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Many regulatory and nonprofit agencies, including the FDA and the Institute for Safe Medication Practices (ISMP), recommend use of tall man lettering on drug labels. Learn why PCCA is adopting the technique for our active pharmaceutical ingredient (API) labels.
According to the CDC, more than 1.5 million people in the U.S. visit emergency departments each year due to adverse drug events; almost 500,000 of those people require hospitalization.1 Adverse events and medication errors occur due to multiple factors — from prescribing to dispensing errors; from patient nonadherence to nondisclosure of vital information. For compounding pharmacists, medication errors can occur due to look-alike, sound-alike names on drug labels.
ISMP, a 501c nonprofit organization, has long recognized how look-alike, sound-alike drug names contribute to medication errors. Since 2008, ISMP maintained a list of drug name pairs and trios with similar sounding or looking names with recommendations of bolded, tall man (uppercase) letters to distinguish the names of drugs.2 The FDA’s Name Differentiation Project adopted ISMP’s recommended use of tall man letters — or mixed case letters — to help distinguish similar looking and similar sounding drug names.3
“Our culture, Core Values and Principles all focus on patient safety and quality products,” said PCCA Vice President of Clinical Services A.J. Day, PharmD. “Adopting tall man lettering will help our members’ and customers’ pharmacy staff more easily differentiate products on the shelf.”
Take, for example, medroxyprogesterone and methylprednisolone. Although the names may look and sound similar, the two APIs are prescribed for vastly different conditions.
By adopting tall man lettering, the PCCA product labels are revised: MEDROXYPROGESTERONE ACETATE USP MIC. (YAM) becomes medroxyPROGESTERone ACETATE USP MIC. (YAM); METHYLPREDNISOLONE USP MICRONIZED changes to methylPREDNISolone USP MICRONIZED (see image below).
Although use of tall man lettering has been applied to labels within our online product catalog, we are not relabeling existing stock currently on our shelves. As existing stock is depleted and new stock is repackaged, application of labels with tall man lettering will begin. Please note that some API product labels may not convert to tall man lettering for up to 18 months, depending upon expiration dates and inventory turnover.
PCCA members with clinical services access may contact our Clinical Services team for help with tall man lettering and other compounding concerns.