Naranjo Nomogram for Adverse Drug Reaction Assessment
Naranjo Nomogram for Adverse Drug Reaction Assessment
(the student may need to make additional copies of this form)
| |Yes |No |Do Not Know|Score |
|1. Are there previous conclusive reports on this reaction? |+1 |0 |0 | |
|2. Did the adverse event appear after the suspected drug was |+2 |-1 |0 | |
|administered? | | | | |
|3. Did the adverse reaction improve when the drug was |+1 |0 |0 | |
|discontinued or a specific antagonist was administered? | | | | |
|4. Did the adverse reaction reappear when the drug was |+2 |-1 |0 | |
|readministered? | | | | |
|5. Are there alternative causes (other than the drug) that could on |-1 |+2 |0 | |
|their own have caused the reaction? | | | | |
|6. Did the reaction appear when a placebo was given? |-1 |+1 |0 | |
|7. Was the drug detected in the blood (or other fluids) in |+1 |0 |0 | |
|concentrations known to be toxic? | | | | |
|8. Was the reaction more severe when the dose was increased, or |+1 |0 |0 | |
|less severe when dose decreased? | | | | |
|9. Did the patient have a similar reaction to the same or similar |+1 |0 |0 | |
|drugs in any previous exposure? | | | | |
|10. Was the adverse event confirmed by any objective evidence? |+1 |0 |0 | |
Total Score = 0[pic]0
Definite: score > 9
Probable: 5-8
Possible: 1-4
Doubtful: < 0
(Michel DJ, Knobel Lc. Comparison of three algorithms used to evaluate adverse drug reactions. Am J Hosp Pharm. 1986;43:1711.)
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