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What is InpharmD™?

Literature searching is tedious. InpharmD™ is here to help.

Clinical pharmacists can ask any question, anytime, from anywhere, and we’ll perform a custom literature search.

(And a 32% chance it’s already been asked.)


More than 30 of the world's best health systems hire an InpharmD™ virtual DI pharmacist, yielding:


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This is how InpharmD™ transforms LITERATURE.

What's Being Asked...

What herbal/supplements can help treat Parkinson’s disease? Can these interact with sinemet?
What are recommended dosing strategies for ceftazidime, avycaz, and zerbaxa for VV ECMO assuming normal renal function
How often can a 5-day course of ketorolac be repeated in a patient? Is there an amount of time that the provider must...
What type of immune boosting supplements has the most literature to support their use?
Our health system is looking at a reformulated premixed vancomycin injection product which contains the additive NADA...

What would you like to ask InpharmD™?

InpharmD's Answer GPT's Answer

Author:zophia@inpharmd.com, PharmD, BCPS + InpharmD™ AI LEARN MORE 

Current evidence indicates that commonly studied supplements in Parkinson’s disease, including Mucuna pruriens, vitamin D, and coenzyme Q10, demonstrate heterogeneous and largely non–reproducible clinical effects. Mucuna pruriens may provide faster onset and prolonged ON time due to its intrinsic levodopa content, but substantial variability in commercial preparations introduces unpredictable dopaminergic exposure; vitamin D supplementation reliably increases serum 25(OH)D levels without cons...

Natural products and herbal supplements have been explored as potential adjunctive therapies in Parkinson’s disease, although the evidence base remains predominantly preclinical and heterogeneous. Broad reviews describe multiple classes of compounds, including polyphenols, flavonoids, alkaloids, terpenoids, and amino acid–derived products, which demonstrate antioxidant, anti-inflammatory, anti-apoptotic, anti–α-synuclein aggregation, and mitochondrial-protective effects in experimental models, supporting biologic plausibility for neuroprotection. Selected agents with some degree of clinical investigation include Mucuna pruriens (a natural levodopa source), caffeine, green tea, and traditional formulations such as Jiawei-Liujunzi Tang, which have been associated with potential improvements in motor or nonmotor symptoms in small or limited studies; however, findings are inconsistent and not supported by robust, reproducible randomized data. Importantly, plant-derived compounds are gen...

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A search of the published medical literature revealed 2 studies investigating the researchable question:

What herbal/supplements can help treat Parkinson’s disease? Can these interact with sinemet?

Level of evidence
B - One high-quality study or multiple studies with limitations  

READ MORE→

[1] Bhusal CK, Uti DE, Mukherjee D, et al. Unveiling Nature's potential: Promising natural compounds in Parkinson's disease management. Parkinsonism Relat Disord. 2023;115:105799. doi:10.1016/j.parkreldis.2023.105799
[2] Aktaş E, Hanağası HA, Özgentürk NÖ. Levodopa and Plant-Derived Bioactive Compounds in Parkinson's Disease: Mechanisms, Efficacy, and Future Perspectives. CNS Neurosci Ther. 2025;31(8):e70540. doi:10.1111/cns.70540
[3] Roni MAH, Jami MdABS, Hoque S, et al. Clinically proven natural products in aid of treating Parkinson’s disease: a comprehensive review. Curr Med. 2024;3(1):6. doi:10.1007/s44194-024-00033-w
[4] Nazish Quasmi M, Pooja P, Kumar S. Various herbal remedies for the management of Parkinson’s disease: A Review. RJPT. Published online February 20, 2024:963-970. doi:10.52711/0974-360X.2024.00149
[5] Lim SY, Tan AH, Ahmad-Annuar A, et al. Parkinson's disease in the Western Pacific Region. Lancet Neurol. 2019;18(9):865-879. doi:10.1016/S1474-4422(19)30195-4
[6] Cilia R, Laguna J, Cassani E, et al. Mucuna pruriens in Parkinson disease: A double-blind, randomized, controlled, crossover study. Neurology. 2017;89(5):432-438. doi:10.1212/WNL.0000000000004175
[7] Soumyanath A, Denne T, Hiller A, Ramachandran S, Shinto L. Analysis of Levodopa Content in Commercial Mucuna pruriens Products Using High-Performance Liquid Chromatography with Fluorescence Detection. J Altern Complement Med. 2018;24(2):182-186. doi:10.1089/acm.2017.0054
[8] Zhou Z, Zhou R, Zhang Z, Li K. The Association Between Vitamin D Status, Vitamin D Supplementation, Sunlight Exposure, and Parkinson's Disease: A Systematic Review and Meta-Analysis. Med Sci Monit. 2019;25:666-674. Published 2019 Jan 23. doi:10.12659/MSM.912840
[9] Al-Kuraishy HM, Al-Gareeb AI, Selim HM, et al. Does vitamin D protect or treat Parkinson's disease? A narrative review. Naunyn Schmiedebergs Arch Pharmacol. 2024;397(1):33-40. doi:10.1007/s00210-023-02656-6
[10] Zhu ZG, Sun MX, Zhang WL, Wang WW, Jin YM, Xie CL. The efficacy and safety of coenzyme Q10 in Parkinson's disease: a meta-analysis of randomized controlled trials. Neurol Sci. 2017;38(2):215-224. doi:10.1007/s10072-016-2757-9
[11] Agnieszka W, Paweł P, Małgorzata K. How to Optimize the Effectiveness and Safety of Parkinson's Disease Therapy? - A Systematic Review of Drugs Interactions with Food and Dietary Supplements. Curr Neuropharmacol. 2022;20(7):1427-1447. doi:10.2174/1570159X19666211116142806
InpharmD's Answer GPT's Answer

Author:, PharmD, BCPS + InpharmD™ AI LEARN MORE 

There is severely limited data specifically assessing VV ECMO. In general, Ex vivo studies demonstrate that ceftazidime shows no significant interaction with ECMO circuits, and case reports indicate that standard doses of ceftolozane/tazobactam (3 g Q8H) are sufficient to achieve therapeutic targets. While data for ceftazidime/avibactam on VV ECMO is more limited, its dosing is typically guided by renal function rather than ECMO presence, with augmented renal clearance being the primary conce...

A 2022 comprehensive review was conducted which included an analysis to determine dosage considerations for various beta-lactam/beta-lactamase inhibitors in patients receiving extracorporeal membrane oxygenation (ECMO). However, the authors note that the overall data is limited, and what data was available focuses on venoarterial ECMO (VA-ECMO) rather than venovenous ECMO (VV-ECMO). It is possible that VA-ECMO has different physiological effects.There was no data for ceftazidime/avibactam in the author’s search for ECMO, with most findings focused on other forms of renal replacement therapy. For ceftolozane/tazobactam, two case reports/series were found in patients receiving ECMO. The first case used the standard 3 g Q8H dose which was sufficient for achieving aggressive target levels, although lower Cmax and Cmin were seen on the last 2 days of therapy. In the other case report used as part of prophylaxis in cystic fibrosis for a ECMO post-lung transplant, regular manufacturer dosi...

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A search of the published medical literature revealed 4 studies investigating the researchable question:

What are recommended dosing strategies for ceftazidime, avycaz, and zerbaxa for VV ECMO assuming normal renal function

Level of evidence
D - Case reports or unreliable data  

READ MORE→

[1] Bakdach D, Elajez R, Bakdach AR, Awaisu A, De Pascale G, Ait Hssain A. Pharmacokinetics, Pharmacodynamics, and Dosing Considerations of Novel β-Lactams and β-Lactam/β-Lactamase Inhibitors in Critically Ill Adult Patients: Focus on Obesity, Augmented Renal Clearance, Renal Replacement Therapies, and Extracorporeal Membrane Oxygenation. J Clin Med. 2022;11(23):6898. Published 2022 Nov 22. doi:10.3390/jcm11236898
[2] Arena F, Marchetti L, Henrici De Angelis L, et al. Ceftolozane-Tazobactam Pharmacokinetics during Extracorporeal Membrane Oxygenation in a Lung Transplant Recipient. Antimicrob Agents Chemother. 2019;63(3):e02131-18. Published 2019 Feb 26. doi:10.1128/AAC.02131-18
[3] Argudo E, Riera J, Luque S, et al. Effects of the extracorporeal membrane oxygenation circuit on plasma levels of ceftolozane. Perfusion. 2020;35(3):267-270. doi:10.1177/0267659119864813
[4] Hunt JP, McKnite AM, Green DJ, Whelan AJ, Imburgia CE, Watt KM. Interaction of ceftazidime and clindamycin with extracorporeal life support. J Infect Chemother. 2023;29(12):1119-1125. doi:10.1016/j.jiac.2023.08.007
[5] Leven C, Fillâtre P, Petitcollin A, et al. Ex Vivo Model to Decipher the Impact of Extracorporeal Membrane Oxygenation on Beta-lactam Degradation Kinetics. Ther Drug Monit. 2017;39(2):180-184. doi:10.1097/FTD.0000000000000369
[6] Mané C, Delmas C, Porterie J, et al. Influence of extracorporeal membrane oxygenation on the pharmacokinetics of ceftolozane/tazobactam: an ex vivo and in vivo study. J Transl Med. 2020;18(1):213. Published 2020 May 27. doi:10.1186/s12967-020-02381-1
InpharmD's Answer GPT's Answer

Author:Naveed Aijaz, PharmD, BCPS + InpharmD™ AI LEARN MORE 

Data consistently indicate that the recommended maximum duration of ketorolac use is five days primarily due to safety considerations. Available evidence suggests short-term use is generally well tolerated, while longer use may increase the risk of acute kidney injury and serious gastrointestinal complications (e.g., lesion formation, hemorrhage, or perforation). Notably, there is no consensus on when ketorolac may be safely restarted after a full course, and patients requiring extended analg...

A large United States postmarking surveillance study published in 1996 brought up a concern that the longer duration of parenteral ketorolac therapy (> 5 days) was associated with a higher risk of GI bleeds (odds ratio [OR], 2.20; p= 0.04). Adverse events were dose-dependent with high doses (>105 mg/day) associated with increased risk. Additionally, older patients appeared to be the most vulnerable population with extended use of ketorolac. [1] To address this safety concern, the prescribing information for ketorolac has been revised and now restricts the duration of ketorolac treatment not to exceed 5 consecutive days and recommends that oral ketorolac should only be used as a continuation of intravenous or intramuscular treatment, if necessary, with a total duration of use capped at 5 days as well. Ketorolac is not indicated for chronic painful conditions due to its limited duration of therapy. [2]

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A search of the published medical literature revealed 5 studies investigating the researchable question:

How often can a 5-day course of ketorolac be repeated in a patient? Is there an amount of time that the provider must wait before ordering another course?

Level of evidence
C - Multiple studies with limitations or conflicting results  

READ MORE→

[1] Strom BL, Berlin JA, Kinman JL, et al. Parenteral ketorolac and risk of gastrointestinal and operative site bleeding. A postmarketing surveillance study. JAMA. 1996;275(5):376-382.
[2] Toradol (ketorolac tromethamine) [prescribing information]. Roche Laboratories Inc.; 2008.
InpharmD's Answer GPT's Answer

Author:azkaa@inpharmd.com, PharmD, BCPS + InpharmD™ AI LEARN MORE 

There is a large body of evidence evaluating immune-supportive supplements, particularly micronutrients; however, variability in formulations, dosing, study populations, and study quality contributes to heterogeneous findings and limited generalizability. Across studies, vitamin C, vitamin D, and zinc have the most clinical data, showing modest effects such as small reductions in respiratory infection risk and/or shorter symptom duration, with benefits more apparent in individuals with baseli...

The 2025 National Institutes of Health (NIH) Dietary Supplements for Immune Function and Infectious Diseases fact sheet describes that adequate intake of vitamins and minerals is required for normal immune function, and deficiencies in nutrients such as vitamins A, B6, B12, C, D, and E, as well as minerals including zinc and selenium, are associated with impaired immune responses and increased susceptibility to infection. Supplementation can restore immune function in deficient individuals, but routine supplementation in individuals without deficiency has limited effect on preventing or treating infections. [1] Clinical evidence for specific micronutrients is mixed and population-dependent. Vitamin A supplementation reduces diarrhea incidence and mortality in children in low- and middle-income countries but shows inconsistent or no benefit for respiratory infections and does not improve most HIV-related outcomes. Vitamin C supplementation does not reduce incidence of the common c...

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A search of the published medical literature revealed 1 study investigating the researchable question:

What type of immune-boosting supplements has the most literature to support their use?

Level of evidence
B - One high-quality study or multiple studies with limitations  

READ MORE→

[1] National Institutes of Health Office of Dietary Supplements. Dietary supplements for immune function and infectious diseases: fact sheet for health professionals. Updated March 10, 2025. Accessed March 17, 2026. https://ods.od.nih.gov/factsheets/ImmuneFunction-HealthProfessional/
[2] Abioye AI, Bromage S, Fawzi W. Effect of micronutrient supplements on influenza and other respiratory tract infections among adults: a systematic review and meta-analysis. BMJ Glob Health. 2021;6(1):e003176. doi:10.1136/bmjgh-2020-003176
[3] Crawford C, Brown LL, Costello RB, Deuster PA. Select Dietary Supplement Ingredients for Preserving and Protecting the Immune System in Healthy Individuals: A Systematic Review. Nutrients. 2022;14(21):4604. Published 2022 Nov 1. doi:10.3390/nu14214604
[4] Gombart AF, Pierre A, Maggini S. A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection. Nutrients. 2020;12(1):236. Published 2020 Jan 16. doi:10.3390/nu12010236
[5] Rondanelli M, Miccono A, Lamburghini S, et al. Self-Care for Common Colds: The Pivotal Role of Vitamin D, Vitamin C, Zinc, and Echinacea in Three Main Immune Interactive Clusters (Physical Barriers, Innate and Adaptive Immunity) Involved during an Episode of Common Colds-Practical Advice on Dosages and on the Time to Take These Nutrients/Botanicals in order to Prevent or Treat Common Colds. Evid Based Complement Alternat Med. 2018;2018:5813095. Published 2018 Apr 29. doi:10.1155/2018/5813095
InpharmD's Answer GPT's Answer

Author:Younghee Kwon, PharmD, BCPS + InpharmD™ AI LEARN MORE 

Available data on N-acetyl-D-alanine (NADA) in pregnancy are extremely limited and do not allow for a reliable safety assessment. No clinical studies, case reports, or human data evaluating maternal or fetal outcomes with NADA exposure have been identified, and it is not included in established excipient safety databases or references. Nonclinical data from FDA review documents indicate that NADA is a novel excipient evaluated primarily in animal studies, where intravenous exposure in rabbits...

According to the U.S.  Food & Drug Administration (FDA) review of the supplemental new drug application (sNDA) for Tyzavan (vancomycin injection), received September 26, 2023, the manufacturer submitted a reformulation of the drug product to remove the excipient polyethylene glycol 400 (PEG 400). As a result of this formulation change, the FDA approved the removal of the Boxed Warning related to potential risks of excipient exposure during early pregnancy. Corresponding pregnancy-related warnings and recommendations for pregnancy testing were also removed from the prescribing information, and pediatric dosing sections were updated to clarify limitations of the available strengths. [1] A comprehensive search of the published literature and excipient safety databases did not identify any data on the use or safety of N-acetyl-D-alanine (NADA) in pregnancy. No clinical studies, case reports, or regulatory assessments specifically addressing maternal or fetal outcomes with NADA exposu...

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A search of the published medical literature revealed 0 studies investigating the researchable question:

Our health system is looking at a reformulated premixed vancomycin injection product which contains the additive NADA. What is the safety data regarding NADA in pregnancy?

Level of evidence
X - No data  

READ MORE→

[1] U.S.  Food & Drug Administration (FDA). Letter: NDA 211962/S‑017. Tyzavan (vancomycin injection). June 27, 2025. Accessed March 17, 2026. https://www.accessdata.fda.gov/drugsatfda_docs/appletter/2025/211962Orig1s017ltr.pdf
[2] Ursino MG, Poluzzi E, Caramella C, De Ponti F. Excipients in medicinal products used in gastroenterology as a possible cause of side effects. Regul Toxicol Pharmacol. 2011;60(1):93-105. doi:10.1016/j.yrtph.2011.02.010
[3] Turner MA, Duncan JC, Shah U, et al. Risk assessment of neonatal excipient exposure: lessons from food safety and other areas. Adv Drug Deliv Rev. 2014;73:89-101. doi:10.1016/j.addr.2013.11.003
[4] Bobillot M, Delannoy V, Trouillard A, Kinowski JM, Sanchez-Ballester NM, Soulairol I. Potentially Harmful Excipients: State of the Art for Oral Liquid Forms Used in Neonatology and Pediatrics Units. Pharmaceutics. 2024;16(1):119. Published 2024 Jan 17. doi:10.3390/pharmaceutics16010119
[5] US Food and Drug Administration. NDA 211962: Multi-Disciplinary Review and Evaluation – Vancomycin Injection (vancomycin hydrochloride). Center for Drug Evaluation and Research; February 19, 2019.

Why choose InpharmD™?

Find answers, not documents.

Before InpharmD™


BeforeTime
Your team spends hours per week cobbling together literature from different studies, many behind paywalls, leaving little time for action.
BeforeTime
TI opportunities are discovered (or presented by third parties) months after the fact, resulting in costly missed savings.
BeforeTime
Decisions may be made without a complete picture, or pushed out while gathering consensus.

After InpharmD™


BeforeTime
InpharmD™ delivers customized, actionable drug information in real time, so you can focus on execution.
BeforeTime
Your team stays informed immediately when new data emerges or prices change, and you’ll always be the first to know when any changes impact your formulary.
BeforeTime
With InpharmD™, your team can make faster, more informed decisions and move forward with confidence.

What Clinical Pharmacists Are Saying...


     

Assists in our research and is a great way or us to get an answer to a medical question without spending an average of 2 hours researching UptoDate or PubMed ourselves.


—   Jordan C., PharmD, New Jersey

     

Huge time saver with thorough responses.


—   Jane D., PharmD, Georgia

     

I’d never heard of a DI pharmacist before, now I have one. In. My. Pocket. Amazing!


     

Holy Shhh. Cow! Holy Cow! These summaries are beautiful.


—   Jane D., PharmD, Georgia

     

I just want to say: This is such a brilliant idea! You people are genius.


     

OH MY GOD WHERE HAVE YOU BEEN ALL MY LIFE!


     

I can’t tell you how much time I spend literature searching. And how I CANNOT STAND PAYWALLS. THIS IS UNBELIEVABLE!! (covers face for sec) thank you, thank you, thank you!


     

So they’re basically connecting academic researchers with front line providers and then automating everything. It’s simply brilliant.


     

The clinical pharmacist was our secret weapon anyway. (Smiles wryly) This pharmacist AI seems superhuman. I’m just blown away, honestly. (Looks at camera somberly.)


     

It’s an ENTIRE DI DEPARTMENT, that lives in Epic. Give me a second. I’m just having a hard time wrapping my head around that.


     

Sorry just give me a second, my mind is blown.


     

Stop reading and just download the app already! I’ve tried all of them. This is by far the most advanced, best-in-class.


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