Getting Started
Eles Rx is a clinical drug interaction checker designed for healthcare professionals. It checks multiple drugs simultaneously across a validated interaction database, flags Beers Criteria medications in older adults, calculates anticholinergic burden, and detects prescribing cascades — all in one screen.
You can also use Eles Rx to quickly look up drug reference information — including classification, approved indications, dosing notes, renal/hepatic adjustments, and links to full prescribing information from DailyMed and other authoritative sources.
How to run a check
- Enter patient details in the left panel (all fields are optional)
- Type a drug name in the search box and select from the dropdown
- Add all relevant medications — up to 15 at once
- Click Check Interactions
- Review results in the centre panel
You don't need to fill in the patient profile to run a basic interaction check. Each field you complete activates additional clinical intelligence.
Patient Profile
All patient profile fields are optional. Each field activates additional checks:
- Age — activates ElderWatch™ for patients aged 65 and over
- Renal function — activates renal dose flags
- Hepatic function — activates hepatic dose flags
- Pregnant — activates pregnancy safety alerts
- Breastfeeding — activates lactation safety alerts
- Frailty — amplifies ElderWatch™ alerts and shows frailty-specific concerns
Understanding Your Results
Eles Rx checks every possible pair of drugs in your list and ranks interactions by severity. The Alert Summary tiles at the top give you a count of each alert type at a glance — click any tile to jump to that section.
Severity levels
- Contraindicated Combination should never be used. Risk outweighs any benefit.
- Major Potentially life-threatening. Avoid unless benefit clearly outweighs risk.
- Moderate May worsen patient condition. Usually requires monitoring or dose adjustment.
- Minor Limited clinical effect. Manageable with routine monitoring.
Each interaction shows
- Mechanism — why the interaction occurs physiologically
- Management — what to do clinically (highlighted in blue)
- References — the validated source of the interaction data
- Class effect — interaction applies to all drugs in this pharmacological class
- Drug-specific — interaction documented for this particular drug only
Conditional alert tiles
Three additional summary tiles appear automatically when specific patient flags are active:
- Pregnancy / Lactation — visible when the Pregnant or Breastfeeding flag is checked in Patient Profile
- Frailty flags — visible when the Frailty flag is active; shows drug-specific concerns beyond standard ElderWatch™ alerts
- Therapeutic duplicates — always visible; flags two or more drugs from the same pharmacological subclass
Eles Rx is a clinical decision support tool. All alerts must be interpreted in clinical context. Always verify with current prescribing information. This tool does not replace clinical judgment.
ElderWatch™
ElderWatch™ flags medications that are potentially inappropriate in adults aged 65 and over, based on the AGS Beers Criteria® 2023 Update — the gold standard reference for medication safety in older adults.
ElderWatch™ activates automatically when you enter a patient age of 65 or older.
Each flagged drug shows
- The category of concern (e.g. CNS, anticholinergic, cardiovascular)
- The specific risk for that drug in older adults
- A recommended clinical action
- Indication-specific alternatives where available
Frailty flag
If the Frailty flag is active in the Patient Profile, ElderWatch™ amplifies its alerts to reflect the reduced physiological reserve in frail patients — where drug sensitivity is significantly increased beyond age alone.
ElderWatch™ alerts are based on the AGS Beers Criteria® 2023. A flag does not mean the drug must be stopped — it means risk-benefit should be reviewed in the context of the individual patient. Eles Rx is not affiliated with or endorsed by the American Geriatrics Society.
Anticholinergic Profile (Composite)
The Anticholinergic Profile currently calculates a cumulative composite anticholinergic burden score for your drug list, based on ACB Scale (Boustani et al., 2008) and GABS (Kiesel et al., 2018) mappings.
Individual drug scores
- 0 — no anticholinergic activity
- 1 — mild anticholinergic activity
- 2 — moderate anticholinergic activity
- 3 — severe anticholinergic activity
Total score interpretation
- 0 — No burden
- 1–2 — Low-moderate burden, monitor
- 3–5 — HIGH burden — associated with cognitive impairment, falls, urinary retention
- 6+ — VERY HIGH burden — strongly consider alternatives
Anticholinergic burden is particularly important in older adults where effects accumulate across multiple medications. In this release, the threshold logic uses the stored composite score; a score ≥3 is treated as high burden.
Source: Boustani et al. (2008) ACB Scale & Kiesel et al. (2018) GABS, via
acbcalc.com (updated July 2024)
Prescribing Cascade Detector
A prescribing cascade occurs when a drug is prescribed to treat the side effect of another drug — and the new drug itself causes further side effects, leading to yet more prescriptions.
Eles Rx detects suspected cascades based on known drug-side effect-treatment patterns in its validated cascade database.
Each suspected cascade shows
- The trigger drug and its known side effect
- The secondary drug typically prescribed to treat it
- Why the cascade occurs clinically
- The recommended clinical action
Example
Amlodipine (CCB) → causes peripheral oedema → Furosemide prescribed to treat oedema → but CCB-induced oedema does NOT respond to diuretics because it is not caused by fluid retention. Recommended action: reduce CCB dose, switch agent, or add an ACE inhibitor/ARB.
Renal / Hepatic Dose Flags
Set the patient's renal or hepatic function in the Patient Profile to activate dose adjustment flags. Eles Rx will highlight drugs in your list that require dose modification.
Renal function grades
- Normal — no flags activated
- Mild — CrCl 60–89 mL/min
- Moderate — CrCl 30–59 mL/min
- Severe — CrCl <30 mL/min
- End-stage / Dialysis — critical flags activated
Hepatic function grades
- Normal — no flags activated
- Mild — Child-Pugh A
- Moderate — Child-Pugh B
- Severe — Child-Pugh C — critical flags activated
Drug Reference
Eles Rx includes a built-in drug reference panel that updates automatically as you add drugs to your list. Use it as a quick reference tool during clinical decision making — no separate lookup needed.
For each drug you'll see
- Classification — ATC-aligned class, subclass and sub-subclass
- Primary and alternative classifications — some drugs have multiple pharmacological roles
- Dosing notes — standard dosing where available
- Renal adjustment guidance — dose modification requirements
- Contraindications — key contraindications from prescribing information
- Monitoring parameters — what to watch clinically
- Full prescribing information links — direct links to DailyMed, LiverTox, StatPearls, Health Canada and EMA
The Drug Reference panel is on the right side of the screen. It updates automatically every time you add or remove a drug from your list.
Therapeutic Duplicate Detector
A therapeutic duplicate occurs when two or more drugs from the same pharmacological subclass are prescribed simultaneously. Same-subclass combinations are rarely appropriate and may result in additive toxicity without additional benefit.
Eles Rx checks every drug in your list against its ATC-aligned subclass assignments and flags pairs that share a subclass — even when the drug names are different (e.g. two different SSRIs, or two ACE inhibitors).
Each detected duplicate shows
- The two drugs sharing the same subclass
- The shared pharmacological subclass
- A note that same-subclass combinations should be reviewed
When duplicates are expected
Some combinations are intentional — for example, dual antiplatelet therapy or combination antihypertensive regimens. A therapeutic duplicate flag means the combination requires clinical justification, not that it is always wrong.
The Therapeutic Duplicate tile is always visible in the Alert Summary — it does not require any patient profile flags to activate.
Free vs Subscription
Eles Rx core features are completely free for all clinicians. A subscription adds patient management and advanced workflow tools.
| Feature | Free | Subscription |
|---|
| Unlimited interaction checks | ✓ | ✓ |
| ElderWatch™ | ✓ | ✓ |
| Anticholinergic Profile | ✓ | ✓ |
| Prescribing Cascade Detector | ✓ | ✓ |
| Therapeutic Duplicate Detector | ✓ | ✓ |
| Copy report as text | ✓ | ✓ |
| Database update notifications | ✓ | ✓ |
| Save patient profiles | 3 max | ✓ |
| Patient notes | 150 chars | ✓ Unlimited |
| Patient history tracking | ✗ | ✓ |
| Flag patients for follow-up | ✗ | ✓ |
| Save drug combinations | ✗ | ✓ |
| Export report as PDF | ✗ | ✓ |
| Print-friendly reports | ✗ | ✓ |
| Remember your top drugs | ✗ | ✓ |
| Dark mode | ✗ | ✓ |
| Priority support | ✗ | ✓ |
Frequently Asked Questions
Is Eles Rx free?
Yes — core drug interaction checking is completely free for all clinicians. A free account gives you unlimited checks and database update notifications. Subscription features are available for clinicians who need patient management and advanced workflow tools.
How current is the database?
The Eles Rx interaction database is continuously updated. Registered users receive notifications when new interactions, drugs, or clinical data are added.
What sources does Eles Rx use?
All interactions are validated against DailyMed (NLM/NIH), LiverTox, StatPearls, PubMed/PMC, EMA (for herbals), and Health Canada. All interaction text is original — not copied from sources.
Can I use Eles Rx for patient care decisions?
Eles Rx is a clinical decision support tool. All alerts must be interpreted in clinical context. Always verify with current prescribing information before acting on any alert. This tool does not replace clinical judgment.
What is a Class effect interaction?
A class effect interaction applies to all drugs within a pharmacological class, not just the specific drug listed. For example, an interaction flagged for Beta-blockers applies to atenolol, metoprolol, bisoprolol and all other beta-blockers.
How is the Anticholinergic score calculated?
Current scores are stored as a combined ACB/GABS composite (via acbcalc.com, updated July 2024). Each drug is scored 0–3 and scores are summed across all drugs in your list. This is not a strict ACB-only implementation.
Why does ElderWatch™ flag some common drugs?
ElderWatch™ is based on the AGS Beers Criteria® 2023 — a conservative evidence-based list. A flag does not mean the drug must be stopped, but that risk-benefit should be reviewed in the context of the individual older patient.
How many drugs can I check at once?
You can add up to 15 drugs in a single check. Eles Rx checks every possible pair — so 15 drugs generates 105 pair checks simultaneously.
About Eles Rx
Eles Rx is a product of PIPPS Smart Apps, a brand of J.C. Epiphany Limited — a Jamaica-based healthcare software company with over 25 years of experience in clinical and pharmacy management systems.
Eles Rx was built by clinicians, for clinicians — combining a validated drug interaction database with modern clinical decision support tools including ElderWatch™, Anticholinergic Profile scoring, and Prescribing Cascade Detection.
Data sources
- DailyMed (NLM/NIH) — US National Library of Medicine. Public domain.
- LiverTox (NLM/NIH) — Hepatotoxicity reference. Public domain.
- StatPearls (NCBI/NIH) — Peer-reviewed clinical reference. Open access.
- PubMed/PMC — Biomedical literature. Public access.
- EMA — European Medicines Agency. Publicly accessible.
- Health Canada — Open Government Licence.
- AGS Beers Criteria® 2023 — ElderWatch™ alerts are based on the AGS Beers Criteria® 2023 Update. Beers Criteria® is a registered trademark of the American Geriatrics Society. Eles Rx is not affiliated with or endorsed by the AGS.
- ACB/GABS Composite - Anticholinergic scores derived from Boustani et al. (2008) and Kiesel et al. (2018), via acbcalc.com (updated July 2024).
All interaction text in Eles Rx is original — written by our clinical team and not reproduced verbatim from any source. Sources are cited for reference and verification purposes only.
Contact
Eles Rx