Keith Pickett, MLIS
Coordinator, Research Services and User Resources
Rudolph Matas Library of the Health Sciences
Tulane University

Content

Litt’s Drug Eruption & Reaction Database is an evidence-based tool published by CRC/Taylor & Francis for identifying and comparing adverse reactions of more than 1,750 drugs, supplements, and other commonly used medical products. The database’s content is based on Litt’s Drug Eruption and Reaction Manual, published annually and currently in its 26^th edition.

Users can search drug profiles by trade or generic name, herbal or supplement name, class, or manufacturer. Users can also identify drugs by searching for specific adverse reactions. At the time of this article, the database included 1,770 drugs; 69,709 reactions; and 147,993 linked references in PubMed.

Every drug profile includes information such as synonyms, trade names, manufacturer information, drug class, indications, half-life, interactions and adverse reactions, black box warnings, and pregnancy category. Any adverse reactions are color-coded and grouped into categories by the affected system/region including central nervous system, cardiovascular, respiratory, ocular, skin, and nails. The adverse reactions also include specific information for pediatric (0-17), adult (18-74) and geriatric (75 and over) patients [1].

Features/Functionality

The URL of Litt’s Drug Eruption & Reaction Database is https://www.drugeruptiondata.com. The home page includes a menu bar, search box, and cards for featured drugs, adverse reactions, drug classes, herbals, reaction categories, companies, and indications. Information on the Litt’s mobile app and a link to an image gallery are also included. From the search box on the home page, users can perform a search by drug name, adverse reaction, drug class, herbals and supplements, or drug company. Search suggestions are provided based on user input.

After searching for a particular drug, users are directed to a profile page containing a wealth of information. The top of the profile displays trade names, indications, synonyms, class, and half-life, in addition to a list of drugs with clinically important, potentially hazardous interactions and pregnancy category. Additional notes are also provided, as well as a link to view adverse reactions by the class to which the drug belongs. Adverse reactions are then listed by body organ/system. A list of linked articles from PubMed can be found below each interaction to provide supporting evidence. Symbols next to each documented interaction indicate the prevalence, seriousness, and/or warnings in other populations (breastfeeding, pediatric, and geriatric). In some cases, images are provided for reactions involving the skin. Under the list of documented interactions is a link to a drug review article in the journal Expert Opinion on Drug Safety (also published by Taylor & Francis) if one is available. Finally, there is a list of adverse reactions attributed to the entire drug class with PubMed links. A similar profile page is given if a user searches by an herbal or supplement name. For an alphabetical list of all herbals and supplements in Litt’s, simply leave the search box empty and click “Go.”

Searching by adverse reaction returns a short definition of the interaction and, in some cases, images depicting the reaction. Searching by drug class or drug company returns a list of drugs that can be compared to one another using the check box to the right of each drug name.

The “Search Multiple Drugs” feature, located in the main menu bar, allows users to select at least one reaction and one drug from a drop-down list to identify which drug might be causing a particular adverse reaction in a patient. Results are provided in real time as the user selects reactions and drugs. There is also an option to clear all selections to restart the search from scratch. The next option provided in the main menu bar is the “Search Class Reactions” feature. This feature offers the ability to select a class of drugs and up to six reactions in order to identify alternatives to drugs that produce adverse or undesired effects. Results are displayed in real time as selections are made in a table format. The left column of the results table includes the names of all drugs in the chosen class, and each name is linked to its full profile. Each chosen interaction has its own column next to the drug name. If there is no reaction documented, the cell is highlighted yellow for quick identification. If the chosen reaction has been documented for a particular drug, the number of relevant resources in PubMed is given which is linked to the full list of citations so that practitioners can quickly access the primary evidence.

Individual subscribers can save drug profiles, watch drug profiles for changes and updates, and save searches.

Business Model

Public users can perform a basic search at https://www.drugeruptiondata.com/, which returns limited drug information including trade name(s), class, indications, FDA approval date, and black box warnings. A subscription is required for complete access to the database.

CRC/Taylor & Francis offers two subscription models for access to Litt’s Drug Eruption & Reaction Database. Individual subscriptions can be purchased directly through https://www.drugeruptiondata.com/subscribe_individual. Individual subscribers are directed to complete a form to receive an invoice and login information. Currently, an individual subscription costs $325 for the first year (as an introductory rate) and $395 to renew annually thereafter [2]. Institutional subscriptions are also available from CRC/Taylor & Francis. Institutional pricing can be obtained by filling out the form at https://www.drugeruptiondata.com/subscribe_institutional or by contacting your library’s CRC/Taylor & Francis sales representative. There are three tiers of institutional pricing depending on the desired number of concurrent users (2, 10, or unlimited).

Both individual and institutional subscriptions include free access to the Litt’s App for iOS & Android mobile devices. The app offers much of the information found on the Litt’s website but does not offer the ability to compare drugs to one another. Individual subscribers can use their login credentials to activate the app, but institutional users must first register at https://www.drugeruptiondata.com/mobile_registration while on their institution’s network [3].

Breakthroughs

Litt’s Drug Eruption & Reaction Database is a useful resource for clinicians and health practitioners looking to identify, predict, and study adverse drug reactions in their patients. The site’s layout is simple and easy to navigate. The added benefit of the Litt’s App for both individual and institutional subscribers adds value by placing drug profiles in the practitioner’s hands at the point of care. The ability to compare adverse reactions across several drugs or an entire drug class can help practitioners and patients make more informed decisions about medications and supplements in the effort to improve health outcomes.

REFERENCES

1. Taylor & Francis Group, LLC. (2020). About. Litt’s Drug Eruption & Reaction Database. https://www.drugeruptiondata.com/about. Accessed September 7, 2020.

2. Taylor & Francis Group, LLC. (2020). Individual Subscription. Litt’s Drug Eruption & Reaction Database. https://www.drugeruptiondata.com/subscribe_individual. Accessed September 7, 2020.

3. Taylor & Francis Group, LLC. (2020). The Litt’s App. Litt’s Drug Eruption & Reaction Database.  https://www.drugeruptiondata.com/devices. Accessed September 7, 2020.