Narrow Therapeutic Index Drugs
- Narrow Therapeutic Index Drugs
- Accession Number
Narrow therapeutic index (NTI) drugs are defined as those drugs where small differences in dose or blood concentration may lead to dose and blood concentration dependent, serious therapeutic failures or adverse drug reactions. Serious events are those which are persistent, irreversible, slowly reversible, or life-threatening, possibly resulting in hospitalization, disability, or even death.
Drug Drug Description Warfarin A vitamin K antagonist used to treat venous thromboembolism, pulmonary embolism, thromboembolism with atrial fibrillation, thromboembolism with cardiac valve replacement, and thromboembolic events post myocardial infarction. Levothyroxine A synthetic T4 hormone used to treat hypothyroidism that can be used along with surgery and radioiodine therapy to manage thyrotropin-dependent well-differentiated thyroid cancer. Digoxin A cardiac glycoside used in the treatment of mild to moderate heart failure and for ventricular response rate control in chronic atrial fibrillation. Digitoxin A cardiac glycoside used in the treatment and management of congestive cardiac insufficiency, arrhythmias and heart failure. Lithium carbonate A medication used to treat manic episodes of bipolar disorder. Fosphenytoin An antiepileptic agent used for the management of generalized convulsive status epilepticus and prevention and treatment of seizures occurring during neurosurgery. Phenytoin An anticonvulsant drug used in the prophylaxis and control of various types of seizures. Theophylline A xanthine used to manage the symptoms of asthma, COPD, and other lung conditions caused by reversible airflow obstruction. Cyclosporine A steroid-sparing immunosuppressant used in organ and bone marrow transplants as well as inflammatory conditions such as ulcerative colitis, rheumatoid arthritis, and atopic dermatitis. Procainamide A medication used to treat life threatening ventricular arrhythmias. Tacrolimus A calcineurin inhibitor used to prevent organ transplant rejection and to treat moderate to severe atopic dermatitis. Sirolimus An immunosuppressant used to prevent organ transplant rejections and to treat lymphangioleiomyomatosis. Temsirolimus A antineoplastic agent used in the treatment of renal cell carcinoma (RCC) that works by inhibiting mTOR. Thiopental A barbiturate used to induce general anesthesia, treat convulsions, and reduce intracranial pressure. Pimozide An antipsychotic used to manage debilitating motor and phonic tics in patients with Tourette's Disorder. Quinidine A medication used to restore normal sinus rhythm, treat atrial fibrillation and flutter, and treat ventricular arrhythmias. Heparin An anticoagulant indicated for thromboprophylaxis and to treat thrombosis associated with a variety of conditions such as pulmonary embolism and atrial fibrillation. Vancomycin A glycopeptide antibiotic used to treat severe but susceptible bacterial infections such as MRSA (methicillin-resistant Staphylococcus aureus) infections. Clindamycin A lincosamide antibiotic used to treat serious infections caused by susceptible anaerobic, streptococcal, staphylococcal, and pneumococcal bacteria. Aminophylline A bronchodilator consisting of theophylline that is used for the treatment of bronchospasm due to asthma, emphysema and chronic bronchitis. Gentamicin An aminoglycoside used to treat a wide variety of infections in the body. Amikacin An aminoglycoside used to treat infections caused by more resistant strains of Gram negative bacteria and some Gram positive bacteria. Amphotericin B An antifungal used to treat fungal infections in neutropenic patients, cryptococcal meningitis in HIV infection, fungal infections, and leishmaniasis. Valproic acid An anticonvulsant used to control complex partial seizures and both simple and complex absence seizures. Phenobarbital A long-lasting barbiturate and anticonvulsant used in the treatment of all types of seizures, except for absent seizures. Rifampicin An antibiotic used to treat several types of mycobacterial infections including Mycobacterium avium complex, leprosy, and in combination with other antibacterials to treat latent or active tuberculosis. Flecainide A class Ic antiarrhythmic agent used to manage atrial fibrillation and paroxysmal supraventricular tachycardias (PSVT). Isotretinoin A retinoid used to treat severe recalcitrant acne. Dofetilide A class III antiarrhythmic drug used for the maintenance of normal sinus rhythm and cardioversion in cases of atrial fibrillation and atrial flutter. Amiodarone A class III antiarrhythmic indicated for the treatment of recurrent hemodynamically unstable ventricular tachycardia and recurrent ventricular fibrillation. Sotalol A methane sulfonanilide beta adrenergic antagonist used to treat life-threatening ventricular arrhythmias and to maintain sinus rhythm in atrial fibrillation or flutter. Argatroban A synthetic direct thrombin inhibitor used for the prevention and treatment of thrombosis related to heparin use. Everolimus A mammalian target of rapamycin (mTOR) kinase inhibitor used to treat various types of malignancies. Mycophenolic acid An immunosuppressant used to prevent organ transplant rejections. Butriptyline Butriptyline is a tricyclic antidepressant which has been used in Europe since 1974. It is the isobutyl side chain homologue of amitriptyline. Amitriptylinoxide Amitriptylinoxide has been used in trials studying Major Depression. Amineptine For the treatment of depression. Dosulepin Indicated in the treatment of symptoms of depressive illness, especially where an anti-anxiety effect is required. Tianeptine Used primarily in the treatment of major depressive disorder and anxiety . It is currently being studied for fibromyalgia pain treatment . Dibenzepin Dibenzepin is approved for use in Europe. Iprindole Not Annotated Oxaprotiline Investigated for the treatment of depression. Quinupramine Quinupramine has been approved in France under the brand name Kinupril, as an antidepressant . Imipramine oxide Not Annotated Tobramycin An aminoglycoside antibiotic used to treat cystic fibrosis, lung infections, eye infections, and a variety of other infections. Neomycin An aminoglycoside antibiotic agent used orally and topically to treat a wide variety of infections in the body. Streptomycin An aminoglycoside antibiotic indicated to treat mycobacterium tuberculosis and various non-tuberculosis infections. Framycetin An aminoglycoside antibiotic used in various formulations and combinations with other agents to treat hemorrhoids, eye and ear infections, and to reduce nasal carriage of staphylococcus. Netilmicin An aminoglycoside used to treat a wide variety of infections in the body. Kanamycin An aminoglycoside antibiotic agent used in the treatment of various infections caused by susceptible bacteria. Paromomycin An aminoglycoside antibiotic used in the treatment of acute and chronic intestinal amebiasis, and as an adjunct for the management of hepatic coma. Ribostamycin A broad spectrum aminoglycoside antibiotic on the list of WHO critical antimicrobials for human medicine. Geneticin Geneticin (also known as G418) is an aminoglycoside antibiotic similar in structure to gentamicin B1, produced by Micromonospora rhodorangea. Geneticin blocks polypeptide synthesis by inhibiting the elongation step in both... Apramycin For the treatment of bacterial infections in animals. Gentamicin C1a Not Available Neamine Not Available Arbekacin Arbekacin is used for the short term treatment of multi-resistant bacterial infections, such as methicillin-resistant Staphylococcus aureus (MRSA). Puromycin Puromycin is an antibiotic that prevents bacterial protein translation. It is utilized as a selective agent in laboratory cell cultures. Puromycin is toxic to both prokaryotic and eukaryotic cells, resulting... Dihydrostreptomycin Dihydrostreptomycin is an antibiotic. Hygromycin B Hygromycin B is an aminoglycoside antibiotic produced by the bacterium Streptomyces hygroscopicus which kills bacteria, fungi and higher eukaryotic cells by inhibiting protein synthesis. Sisomicin Sisomicin has been used in trials studying the treatment of Pyoderma. Plazomicin An aminoglycoside antibiotic used to treat complicated urinary tract infections. Dibekacin Dibekacin is an aminoglycoside antibiotic marketed in Japan . Micronomicin Micronomicin is an aminoglycoside antibiotic which is marketed in Japan, and sold under the brand names Sagamicin and Luxomicina. Isepamicin Not Annotated Bekanamycin Not Annotated Acenocoumarol An anticoagulant drug used in the prevention of thromboembolic diseases in infarction and transient ischemic attacks, as well as management of deep vein thrombosis and myocardial infarction. Dicoumarol For decreasing blood clotting. Often used along with heparin for treatment of deep vein thrombosis. Phenprocoumon Used for the prevention and treatment of thromboembolic disease including venous thrombosis, thromboembolism, and pulmonary embolism as well as for the prevention of ischemic stroke in patients with atrial fibrillation... 4-hydroxycoumarin Not Available Hymecromone Not Available Coumaphos This drug is a fat-soluble phosphorothioate agent that kills both insects and mites. It is non-volatile in nature and is well known by a variety of names as such a... Phenindione For the treatment of pulmonary embolism, cardiomyopathy, atrial fibrillation and flutter, cerebral embolism, mural thrombosis, and thrombophili. Also used for anticoagulant prophylaxis. Fluindione Fluindione is under investigation for the treatment of Venous Thrombosis, Pulmonary Embolism, Permanent Atrial Fibrillation, and Anticoagulating Treatment on a Duration at Least 12-month-old Superior. Fluindione has been investigated for... Clorindione Clorindione is a vitamin K antagonist, which may be useful to decrease prothrombin levels in humans. Busulfan An alkylating agent used to treat chronic myelogenous leukemia. Paclitaxel A taxoid chemotherapeutic agent used as first-line and subsequent therapy for the treatment of advanced carcinoma of the ovary, and other various cancers including breast and lung cancer. Capreomycin An aminoglycoside antibiotic used as an adjunct drug in tuberculosis. Methotrexate An antineoplastic agent used the treatment of a wide variety of cancers as well as severe psoriasis, severe rheumatoid arthritis, and juvenile rheumatoid arthritis. Zanubrutinib A kinase inhibitor used to treat mantle cell lymphoma, a type of B-cell non-Hodgkin lymphoma, in adults who previously received therapy. Vorinostat A histone deacetylase (HDAC) inhibitor used for the treatment of cutaneous manifestations in patients with progressive, persistent, or recurrent cutaneous T- cell lymphoma (CTCL) following prior systemic therapies. Vinorelbine A vinca alkaloid used in the treatment of metastatic non-small cell lung carcinoma (NSLC) and in conjunction with other drugs in locally advanced NSCLC. Vinflunine A vinca alkaloid used to treat advanced or metastatic transitional cell carcinoma of the urothelial tract after a platinum containing treatment has failed. Vincristine A vinca alkaloid used to treat acute leukemia, malignant lymphoma, Hodgkin's disease, acute erythraemia, and acute panmyelosis. Aldesleukin A recombinant analog of interleukin-2 used to induce an adaptive immune response in the treatment of renal cell carcinoma. Vinblastine A vinca alkaloid used to treat breast cancer, testicular cancer, neuroblastoma, Hodgkin's and non-Hodgkins lymphoma, mycosis fungoides, histiocytosis, and Kaposi's sarcoma. Venetoclax A BCL-2 inhibitor used to treat chronic lymphocytic leukemia, small lymphocytic lymphoma, or acute myeloid leukemia. Alemtuzumab A monoclonal anti-CD52 antibody used in the treatment of B-cell chronic lymphocytic leukemia and relapsing forms of multiple sclerosis. Vemurafenib A kinase inhibitor used to treat patients with Erdheim-Chester Disease who have the BRAF V600 mutation, and melanoma in patients who have the BRAF V600E mutation. Vandetanib An antineoplastic kinase inhibitor used to treat symptomatic or progressive medullary thyroid cancer in patients with unresectable locally advanced or metastatic disease. Uracil mustard Used for its antineoplastic properties. Altretamine An antineoplastic agent used in palliative treatment of persistent or recurrent ovarian cancer. Decitabine A chemotherapeutic agent used for the treatment of myelodysplastic syndromes (MDS), chronic myelomonocytic leukemia, and conditions related to refractory anemia. Trimetrexate A folate antagonist used for the treatment of moderate-to-severe Pneumocystis carinii pneumonia (PCP) in immunocompromised patients as an alternative therapy in combination with leucovorin. Trilostane Used in the treatment of Cushing's syndrome. It is normally used in short-term treatment until permanent therapy is possible. Amsacrine A cytotoxic agent used to induce remission in acute adult leukemia that is not adequately responsive to other agents. Denileukin diftitox A recombinant cytotoxic protein based on a combination of diphtheria toxin fragments and interleukin-2 used to treat cutaneous T-cell lymphoma by targeting the interleukin-2 receptor. Trastuzumab emtansine An antineoplastic agent and antibody-drug conjugate used to treat HER2-overexpressing breast cancer. Trastuzumab A monoclonal anti-human epidermal growth factor receptor 2 protein antibody used to treat HER2-positive breast, gastroesophageal, and gastric cancers. Fluorouracil A pyrimidine analog used to treat basal cell carcinomas, and as an injection in palliative cancer treatment. Dinutuximab An immunotherapeutic agent used in combination with other immunomodulating agents to treat high-risk neuroblastoma in pediatric patients who achieve at least a partial response to prior first-line multiagent, multimodality therapy. Gemcitabine A nucleoside metabolic inhibitor used as adjunct therapy in the treatment of certain types of ovarian cancer, non-small cell lung carcinoma, metastatic breast cancer, and as a single agent for pancreatic cancer. Gemtuzumab ozogamicin A monoclonal anti-CD33 antibody used to treat CD33-positive acute myeloid leukemia. Trabectedin An alkylating agent approved for the treatment of unresectable or metastatic soft tissue sarcoma (liposarcoma or leiomyosarcoma). Asparaginase Erwinia chrysanthemi An asparagine specific enzyme used as part of a chemotherapeutic regimen to treat patients with acute lymphoblastic leukemia. Durvalumab An antineoplastic monoclonal antibody used to treat urothelial carcinoma and locally advanced, unresectable non-small cell lung cancer. Asparaginase Escherichia coli An asparaginase enzyme from E. coli used as part of treatment regimens for acute lymphoblastic leukemias. Topotecan An antineoplastic agent used to treat ovarian cancer, small cell lung cancer, or cervical cancer. Hydroxyurea An antimetabolite used to treat sickle cell anemia crisis. Axicabtagene ciloleucel A CAR T cell therapy for relapsed or refractory large B-cell lymphoma, diffuse large B-cell lymphoma, primary mediastinal large B-cell lymphoma, high grade B-cell lymphoma, and diffuse large B-cell lymphoma from follicular lymphoma. Thiotepa An alkylating agent used to prevent graft rejection in stem cell transplantation and to treat a variety of malignancies including certain types of adenocarcinoma and superficial bladder carcinomas. Eribulin A microtubule inhibitor used to treat metastatic breast cancer and metastatic or unresectable liposarcoma. Ibrutinib An antineoplastic agent used to treat chronic lymphocytic leukemia, mantle cell lymphoma, and Waldenstrom's Macroglobulinemia. Teniposide A cytotoxic drug used as an adjunct for chemotherapy induction in the treatment of refractory childhood acute lymphoblastic leukemia. Bendamustine An antineoplastic agent used for the treatment of chronic lymphocytic leukemia (CLL) and indolent B-cell non-Hodgkin lymphoma (NHL) that has progressed following rituximab therapy. Ixabepilone A microtubule inhibitor administered in combination with capecitabine or alone in the treatment of metastatic or locally advanced breast cancer that has shown inadequate response to taxanes and anthracyclines. Bicalutamide An androgen receptor inhibitor used to treat Stage D2 metastatic carcinoma of the prostate. Temozolomide An alkylating agent used to treat glioblastoma multiforme and refractory anaplastic astrocytoma. Fludarabine A purine analog antimetabolite that inhibits DNA synthesis. Temoporfin A photosensitizer used to treat squamous cell carcinomas of the head and neck. Bleomycin A chemotherapy agent used to treat various malignancies, including head and neck malignancy, lymphoma, and testicular tumors, among others. Tegafur An antineoplastic agent used in combination with other anticancer medications to treat advanced gastric and colorectal cancers. Blinatumomab An antineoplastic antibody used to treat Philadelphia chromosome-negative relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL). Interferon alfa-2b A form of recombinant human interferon used to treat hepatitis B and C infection, genital warts, hairy cell leukemia, follicular lymphoma, malignant melanoma, and AIDs-related Kaposi's sarcoma. Miltefosine An antileishmanial agent used to treat leishmaniasis, a group of disease caused by parasites of the Leishmania type. Melphalan An alkylating antineoplastic agent used to treat multiple myeloma and ovarian carcinoma. Mercaptopurine An antineoplastic agent used to treat acute lymphocytic leukemia. Mitomycin An antimetabolite used as an adjunct to ab externo (outside approach) eye surgeries for the treatment of glaucoma and used as a chemotherapeutic agent for various malignancies. Mitotane An adrenal cortex inhibitor used to treat adrenocortical tumors and Cushing's syndrome. Omacetaxine mepesuccinate A cephalotaxine used in the treatment of Chronic Myeloid Leukemia (CML) that is intolerant to or resistant to two or more tyrosine kinase inhibitors. Osimertinib A tyrosine kinase inhibitor used in the treatment of certain types of non-small cell lung carcinoma. Tamoxifen A selective estrogen receptor modulator used to treat estrogen receptor positive breast cancer, reduce the risk of invasive breast cancer following surgery, or reduce the risk of breast cancer in high risk women. Oxaliplatin A platinum based chemotherapy agent used to treat carcinoma of the colon or rectum or stage III colon cancer. Moxetumomab Pasudotox A CD22-specific antibody conjugated to a truncated exotoxin used to treat relapsed or refractory hairy cell leukemia in patients who have already been treated with a purine nucleoside analog and one other treatment. Talazoparib A poly-ADP ribose polymerase inhibitor used to treat HER2-, BRCA mutated locally advanced or metastatic breast cancer. Lomustine An alkylating agent used as a part of chemotherapeutic regimens for the treatment of primary and metastatic brain tumors as well as refractory or relapsed Hodgkin's disease in addition to surgical and/or radiotherapeutic treatments. Nelarabine A purine nucleoside analog and antineoplastic agent used for the treatment of with acute T-cell lymphoblastic leukemia and T-cell lymphoblastic lymphoma with inadequate clinical response to prior chemotherapeutic treatments. Tagraxofusp A CD123-directed cytotoxin used to treat plasmacytoid dendritic cell neoplasm. Sunitinib A receptor tyrosine kinase inhibitor and chemotherapeutic agent used for the treatment of renal cell carcinoma (RCC) and imatinib-resistant gastrointestinal stromal tumor (GIST). Palbociclib An endocrine-based chemotherapeutic agent used in combination with other antineoplastic agents to treat HER2-negative and HR-positive advanced or metastatic breast cancer. Streptozocin A nitrosourea antineoplastic agent used in the treatment of metastatic pancreatic islet cell carcinoma. Peginterferon alfa-2a A modified form of recombinant human interferon used to stimulate the innate antiviral response in the treatment of hepatitis B and C viruses. Pemetrexed A folate analog used to treat mesothelioma and non-small cell lung cancer. Pentostatin An adenosine deaminase inhibitor used to treat hairy cell leukemia. Pexidartinib An antitumor agent that is used for the treatment of rare disease tenosynovial giant cell tumors (TGCT) by inhibiting colony-stimulating factor 1 and its receptor. Sorafenib A kinase inhibitor used in the treatment of unresectable liver carcinoma and advanced renal carcinoma. Carboplatin A alkylating agent used to treat advanced ovarian cancer. Sonidegib An antineoplastic agent used for the treatment of locally advanced recurrent basal cell carcinoma (BCC) following surgery and radiation therapy, or in cases where surgery or radiation therapy are not appropriate. Pixantrone An antineoplastic agent use to treat patients with relapsed or refractory aggressive Non-Hodgkin B-cell Lymphomas (NHL). Carmustine An alkylating agent used in the treatment of various malignancies, including brain tumours and multiple myeloma, among others. Niraparib A poly-ADP ribose polymerase inhibitor used to treat recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer responding to platinum based chemotherapy. Mechlorethamine An antineoplastic agent used to treat Hodgkin's disease, lymphosarcoma, and chronic myelocytic or lymphocytic leukemia. Ponatinib A kinase inhibitor used to treat patients with various types of chronic myeloid leukemia (CML). Cemiplimab A programmed death receptor-1 blocking antibody used to treat metastatic cutaneous squamous cell carcinoma. Ruxolitinib A kinase inhibitor used to treat various types of myelofibrosis, polycythemia vera in patients who have not responded to or cannot tolerate hydroxyurea, and to treat graft-versus-host disease in cases that are refractory to steroid treatment. Pralatrexate An antineoplastic agent used for the treatment of relapsed or refractory peripheral T-cell lymphoma. Trametinib A kinase inhibitor used to treat patients with specific types of melanoma, non-small cell lung cancer, and thyroid cancer. Rituximab A monoclonal anti-CD20 antibody used to treat non-Hodgkin's lymphoma, chronic lymphocytic leukemia, Wegener's granulomatosis, pemphigus vulgaris, and rheumatoid arthritis. Ceritinib An antineoplastic kinase inhibitor used to treat anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer (NSCLC) in patients with inadequate clinical response or intolerance to crizotinib. Cetuximab An endothelial growth factor receptor binding fragment used to treat colorectal cancer as well as squamous cell carcinoma of the head and neck. Procarbazine An antineoplastic agent indicated for the treatment of stage III and stage IV Hodgkin's disease in combination with other chemotherapeutic agents. Chlorambucil A chemotherapy agent used in the management of chronic lymphocytic leukemia and malignant lymphomas. Vindesine A vinca alkaloid derived from vinblastine used for various types of malignancies, but mainly acute lymphocytic leukemia (ALL). Cisplatin A platinum based chemotherapy agent used to treat various sarcomas, carcinomas, lymphomas, and germ cell tumors. Cladribine A purine antimetabolite used for the management of relapsing forms of Multiple Sclerosis (MS), used in patients who have not responded to or who were unable to tolerate alternative MS drugs. Romidepsin A histone deacetylase (HDAC) inhibitor used to treat cutaneous and peripheral T-cell lymphoma. Ipilimumab A human cytotoxic T-lymphocyte antigen 4 (CTLA-4) blocking antibody used to treat metastatic or unresectable melanoma. Daratumumab A CD38-directed cytolytic antibody used alone or as an adjunct drug in the treatment of multiple myeloma. Elotuzumab An antineoplastic agent and SLAMF7-directed immunostimulatory antibody used for the treatment of refractory multiple myeloma in combination with other antineoplastic agents. Mogamulizumab A monoclonal antibody used to treat relapsed or refractory mycosis fungoides or Sézary syndrome after attempting one other therapy. Necitumumab A monoclonal antibody used to treat metastatic squamous non-small cell lung cancer. Cyclophosphamide A nitrogen mustard used to treat lymphomas, myelomas, leukemia, mycosis fungoides, neuroblastoma, ovarian adenocarcinoma, retinoblastoma, and breast carcinoma. Raltitrexed A folate analog thymidylate synthase inhibitor used in the treatment of advanced colorectal cancer. Ramucirumab An antineoplastic agent and direct VEGFR2 (vascular endothelial growth factor receptor 2) antagonist that blocks the binding of natural VEGF ligands, which are secreted by solid tumors to promote angiogenesis and enhance tumor blood supply. Sodium phosphate P 32 Not Annotated Ziconotide An N-type calcium channel antagonist used to manage patients with severe chronic pain who cannot tolerate, or who have not responded adequately to other treatments such as intrathecal morphine and systemic analgesics. Chloramphenicol succinate A broad-spectrum antibiotic agent used for the treatment of acute and severe infections caused by susceptible bacterial strains. Bortezomib A proteasome inhibitor used to treat multiple myeloma in patients who have not been successfully treated with at least two previous therapies.
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