> ## Documentation Index
> Fetch the complete documentation index at: https://help.clinikehr.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Drug interaction screening

> How ClinikEHR screens a cart or a script for interactions, why only some alerts stop you, and how to clear a product that cannot be screened.

export const StillStuck = ({topic}) => <div className="ck-callout ck-callout--note" role="note">
    <p className="ck-callout__body">
      <strong>Still stuck{topic ? ` with ${topic}` : ''}?</strong>{' '}
      Check <a href="/platform/help/troubleshooting">Troubleshooting</a> first —
      it covers the failures we see most often. If that does not resolve it,{' '}
      <a href="/platform/help/contact-support">contact support</a> and include
      your workspace name and the time the problem happened, so we can find the
      matching entry in your audit log.
    </p>
  </div>;

export const Path = ({steps = []}) => <span className="ck-path">
    {steps.map((s, i) => <span key={i} className="ck-path__step">
        {i > 0 ? <span className="ck-path__sep" aria-hidden="true">
            ›
          </span> : null}
        {s}
      </span>)}
  </span>;

export const Availability = ({editions = ['all'], plans, roles, note}) => {
  const list = editions.includes('all') ? ['clinic', 'pharmacy', 'lims'] : editions;
  return <div className="ck-avail" role="note" aria-label="Feature availability">
      <span className="ck-avail__label">Available in</span>

      {list.map(e => <span key={e} className={`ck-pill ck-pill--${e}`}>
          {EDITION_LABELS[e] || e}
        </span>)}

      {plans ? <span className="ck-avail__label">Plan</span> : null}
      {plans ? <span className="ck-pill ck-pill--plan">{plans}</span> : null}

      {roles ? <span className="ck-avail__label">Who</span> : null}
      {roles ? <span className="ck-pill ck-pill--role">{roles}</span> : null}

      {note ? <span className="ck-avail__note">{note}</span> : null}
    </div>;
};

<Availability editions={['pharmacy']} plans="Professional and above" roles="Any staff member at the till or the dispensing form" />

Every cart at the till and every script on the dispensing form is checked for drug-drug interactions, drug-food interactions, allergies on file and duplicate therapy. Alerts appear in the cart column as you add lines — you do not run anything.

<Path steps={['Sidebar', 'POS']} />

<Path steps={['Sidebar', 'Pharmacy Station', 'Inventory', 'Fill Rx']} />

## Why some alerts stop you and others do not

This is the question the counter asks first, and the ranking is deliberate. Alerting on everything trains people to dismiss everything, which is worse than not screening at all. So the product is loud exactly four times and quiet the rest of the time.

| What was found  | What you see                                                 | Does it stop the sale?             |
| --------------- | ------------------------------------------------------------ | ---------------------------------- |
| Contraindicated | A red panel badged **Do not dispense**                       | Yes — one acknowledgement required |
| Major           | An orange panel badged **Major interaction**                 | Yes — one acknowledgement required |
| Moderate        | An amber badge, **Moderate interaction**, inline in the cart | No                                 |
| Minor           | Nothing at all                                               | No                                 |

A contraindicated or major finding opens the **Interaction detected** sheet — "Review before dispensing. Advisory only — it does not replace your professional judgement." It lists what was found, the mechanism and the management, and offers two ways out: **Cancel sale** (**Cancel** on the dispensing form) or **Acknowledge and dispense**.

Before you acknowledge there is a **Reason for proceeding** box, marked "(optional — recorded in the audit log)". Fill it. "e.g. prescriber contacted and confirmed" is the shape of a useful entry, and it is the only thing that explains the decision to whoever reads the record later.

The sheet interrupts **once** per cart. Acknowledging clears it for that sale; changing the cart re-screens and can raise it again.

<Warning>
  Screening is a decision aid, not a second pharmacist. The rules cover what is in the dataset and the ingredients recorded against your products — nothing else. The acknowledgement is recorded against the person who gave it, by name, with the time. Never acknowledge a finding you have not read.
</Warning>

Some findings carry an **AI counselling** note under the rule, with a **Watch for:** line. It is always secondary to the rule above it, always badged as AI-generated, and sometimes absent. Treat it as counselling copy for the customer, not as the finding.

## Products that cannot be screened

An item with no ingredients recorded is not silently passed — the cart shows a dashed panel saying how many items were **not screened**, names them, and states that interactions were **not** checked for them.

That panel is fixable where you feel it. Select **Add ingredients to screen it** to open the **Unscreened products** sheet.

<Steps>
  <Step title="Pick the product">
    The sheet lists everything in your catalogue with nothing on file. Choose the one the cart named.
  </Step>

  <Step title="Answer 'How should this be screened?'">
    Four choices, and picking the right one matters:

    * **Medication** — "Screened for interactions."
    * **Supplement** — "Screened, but interaction coverage for supplements is weaker."
    * **Consumable (not a medicine)** — "Excluded from screening by design (gloves, saline, dressings)."
    * **Contents unknown** — "Not screened — use only if the contents are genuinely unknown."
  </Step>

  <Step title="Declare the ingredients">
    For a medication or a supplement, search under **Declare ingredients** — "Search ingredients…" — and add each active ingredient.
  </Step>

  <Step title="Save">
    Select **Save and screen**. The sheet confirms the product is now screenable, and the cart re-screens with it included.
  </Step>
</Steps>

Clear these as you meet them. An unscreenable product is a silent gap: the customer's other medicines are checked, that one is not, and nothing about the sale looks unusual. When nothing is left the sheet reads **Everything is mapped**.

## The provisional dataset

Screening ships with a ruleset that starts **provisional**. Until a pharmacist at your branch has looked at it, the cart carries a small line — "Provisional dataset — pending pharmacist review." — and the alerts still fire.

Select the review link to open **Interaction rules**, which shows the rule count, the version, the source, and every drug-drug and drug-food rule with its severity, mechanism and management. A **Reviewer note** ("(optional — recorded in the audit log)") lets you record what you checked it against, and **Accept for clinical use** ends the provisional state.

Accepting applies to your branch only, and a new dataset version has to be accepted again. Once accepted the panel reads **In clinical use here** and the provisional line disappears.

If the ruleset is older than it should be, the cart says so rather than presenting stale rules as current. Trust the label.

## Without the Professional plan

Screening is gated. On Starter, the place the alerts would sit shows a quiet dashed card headed **Drug & food interaction screening** with an **Upgrade** button, and it says "Available on Professional and above". Checkout and dispensing are otherwise untouched — nothing is blocked, and nothing is screened. See [Change your plan](/platform/plans/change-plan).

A plan that lapses out of active or trialing loses the feature the same way.

## If something goes wrong

<AccordionGroup>
  <Accordion title="A sale is blocked and I disagree with the finding">
    Use **Acknowledge and dispense** and put your reasoning in **Reason for proceeding**. The decision is yours; the record of it is the point.
  </Accordion>

  <Accordion title="No alerts appear at all, on any cart">
    Check the plan first — Starter shows the upgrade card instead of alerts. If you are on Professional or above, check that the products in the cart have ingredients recorded; a cart of entirely unscreened items produces the dashed "not screened" panel, not silence.
  </Accordion>

  <Accordion title="An allergy the customer told us about was not caught">
    Allergy findings read the allergy list on the customer's record. If it was never recorded there, it cannot be matched. Add it to the record — see [Customers](/pharmacy/customers/index).
  </Accordion>

  <Accordion title="The same product keeps appearing as unscreened">
    Saving **Contents unknown** deliberately leaves it unscreened. Re-open the sheet and choose **Medication** or **Supplement**, then declare the ingredients.
  </Accordion>

  <Accordion title="Screening while the till is offline">
    Screening runs against the ruleset the device already holds, and the cart labels it as stale rather than hiding its age. See [Selling offline](/pharmacy/pos/offline).
  </Accordion>
</AccordionGroup>

<StillStuck topic="an interaction alert" />