Look-Alike Drug Vials: Latest Stories & Gallery

Look-Alike Drug Vials

The following alerts and photos show how look-alike drug vials and packaging can contribute to medication errors and impact patient safety.

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Latest Alerts

Estradiol, Tamoxifen Citrate
April 4, 2022

Estradiol, Tamoxifen Citrate

Estradiol, Tamoxifen Citrate

[Drug mix-up administration can be even more troublesome] because tamoxifen is used after breast cancer to decrease estrogen, and [this vial is simply] exogenous estrogen.

Submitted by
Emahn Wilder, PharmD
Midwestern University


Ephedrine, Phenylephrine, Metoclopramide, Famotidine | Cefazolin, Flumazenil | Tranexamic Acid Injection (same medication labeled with multiple colors) | Atropine Sulfate, Ondansetron, Dexmedetomidine | Heparin Sodium Injection, Calcium Gluconate
April 2, 2022

Latest look-a-likes in our drug drawer!

Ephedrine, Phenylephrine, Metoclopramide, Famotidine

Ephedrine, Phenylephrine, Metoclopramide, Famotidine

Cefazolin, Flumazenil

Cefazolin, Flumazenil

Tranexamic Acid Injection (same medication labeled with multiple colors)

Tranexamic Acid Injection (same medication labeled with multiple colors)

Atropine Sulfate, Ondansetron, Dexmedetomidine (same medication labeled with multiple colors)

Atropine Sulfate, Ondansetron, Dexmedetomidine (same medication labeled with multiple colors)

Heparin Sodium Injection, Calcium Gluconate

Heparin Sodium Injection, Calcium Gluconate


Submitted by
Janette McVey, MD
University of Missouri Healthcare


Vazculep, Neostigmine Methylsulfate Injection
March 4, 2022

Vazculep, Neostigmine Methylsulfate Injection

Vazculep, Neostigmine Methylsulfate Injection

Pharmacy is now stocking 5 ml vials of concentrated phenylephrine in our top drawer.

Submitted by
Jennifer Jones, CRNA


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