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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.)


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This is how InpharmD™ transforms LITERATURE.

What's Being Asked...

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 is the evidence for use of beta blockers preop for oral maxicillofacial surgery?
What cost effectiveness data are available regarding use of aprepitant or fosaprepitant for prevention of post-operat...
Summarize the data on formaldehyde use for hemorrhagic cystitis

What would you like to ask InpharmD™?

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  

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[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  

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[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.
InpharmD's Answer GPT's Answer

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

Evidence for the use of beta blockers for oral maxillofacial surgery in the preoperative setting supports the continuity of chronic therapy. Current preoperative guidelines recommend continuing beta-blockers in patients already receiving them, while new initiation should occur well in advance of surgery (ideally >1 week to 30 days) with careful titration to balance benefits against risks. Given the high prevalence of hypertension in surgical patients and the association between prolonged intr...

According to the 2024 American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery, for patients on stable doses of beta-blockers undergoing non-cardiac surgery (NCS), it is recommended to continue the use of beta-blockers throughout the perioperative period, unless clinical circumstances dictate otherwise. This approach ensures the management of potential cardiovascular risks associated with the surgical process, maintaining hemodynamic stability and reducing perioperative cardiac events. The decision to proceed with beta-blocker therapy should be tailored to individual patient needs and specific clinical situations encountered during the perioperative period. In patients scheduled for elective non-cardiac surgery (NCS) who have a new indication for beta-blockade, it is advised to start beta blockers well in advance of surgery, preferably more than 7 days before the proced...

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

What is the evidence for use of beta blockers preop for oral maxicillofacial surgery?

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

READ MORE→

[1] Writing Committee Members, Thompson A, Fleischmann KE, Smilowitz NR, et al. 2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM guideline for perioperative cardiovascular management for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2024;84(19):1869-1969. doi:10.1016/j.jacc.2024.06.013
[2] Allyn S, Bentov N, Dillon J. Perioperative Optimization and Management of the Oral and Maxillofacial Surgical Patient: A Narrative Review on Updates in Anticoagulation, Hypertension and Diabetes Medications. J Oral Maxillofac Surg. 2024;82(3):364-375. doi:10.1016/j.joms.2023.11.015
[3] Herrera Hernández D, Abreu B, Xiao TS, et al. Beta-Blocker Use in Patients Undergoing Non-Cardiac Surgery: A Systematic Review and Meta-Analysis. Med Sci (Basel). 2024;12(4):64. Published 2024 Nov 11. doi:10.3390/medsci12040064
[4] Sear JW, Foex P. Recommendations on perioperative beta-blockers: differing guidelines: so what should the clinician do?. Br J Anaesth. 2010;104(3):273-275. doi:10.1093/bja/aeq007
InpharmD's Answer GPT's Answer

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

Cost-effectiveness data for aprepitant and fosaprepitant in post-operative nausea and vomiting (PONV) prevention are limited, and formal economic evaluations are largely lacking. A 2023 retrospective study in bariatric surgery patients found that fosaprepitant reduced overall antiemetic medication and administration costs (approximately $46.47 vs. $25.69 per patient) and improved patient satisfaction, although 12.5% required an additional dose. A 2024 retrospective analysis reported that apre...

While a lot of studies evaluated aprepitant and fosaprepitant, the research has focused primarily on post-operative nausea and vomiting (PONV) incidence, vomiting rates, rescue antiemetic use, and adverse events rather than healthcare utilization metrics. Evidence shows that aprepitant reduces nausea, vomiting, and rescue antiemetic requirements, with enhanced effects when combined with dexamethasone and ondansetron, and appears more effective at preventing vomiting than nausea. Fosaprepitant, particularly when added to standard prophylaxis in high-risk patients, lowers PONV incidence, emetic episodes, and rescue antiemetic use, though it may increase intraoperative hypotension. Network meta-analyses rank NK₁ receptor antagonists among the most effective single agents for vomiting prevention, with drug combinations generally showing greater efficacy. Overall, serious adverse events are uncommon, and safety profiles are favorable, but no studies reported outcomes such as cost-effecti...

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

What cost effectiveness data are available regarding use of aprepitant or fosaprepitant for prevention of post-operative nausea and vomiting? What evidence is available on outcomes such as length of stay or need for admission?

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

READ MORE→

[1] Grigio TR, Timmerman H, Dos Santos NP, Pereira JEG, Sousa AM, Wolff AP. Aprepitant and fosaprepitant as a prophylactic antiemetic for preventing postoperative nausea and vomiting after general anaesthesia: a systematic review and meta-analysis. Clinics (Sao Paulo). 2025;80:100783. doi:10.1016/j.clinsp.2025.100783
[2] Liu Y, Chen X, Wang X, et al. The efficacy of aprepitant for the prevention of postoperative nausea and vomiting: A meta-analysis. Medicine (Baltimore). 2023;102(29):e34385. doi:10.1097/MD.0000000000034385
[3] Huang Q, Wang F, Liang C, et al. Fosaprepitant for postoperative nausea and vomiting in patients undergoing laparoscopic gastrointestinal surgery: a randomised trial. Br J Anaesth. 2023;131(4):673-681. doi:10.1016/j.bja.2023.06.029
[4] Weibel S, Rücker G, Eberhart LH, et al. Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis. Cochrane Database Syst Rev. 2020;10(10):CD012859. Published 2020 Oct 19. doi:10.1002/14651858.CD012859.pub2
[5] Tingley K, Severn M; Authors. Aprepitant for the Prevention of Post-Operative Nausea and Vomiting in Refractory or High-Risk Patients: Rapid Review [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2022 May. Available from: https://www.ncbi.nlm.nih.gov/books/NBK605083/
[6] Qiu T, Men P, Sun T, Zhai S. Cost-Effectiveness of Aprepitant in Preventing Chemotherapy-Induced Nausea and Vomiting: A Systematic Review of Published Articles. Front Public Health. 2021;9:660514. Published 2021 Aug 25. doi:10.3389/fpubh.2021.660514
[7] Aghazarian GS, Lind R, Motola D, et al. Impact of Emend on Perioperative Bariatric Surgery Antiemetic Utilization, Patient Satisfaction, and Costs. Surg Laparosc Endosc Percutan Tech. 2023;33(3):265-269. Published 2023 Jun 1. doi:10.1097/SLE.0000000000001101
[8] Dahman M, Ratermann C, Rozzo A. Use of aprepitant (80 mg) for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic sleeve gastrectomy. Innovations in Surgery and Interventional Medicine. 2024;4(2024):1-5. doi:10.36401/ISIM-23-04
InpharmD's Answer GPT's Answer

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

Available data on the use of formaldehyde (formalin solution) for hemorrhagic cystitis (HC) is primarily limited to small retrospective studies and older case reports, and formall guidance on its use is scarce. One guideline by the Canadian Urological Association, as well as several clinical practice reviews, consistently describe intravesical formalin as a last-line intervention for refractory HC, emphasizing that it is typically considered only after other medical and procedural therapies h...

A 2019 Canadian Urological Association best practice report on the management of hemorrhagic cystitis in the pediatric population states that clinicians can consider sclerotherapy with formalin in severe, refractory cases, but as a last resort prior to irreversible surgical options (Level 3 evidence, Grade D recommendation). Given that instillation is painful, general anesthesia is required and it is recommended that all patients undergo evaluation for vesicoureteral reflux (VUR) beforehand to prevent upper-tract injury. If VUR is present, ureteral orifices may be temporarily occluded during treatment with Fogarty catheters. Reports using 4% formalin have been effective with some children improving after a single treatment while lower concentrations (1-2%) have been effective but required multiple instillations. The guideline emphasizes that due to potential long-term bladder compromise (e.g., bladder scarring), formalin should be typically avoided or use as a last resort, especiall...

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

Summarize the data on formaldehyde use for hemorrhagic cystitis

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

READ MORE→

[1] Hannick JH, Koyle MA. Canadian Urological Association Best Practice Report: Pediatric hemorrhagic cystitis. Can Urol Assoc J. 2019;13(11):E325-E334. doi:10.5489/cuaj.5993
[2] Mihailidis T, Davenport K. The Practical Management of Intractable Haematuria Within the National Health Service of the United Kingdom: A Literature Review. Cureus. 2025;17(11):e96083. Published 2025 Nov 4. doi:10.7759/cureus.96083
[3] Jefferson FA, Linder BJ. Hemorrhagic Cystitis: Making Rapid and Shrewd Clinical and Surgical Decisions for Improving Patient Outcomes. Res Rep Urol. 2023;15:291-303. Published 2023 Jun 29. doi:10.2147/RRU.S320684
[4] Petca RC, Popescu RI, Toma C, et al. Chemical hemorrhagic cystitis: Diagnostic and therapeutic pitfalls (Review). Exp Ther Med. 2021;21(6):624. doi:10.3892/etm.2021.10056
[5] Chorbińska J, Krajewski W, Zdrojowy R. Urological complications after radiation therapy-nothing ventured, nothing gained: a Narrative Review. Transl Cancer Res. 2021;10(2):1096-1118. doi:10.21037/tcr-20-2589
[6] Leddy LS. Management of Lower Urinary Tract Symptoms After Pelvic Radiation in Females. Curr Urol Rep. 2018;19(12):106. Published 2018 Oct 31. doi:10.1007/s11934-018-0848-2
[7] Vicente J, Rios G, Caffaratti J. Intravesical formalin for the treatment of massive hemorrhagic cystitis: retrospective review of 25 cases. Eur Urol. 1990;18(3):204-206. doi:10.1159/000463910

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.


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


     

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


     

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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.)


     

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