Drug Information: A Guide for Pharmacists, 5e

15–2: Appendix 15–2 Naranjo Algorithm

Naranjo Algorithm

^∗Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method of estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239-45.

To assess the adverse drug reaction, please answer the following questionnaire and give the pertinent score.

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Yes

Don't Know

Score

1. Are there previous conclusive reports on this reaction?

2. Did the adverse event appear after the suspected drug was administered?

−1

3. Did the adverse reaction improve when the drug was discontinued or a specific antagonist was administered?

4. Did the adverse reaction reappear when the drug was readministered?

−1

5. Are there alternative causes (other than the drug) that could on their own have caused the reaction?

−1

6. Did the reaction reappear when a placebo was given?

−1

7. Was the drug detected in the blood (or other fluids) in concentrations known to be toxic?

8. Was the reaction more severe when the dose was increased, or less severe when the dose was decreased?

9. Did the patient have a similar reaction to the same or similar drugs in any previous exposure?

10. Was the adverse event confirmed by any objective evidence?

Total Score_____

Score Interpretation

___Definite: ≥ 9

___Probable: 5 to 8

___Possible: 1 to 4

___Doubtful: ≤ 0

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15–2: Appendix 15–2 Naranjo Algorithm

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Naranjo Algorithm

Score Interpretation

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