Combination is contraindicated. Hard stop in the prescribing flow. Requires explicit override with clinical justification.
Decision support. ChironAI surfaces drug-interaction context for the prescribing clinician. The clinician decides whether to write, modify, or hold the prescription. ChironAI does not make a regulatory clearance claim; see Disclosures.
Prescriptions with the full pharmacology context.
ChironAI does not treat drug interactions as a checkbox warning. Before anything is drafted, the Chiron copilot runs a drug_interactions() check against the working medication list — so each prescription arrives with the full medication context (indications, dosing and contraindications from the FDA label) and each interaction surfaces with the pharmacology mechanism, severity tier, and the canonical source that warrants the call. The copilot proposes; it asks for your approval before it acts.
Safety screened before anything is drafted.

From contraindicated to informational.
Significant interaction risk. Monitoring required. Recommendation surfaced inline with the prescription.
Caution. Surfaced as informational alert. Clinician can proceed but should consider alternatives or counsel the patient.
Informational. Surfaced for awareness; rarely changes the prescription. Suppressible per clinician preference.
Must review before final
Decision-support output. Clinician review and attestation required before this content is signed into the chart.
new: TMP-SMX · against: warfarin, lisinopril, metformin
One major interaction returned; two cleared. Surfaced before the script is drafted.
Interaction
Warfarin
×Trimethoprim-sulfamethoxazole
Mechanism
TMP-SMX inhibits warfarin metabolism via CYP2C9, displaces warfarin from protein binding, and may potentiate hypoprothrombinemia. INR can rise within 3–5 days of initiation, with bleeding risk.
Recommendation
Avoid combination if alternative antibiotic available. If unavoidable, reduce warfarin dose by 25–50% and monitor INR within 3–5 days.
Awaiting your approval
Decided before the medicine is added.
A critical interaction or a recorded allergy brings the strongest warning and needs a written reason; a major interaction needs a written reason; a moderate or minor one is acknowledged. If the check could not complete, the medicine is added only by saying so.
None of these is a hard stop — the clinician decides — and every decision is kept in an append-only record before the medicine is added.