Using tall man letters in drug labeling (for example, HumaLOG and HumuLIN) is gaining wider acceptance, according to a recent survey conducted by the Institute for Safe Medication Practices (ISMP). Sixty-four percent of the 451 survey respondents said this type of lettering, which draws attention to the differences in otherwise-similar drug names, has prevented them from dispensing or administering the wrong drug.
Tall man letters aren't meant to replace drug name safety testing, which is aimed at preventing drugs with similar names from coming onto the market. As part of its Name Differentiation Project, the FDA has approved tall man lettering for 33 generic drug names. Based on responses to its survey, the ISMP developed a list of 42 additional pairs of drug names that might benefit from being written with tall man letters (see chart below). Tall man letters should be used on computer-generated pharmacy labels, pharmacy computer drug selection screens, shelf labels, automated dispensing cabinet screens, computer- generated medication administration records, and preprinted order sheets.
FDA-approved generic drug names with tall man letters
acetoHEXAMIDE-acetaZOLAMIDE
buPROPion-busPIRone
chlorproMAZINE-chlorproPAMIDE
clomiPHENE-clomiPRAMINE
cycloSPORINE-cycloSERINE
DAUNOrubicin-DOXOrubicin
dimenhyDRINATE-diphenhydrAMINE
DOBUTamine-DOPamine
glipiZIDE-glyBURIDE
hydrALAZINE-hydrOXYzine
medroxyPROGESTERone
methylPREDNISolone
methylTESTOSTERone
niCARdipine-NIFEdipine
predniSONE-prenisoLONE
sulfADIAZINE-sulfiSOXAZOLE
TOLAZamide-TOLBUTamide
vinBLAStine-vinCRIStine
ISMP's suggested list of additional drug names with tall man letters
ALPRAZolam-LORazepam
amLODIPine-aMILoride
azaCITIDine-azaTHIOprine
ceFAZolin-cefTRIAXone
CeleBREX-CeleXA
chlorproMAZINE-chlordiazePOXIDE
CISplatin-CARBOplatin
clonazePAM-cloNIDine
clonazePAM-LORazepam
cloNIDine-KlonoPIN
DACTINomycin-DAPTOmycin
ePHEDrine-EPINEPHrine
fentaNYL-SUFentanil
FLUoxetine-DULoxetine
guanFACINE-guaiFENesin
HumaLOG-HumuLIN
HYDROcodone-oxyCODONE
IDArubicin-DOXOrubicin
INVanz-AVINza
LaMICtal-LamiSIL
lamiVUDine-lamoTRIgine
metroNIDAZOLE-metFORMIN
morphine-HYDROmorphone
NexIUM-NexAVAR
niMODipine-NIFEdipine
NovoLOG-NovoLIN
OXcarbazepine-carBAMazepine
oxyCODONE-OxyCONTIN
PARoxetine-FLUoxetine
PENTobarbital-PHENonbarbital
PriLOSEC-PROzac
QUEtiapine-OLANZapine
quiNINE-quiNIDine
riTUXimab-inFLIXimab
SandIMMUNE-SandoSTATIN
SEROquel-SINEquan
Solu-MEDROL-Solu-CORTEF
SUMAtriptan-sitaGLIPtin
tiZANidine-tiaGABine
traZODone-traMADol
TRENtal-TEGretol
ZyPREXA-ZyrTEC G