback!

The high risk medicines safety information survey has been designed to capture feedback from healthcare professionals to help us tailor future safety information to meet local needs. Feedback is confidential.

Visit the the survey here

Publications and links

Vincristine can be fatal if administered by the intrathecal route. How does your organisation measure up against the vincristine alert recommendations? Download the attached file to audit your practice.

High risk medicine alert audit - vincristine (178kb, pdf)

Confusing drug names is one of the most common causes of medication error. The attached article provides details of the issues and some suggestions to minimise the risks.

Look-alike, sound-alike medication names (659kb, pdf)

Alerts and Advisories Links: