A drug prescribed to treat the side effect of another drug. Nobody caught it, because the specialists never compared notes.
The cardiologist’s diuretic fighting the rheumatologist’s NSAID. A second antidepressant duplicating one already prescribed. A drug still on the chart years after the fall that should have ended it. Consilium finds what a single reviewer misses, and cites the published criterion for every finding — never a guess. Nothing changes without a clinician’s sign-off.
example finding
| diazepam 5mg, at night | stop |
meets STOPP-D5 · O’Mahony et al., STOPP/START criteria v2, Age and Ageing 2015
| substance | dose | frequency | route | started | prescriber specialty | |
|---|---|---|---|---|---|---|
| allopurinol | 100mg | once daily | oral | 2018-01-01 | rheumatology | |
| warfarin | 5mg | once daily | oral | 2017-01-01 | cardiology | |
| levothyroxine | 100mcg | once daily | oral | 2012-01-01 | endocrinology | |
| lisinopril | 10mg | once daily | oral | 2015-01-01 | cardiology | |
| atorvastatin | 20mg | once daily | oral | 2016-01-01 | cardiology | |
| tamsulosin | 0.4mg | once daily | oral | 2020-01-01 | urology |
the specialists review the regimen and a mediator proposes changes. usually under a minute, then it waits for your approval before anything is finalised.