{
 "query": "chlorhexidine / sodium nitrite",
 "ingredient": "chlorhexidine / sodium nitrite",
 "slug": "chlorhexidine-sodium-nitrite",
 "rxcui": "1007076",
 "brands": [],
 "names": [
  "chlorhexidine / sodium nitrite"
 ],
 "components": [
  {
   "ingredient": "chlorhexidine",
   "slug": "chlorhexidine",
   "grade": "B",
   "total": 86,
   "scores": {
    "safety": "B",
    "evidence": "B",
    "regulatory": "B",
    "conflict": "A",
    "options": "A"
   },
   "boxed": false,
   "controlled": false,
   "first_approval_fmt": "09/17/1976",
   "first_approval": "19760917"
  },
  {
   "ingredient": "sodium nitrite",
   "slug": "sodium-nitrite",
   "grade": "C",
   "total": 68,
   "scores": {
    "safety": "C",
    "evidence": "F",
    "regulatory": "A",
    "conflict": "A",
    "options": "C"
   },
   "boxed": true,
   "controlled": false,
   "first_approval_fmt": "02/14/2012",
   "first_approval": "20120214"
  }
 ],
 "classes": [],
 "alternatives": [],
 "label": {},
 "faers": null,
 "faers_base": {
  "total": 20692304,
  "serious_share": 0.5742697381596559,
  "death_share": 0.09102355155810585
 },
 "recalls": [],
 "recall_total": 0,
 "drugsfda": {
  "first_approval": "19760917",
  "first_approval_fmt": "",
  "anda": 0,
  "nda": 0,
  "rems": false,
  "labeling_recent": 0
 },
 "trials": null,
 "pubmed": null,
 "payments": {
  "year": "2024",
  "usd": 0.0,
  "records": 0,
  "by_name": [],
  "names_checked": [
   "chlorhexidine / sodium nitrite"
  ],
  "source": "bulk-index"
 },
 "partd": null,
 "mdl": [],
 "dsc": [],
 "settlements": [],
 "prescrire": null,
 "eml": null,
 "exposure": null,
 "scores": {
  "safety": {
   "score": 70,
   "letter": "C",
   "why": [
    "Graded by its riskiest ingredient, sodium nitrite (70)",
    "Carries an FDA boxed warning, the strongest warning the FDA issues (-30)"
   ],
   "weight": 0.35
  },
  "evidence": {
   "score": 27,
   "letter": "F",
   "why": [
    "Graded by its riskiest ingredient, sodium nitrite (27)",
    "25 randomized trials and 1 systematic reviews/meta-analyses indexed in PubMed",
    "On the WHO Model List of Essential Medicines (shown for context; no score effect)",
    "No Cochrane review found (-5)",
    "24% of registered trials were terminated, withdrawn, or suspended (-8)"
   ],
   "weight": 0.25
  },
  "regulatory": {
   "score": 87,
   "letter": "B",
   "why": [
    "Graded by its riskiest ingredient, chlorhexidine (87)",
    "Recalls since 2016: 0 Class I, 3 Class II, 1 Class III across 16 generic makers (-5)",
    "7 label changes approved since 2021: the safety story is still moving (-8)"
   ],
   "weight": 0.15
  },
  "conflict": {
   "score": 100,
   "letter": "A",
   "why": [
    "Graded by its riskiest ingredient, chlorhexidine (100)",
    "Pharma paid doctors $1,742 tied to this drug last year: negligible",
    "Not named in any pending federal MDL"
   ],
   "weight": 0.15
  },
  "options": {
   "score": 70,
   "letter": "C",
   "why": [
    "Graded by its riskiest ingredient, sodium nitrite (70)",
    "No generic version approved: brand-only pricing (-30)",
    "26 same-class alternatives exist"
   ],
   "weight": 0.1
  }
 },
 "total": 66,
 "grade": "C",
 "questions": [
  "This is a fixed combination of chlorhexidine and sodium nitrite. Why both together, instead of only the one I need?",
  "In 2017 the FDA issued a safety communication about this drug (FDA warns about rare but serious allergic reactions with the skin antiseptic chlorhexidine gluconate). Does that risk apply to me?",
  "The most-reported problems in FDA's adverse event data are rash, fatigue, joint swelling, pain. How would we recognize and handle those?",
  "Why this one over acetic acid, acriflavine hydrochloride, aluminum acetotartrate? What would make you pick one of those instead?",
  "What result are we expecting, by when, and what is the plan if it does not happen?",
  "If 100 people like me took this drug, how many would actually get better because of it, and how many would be harmed by it? (Doctors call these the number needed to treat and the number needed to harm.)",
  "This drug carries a boxed warning. Which specific risk does it cover, and does it apply to me?",
  "The most-reported problems in FDA's adverse event data are completed suicide, methaemoglobinaemia, toxicity to various agents, overdose. How would we recognize and handle those?",
  "Why this one over 4-dimethylaminophenol, acetylcysteine, amyl nitrite? What would make you pick one of those instead?",
  "There is no generic. Is there an older generic in the same class that works as well for my situation?"
 ]
}