Limitations of Common Information Sources used by UKMi

version 3.0,March 2013–Major changes since last edition in Dec 09, picked out in red

This is not a comprehensive 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 Issues

(1)No single source is totally comprehensive or completely up-to-date in all respects,use your professional judgement to decide when you need to verify facts in another resource.

(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(4)You should expect most books to be at least 1-2 years out-of-date at the point of publication.Even paper texts that are updated on a regular basis eg Martindale, Stockley and Hale, have online versions that are updated more regularly

(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 governmental 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:

(8)When using any database, including Embase and Medline, be aware that keywords were chosen by people and so the choice may not always be entirely consistent or logical.

(9)Some websites are particularly difficult to search eg MHRA and NICE. For a general search of these sites, use Google Advanced Search and cut and paste the website address eg into the box labelled “Search within a site or domain”. Then enter your search terms.

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)The prices quoted for medicines are a general guide and may not be up-to-date.
(3)Do not rely on for information about current malaria prophylaxis & travel vaccines, use other more up to date sources such as Travax, Fit for Travel, NaTHNaC, andMIMS.
(4)Listed side effects may not indicate frequency of occurrence.
(5)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.
(6)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.
(7)Whilst errors with a significant potential to cause clinical harm will be corrected immediately on MedicinesComplete, most errors will only be corrected in the next published edition. Users of the BNF will be notified of such errors and the corrective action via announcements in relevant journals. Details of the error and corrective action will also be included in the Clarifications & Corrections logs on The same process applies to the BNF for Children.
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 and paste into the box labelled “Search within a site or domain”. Then enter your search terms.
DrugDex / (1) This is a US database. Check it reflects UK practice.
(2) Check currency via the “last modified” date after the references list at the end.
(3) Whilst SPCs are held on Drugdex – users are advised that they may not be as up-to-date as those on the eMC.
(4) Be careful of American spellings – if looking down a lot of interacting drugs make sure you check the American name (e.g. pethidine/meperidine; salbutamol/albuterol etc.. See Q+A (Point 3 of general issues above) for more examples).
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)Although coverage is continually improving, not all SPCs for generic products are available through the eMC.
Fridge Database / If you do not find what you are looking for, search using generic name or brandname. Only updated every 2 years – manufacturing process may have been updated during this time.
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 / A few monographs have not been updated recently. Check with more recent sources if necessary.
Medications in Mothers’ Milk (“Hale”) 14th edition / (1)Some monographs are based on more complete literature searches than others. Be careful about relying upon as a sole source.
(2)An on-line subscription to Hale is preferable, since this is updated on an ad-hoc basis in between published editions. However, when a new paper edition is published, for a short period, this may be the most up-to-date version. There is a lag time, of around a couple of months, until the on-line version is updated and brought in-line. During this time, if a Centre has both a print and an on-line version, both copies should be checked. Alternatively, if the information cannot be clarified elsewhere, one of the specialist breast-feeding centres can be contacted to double check both versions.
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 function on the right-hand side. However, be aware that articles are not always appropriately keyworded.
(2)If searching Drug Analysis Prints online check which term the database uses for the side effect in question (e.g. dysgeusia or ageusia rather than ‘taste disturbance’).
Natural Medicines Comprehensive Database / (1)Some natural medicines have very similar or identical names but contain different ingredients. Check names carefully.
(2)This is a US database, and European brand names are not always included.
(3)Beware using the ‘interaction checker’ in isolation as this might miss pharmacodynamic interactions as well as drug/ disease interactions.
Palliative Care Formulary 4th edition / (1)Available in paper and electronic formats. A number of errors have been identified and therefore a number of reprint versions of the 4th edition are available – later reprint versions will contain fewer errors. Reprint changes to the first print run have not been widely circulated; however, subsequent errors identified will now be made available via
MI-UK Mailbase and also on their own website. In addition, new and updated monographs are being included in the electronic format. The electronic format is therefore the most up to date and is the recommended format.
(2)If the paper format is purchased, ensure you are registered on-line since the syringe driver tables remain free to access. Also ensure that you have ticked to receive emails and alerts, and you will then be notified of any further errors identified.
Renal Drug Handbook 3rd edition / (1)Despite some references to published data, some dose recommendations are based upon specialist experience/practice.
(2)As the doses given may therefore differ from the licensed doses, it is particularly important to check the SPC as well.
(3)The online version is a PDF of the latest edition of the book – if you have access to both a paper copy and the online copy check the versions are the same as some centres may have an earlier version of the same edition of the book. In addition updated monographs have not been widely circulated and may not have been included in either the online or the book version.
Schaefer – Drugs in Pregnancy and Lactation 2nd edition / (1) This has not been updated recently – it is advised that other more recently updated sources of information on drug use in pregnancy and lactation are consulted.
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).
Tic-Tac / (1)Sometimes colours are described oddly within the database so, if possible, focus on other characteristics instead/as well to aid identification where possible.
(2)Avoid using the size function to narrow down your search, as this risks excluding matching products.
(3)Products that have recently been added and for which a sample is awaited will only be found by searching the ‘any product form’.
UCL Hospitals Injectable Medicines Administration Guide – 3rd edition / (1) This edition contains a number of errors which were not notified on the publication’s website. These have been shared via the UKMi network. If any other errors are found, UKMi will circulate them via its network.
(2) The information contained in the guide mainly reflects local practice.

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